Abstract
Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway collapse during sleep, leading to intermittent hypoxemia and sleep fragmentation. Untreated OSA is associated with increased risks of cardiovascular, metabolic, and neurocognitive comorbidities, as well as considerable socioeconomic burden. Positive airway pressure (PAP) remains the gold standard therapy; however, limited long-term adherence underscores the need for alternative, patient-centered approaches. Conventional modalities such as oral appliances, surgery, weight reduction, and positional therapy provide clinical benefits but have variable efficacy and tolerability. Recent advances highlight innovative strategies, including hypoglossal nerve stimulation (HGNS), anti-obesity pharmacotherapy with glucagon-like peptide-1 receptor agonists, and upper airway muscle-targeted agents, which exemplify precision medicine approaches tailored to individual OSA phenotypes. This review synthesizes current evidence on both conventional and emerging therapies, emphasizing the transition from a "one-size-fits-all" model toward integrated, phenotype-driven management aimed at improving outcomes and quality of life for patients with OSA.