Four phenotypes of obstructive sleep apnea hypopnea syndrome (OSAHS) have been
identified. Only one of these is anatomical. As such, anatomically based treatments for OSAHS
may not fully resolve the condition. Equally, compliance and uptake of gold-standard treatments
is inadequate. This has led to interest in novel therapies that provide the basis for personalized
treatment protocols. This review examines each of the four phenotypes of OSAHS and explores how
these could be targeted using breathing re-education from three dimensions of functional breathing:
biochemical, biomechanical and resonant frequency. Breathing re-education and myofunctional
therapy may be helpful for patients across all four phenotypes of OSAHS. More research is urgently
needed to investigate the therapeutic benefits of restoring nasal breathing and functional breathing
patterns across all three dimensions in order to provide a treatment approach that is tailored to the
individual patient