Modern Strategies for Managing Sleep Apnea (Atul Malhotra, MD)

Obstructive sleep apnea (OSA) affects up to 1 billion people worldwide and requires a move toward personalized, mechanism-based treatment. CPAP remains the first-line therapy, improving symptoms, blood pressure, and multiple cardiometabolic outcomes, but adherence and patient selection remain challenges. Emerging therapies include hypoglossal nerve stimulation, pharmacologic approaches targeting upper-airway physiology, and GLP-1/GIP agonists such as tirzepatide, which substantially reduce AHI and improve symptoms in patients with obesity. The future of OSA care lies in identifying individual endotypes, combining therapies, and treating both airway obstruction and underlying contributors such as obesity.