Sympathoadrenal mechanisms in the pathogenesis of sleep apnea-related hypertension

Obstructive sleep apnea-hypopnea (OSAH) is regarded as an increasingly common cause of sustained hypertension. The vast majority of mechanistic studies linking these entities have focused on the role of sympathoactivation. This review therefore addresses this purported mechanism by highlighting studies conducted in the past 5 years that speak to OSAH-related changes in sympathoregulation, independent of obesity, as well as the intervening players and pathways that may be relevant to such changes. Finally, studies with a focus on changes in sympathoregulation induced by continuous positive airway pressure (CPAP) therapy are discussed. Taken together, these findings strengthen the claim that the sympathoadrenal pressor system is essential for the development of the hypertensive state in individuals with OSAH.