{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:56:05Z","timestamp":1793386565894,"version":"4.5.0"},"reference-count":102,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,5,5]],"date-time":"2017-05-05T00:00:00Z","timestamp":1493942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH Program Project Grant","award":["HL094307"],"award-info":[{"award-number":["HL094307"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>\n                    <jats:styled-content style=\"fixed-case\">ABSTRACT<\/jats:styled-content>\n                  <\/jats:title>\n                  <jats:p>\n                    <jats:styled-content style=\"fixed-case\">P4<\/jats:styled-content>\n                    medicine is an evolving approach to personalized medicine. The four Ps offer a means to:\n                    <jats:italic>Predict<\/jats:italic>\n                    who will develop disease and co\u2010morbidities;\n                    <jats:italic>Prevent<\/jats:italic>\n                    rather than react to disease;\n                    <jats:italic>Personalize<\/jats:italic>\n                    diagnosis and treatment; have patients\n                    <jats:italic>Participate<\/jats:italic>\n                    in their own care.\n                    <jats:styled-content style=\"fixed-case\">P4<\/jats:styled-content>\n                    medicine is very applicable to obstructive sleep apnoea (\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    ) because each\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    patient has a different pathway to disease and its consequences.\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    has both structural and physiological mechanisms with different clinical subgroups, different molecular profiles and different consequences. This may explain why there are different responses to alternative therapies, such as intraoral devices and hypoglossal nerve stimulation therapy. Currently, technology facilitates patients to participate in their own care from screening for\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    (snoring and apnoea apps) to monitoring response to therapy (sleep monitoring, blood pressure, oxygen saturation and heart rate) as well as monitoring their own continuous positive airway pressure (\n                    <jats:styled-content style=\"fixed-case\">CPAP<\/jats:styled-content>\n                    ) compliance. We present a conceptual framework that provides the basis for a new,\n                    <jats:styled-content style=\"fixed-case\">P4<\/jats:styled-content>\n                    medicine approach to\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    and should be considered more in depth: predict and prevent those at high risk for\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    and consequences, personalize the diagnosis and treatment of\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    and build in patient participation to manage\n                    <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                    .\n                  <\/jats:p>","DOI":"10.1111\/resp.13063","type":"journal-article","created":{"date-parts":[[2017,5,5]],"date-time":"2017-05-05T21:45:31Z","timestamp":1494020731000},"page":"849-860","source":"Crossref","is-referenced-by-count":61,"title":["<scp>P4<\/scp>\n                    medicine approach to obstructive sleep apnoea"],"prefix":"10.1111","volume":"22","author":[{"given":"Diane C.","family":"Lim","sequence":"first","affiliation":[{"name":"Division of Sleep Medicine\/Department of Medicine, Center for Sleep and Circadian Neurobiology University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan I.","family":"Pack","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine\/Department of Medicine, Center for Sleep and Circadian Neurobiology University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1500523"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5288"},{"key":"e_1_2_11_4_1","unstructured":"NandakumarR GollakotaS WatsonN.Contactless sleep apnea detection on smartphones. MobiSys'15; 18\u201322 May 2015 Fortezza da Basso Florence Italy. Florence: ACM 2015."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201604-235PS"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157077"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052306"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1589"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-07-2947"},{"key":"e_1_2_11_10_1","unstructured":"Multiple Myeloma Research Foundation. Multiple Myeloma Research Consortium (MMRC) activates clinical trials 30\u201340 percent faster than industry standard 2009. Norwalk: MMRFSM. [Accessed 21 Apr 2017.] Available from URL:http:\/\/www.themmrf.org\/archive\/outdated\u2010content\/press\u2010releases\u2010061809.html"},{"key":"e_1_2_11_11_1","unstructured":"Adenoid Cystic Carcinoma Research Foundation.2010. [Accessed 17 Jan 2017.] Available from URL:https:\/\/www.accrf.org\/research\/research\u2010agenda\/"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1200\/jco.2009.27.15_suppl.1535","article-title":"The Love\/Avon Army of Women: a \"just in time\" resource to encourage research in women","volume":"27","author":"Love SM","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"e_1_2_11_13_1","unstructured":"Army of Women. Army of Women 2010. [Accessed 21 Dec 2016.] Available from URL:https:\/\/www.armyofwomen.org\/"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nbt0904-1071"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-042915-102623"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4082"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.5.7582313"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201303-0448OC"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201404-0783OC"},{"key":"e_1_2_11_21_1","first-page":"961","article-title":"An integrative model of physiological traits can be used to predict obstructive sleep apnea and response to non positive airway pressure therapy","volume":"38","author":"Owens RL","year":"2015","journal-title":"Sleep"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2005.06.006"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2007.20"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2011.02093.x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4072"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2005.265"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.1002705"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3596"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.6226"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201511-2172OC"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.8.1075"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12747"},{"key":"e_1_2_11_33_1","first-page":"877","article-title":"Racial\/ethnic differences in sleep disturbances: the Multi\u2010Ethnic Study of Atherosclerosis (MESA)","volume":"38","author":"Chen X","year":"2015","journal-title":"Sleep"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27768"},{"key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.5664\/jcsm.27353","article-title":"Prevalence of sleep related symptoms in four Latin American cities","volume":"4","author":"Bouscoulet LT","year":"2008","journal-title":"J. Clin. Sleep Med."