[From evidence-based to precision medicine: advancing a new paradigm for the diagnosis and treatment of obstructive sleep apnea].

The 2025 edition of the Guidelines for the Diagnosis and Treatment of Adults with Obstructive Sleep Apnea in adults represents a major milestone in the sleep medicine field in China, marking a transition in obstructive sleep apnea management from an "experience-based" to an "evidence-based" approach, and heralding a new era of "evidence-driven, phenotype-oriented, and whole-course management". The new guideline systematically addresses 18 key clinical questions, employing the structured PICOS framework and adheres strictly to international AGREE Ⅱ and RIGHT standards to ensure scientific rigor and transparency in its recommendations. Several important advances distinguish the updated version: it introduces composite indices such as hypoxic burden (HB) and sleep breathing impairment index (SBII Obstructive Sleep Apnea I), shifting assessment from "event frequency" to "pathophysiological load"; it adopts precise classification based on clinical phenotypes (e.g., excessive daytime sleepiness or asymptomatic types) and endotypes (PALM model), facilitating personalized therapy. Pharmacological treatment has advanced from a state of "no effective drugs" to "targeted precision therapy" with clear indications for wake-promoting agents and GIP/GLP-1 agonists; and it integrates telemedicine and home monitoring technologies to establish a structured follow-up system. Compared with the 2011 edition, which was largely consensus-based, the 2025 guideline is fully grounded in high-quality domestic and international evidence, incorporating the data from Chinese populations. It promotes the standardization, systematization, and individualization of obstructive sleep apnea diagnosis and treatment, providing an authoritative practical framework for achieving the goal of "optimal therapy for every patient".