Recent advances in obstructive sleep apnoea (OSA) pathophysiology and translational research haveopened new lines of investigation for OSA treatment and management. Key goals of such investigationsare to provide efficacious, alternative treatment and management pathways that are better tailored toindividual risk profiles to move beyond the traditional continuous positive airway pressure (CPAP)-focused, “one size fits all” trial-and-error approach, which is too frequently inadequate for many patients.Identification of different clinical manifestations of OSA (clinical phenotypes) and underlyingpathophysiological phenotypes (endotypes) that contribute to OSA have provided novel insights intounderlying mechanisms and have underpinned these efforts. Indeed, this new knowledge has provided theframework for precision medicine for OSA to improve treatment success rates with existing non-CPAPtherapies such as mandibular advancement devices and upper airway surgery, and newly developedtherapies such as hypoglossal nerve stimulation and emerging therapies such as pharmacotherapies andcombination therapy. Additionally, these concepts have provided insight into potential physiologicalbarriers to CPAP adherence for certain patients. This review summarises the recent advances in OSApathogenesis, non-CPAP treatment, clinical management approaches and highlights knowledge gaps forfuture research. OSA endotyping and clinical phenotyping, risk stratification and personalised treatmentallocation approaches are rapidly evolving and will further benefit from the support of recent advances ine-health and artificial intelligence.