},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2009.10.005"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2010.00861.x"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00043210"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00043-0"},{"key":"e_1_2_11_40_1","unstructured":"JeffersonFA BliwiseD PaulKN ClarkK.Sex differences in the REM sleep response to OSA. Gordon Research Conference on Sleep Regulation and Function; 12\u201313 Mar 2016 Galveston:Hotel Galvez 2016."},{"key":"e_1_2_11_41_1","article-title":"Gender differences in symptoms associated with sleep apnea","author":"Runyon JJ","year":"2001","journal-title":"Sleep Rev."},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27650"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2014.11.013"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00032314"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12344"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157318"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201507-1472RR"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200905-0765OC"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3574"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201201-0130OC"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201209-1671OC"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4916"},{"key":"e_1_2_11_53_1","doi-asserted-by":"crossref","unstructured":"GaoX AzarbarzinA KeenanBT OstrowskiM PackFM StaleyB MaislinG PackAI YounesM KunaST. Heritability of heart rate response to arousals in twins.Sleep2017.https:\/\/doi.org\/10.1093\/sleep\/zsx055.","DOI":"10.1093\/sleep\/zsx055"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.00613"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000027"},{"key":"e_1_2_11_57_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5664\/jcsm.4610","article-title":"Meta\u2010analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA\u2010IR, adiponectin, and visceral adipose fat","volume":"11","author":"Iftikhar IH","year":"2015","journal-title":"J. Clin. Sleep Med."},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.10.002"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1115"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3600"},{"key":"e_1_2_11_61_1","first-page":"1071","article-title":"Sleep disordered breathing and mortality: eighteen\u2010year follow\u2010up of the Wisconsin sleep cohort","volume":"31","author":"Young T","year":"2008","journal-title":"Sleep"},{"key":"e_1_2_11_62_1","doi-asserted-by":"crossref","unstructured":"LyonsMM KeenanBT LiJ KhanT ElkasabannyN WalshCM WilliamsNN PackAI GurubhagavatulaI. Symptomless multi\u2010variable apnea prediction index assesses OSA risk and adverse outcomes in elective surgery.Sleep2017.https:\/\/dx.doi.org\/10.1093\/sleep\/zsw081.","DOI":"10.1093\/sleep\/zsw081"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-7-199910050-00002"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0903"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/18.3.158"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.5.7952553"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201404-161OC"},{"key":"e_1_2_11_68_1","first-page":"37","article-title":"Craniofacial phenotyping in obstructive sleep apnea \u2013 a novel quantitative photographic approach","volume":"32","author":"Lee RW","year":"2009","journal-title":"Sleep"},{"key":"e_1_2_11_69_1","first-page":"46","article-title":"Prediction of obstructive sleep apnea with craniofacial photographic analysis","volume":"32","author":"Lee RW","year":"2009","journal-title":"Sleep"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118235"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2003.817636"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0107581"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3460"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.11.007"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201605-1003ED"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201601-0099OC"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1315"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1237424"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2192"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084956"},{"key":"e_1_2_11_81_1","doi-asserted-by":"crossref","unstructured":"CamachoM ChangET SongSA AbdullatifJ ZaghiS PirelliP CertalV GuilleminaultC. Rapid maxillary expansion for pediatric obstructive sleep apnea: a systematic review and meta\u2010analysis.Laryngoscope2016.https:\/\/dx.doi.org\/10.1002\/lary.26352.","DOI":"10.1002\/lary.26352"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2014.11.002"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01148-2015"},{"key":"e_1_2_11_84_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.5664\/jcsm.26795","article-title":"Association of alcohol consumption and sleep disordered breathing in men and women","volume":"3","author":"Peppard PE","year":"2007","journal-title":"J. Clin. Sleep Med."},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200308-1100OC"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308659"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11580"},{"key":"e_1_2_11_88_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5314"},{"key":"e_1_2_11_89_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.6.711"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3118"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0613"},{"key":"e_1_2_11_92_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-201900"},{"key":"e_1_2_11_93_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4934"},{"key":"e_1_2_11_94_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5622"},{"key":"e_1_2_11_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.05.019"},{"key":"e_1_2_11_96_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-014-1068-8"},{"key":"e_1_2_11_97_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.91501.2008"},{"key":"e_1_2_11_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbt.2012.03.004"},{"key":"e_1_2_11_99_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.11100"},{"key":"e_1_2_11_100_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5948"},{"key":"e_1_2_11_101_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4422"},{"key":"e_1_2_11_102_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4898"},{"key":"e_1_2_11_103_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00062914"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fresp.13063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.13063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:23:11Z","timestamp":1696033391000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.13063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,5]]},"references-count":102,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1111\/resp.13063"],"URL":"https:\/\/doi.org\/10.1111\/resp.13063","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,5]]}}}