Comorbidities are of major importance in OSA because they have a significant impact on healthcare use and mortality. Effective OSA treatment may represent an important target for improving cardio-metabolic risk. However, CPAP, the first-line therapy for OSA, fails to alter metabolic or inflammatory markers in obese OSA patients. This emphasises the need to offer a combination of multiple treatment modalities, including weight loss through lifestyle intervention, bariatric surgery or physical activity, and new medications for the reduction of cardiovascular risk that are specifically dedicated to OSA patients. As OSA-related comorbidities lie in different medical specialties, patients may not receive a totally integrated treatment regime due to poor collaboration across different medical services. It is necessary to establish whether an integrated, remote monitoring approach actually improves patient medical outcomes in a cost-effective manner. Telemedicine could be used not only to monitor CPAP compliance, leaks and residual events but also to record physical activity and self-measurements of BP and oximetry at home. This would allow the implementation of individually tailored therapeutic strategies. A panorama of the different therapeutic modalities and strategies together with OSA e-health are presented in the final chapters of this Monograph. As editors, we hope that you will find this issue of the Monograph a useful overview of OSA that aids understanding of the condition and may influence your management of the disease. The chapters are well referenced and should stimulate research initiatives and new management pathways. We are very grateful to all the authors who have contributed excellent chapters to this Monograph. ix
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