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Is obstructive sleep apnea a circadian rhythm disorder?
Julija Šmon1,2, Eva Kočar2, Tadeja Pintar3
1Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Journal of Sleep Research
|March 15, 2023
Summary
Obstructive sleep apnea (OSA) is a common disorder linked to circadian rhythm disruption. Addressing OSA as a circadian issue may offer new diagnostic and therapeutic strategies.
Area of Science:
- Sleep Medicine
- Chronobiology
- Respiratory Medicine
Background:
- Obstructive sleep apnea (OSA) is a prevalent sleep disorder with significant comorbidities, often underdiagnosed.
- Current treatments for OSA have limited efficacy on cardiovascular and metabolic complications.
- Circadian rhythm dysregulation is increasingly implicated in OSA pathogenesis and associated comorbidities.
Purpose of the Study:
- To summarize current knowledge on OSA, circadian rhythms, and their interplay.
- To critically evaluate studies linking OSA with circadian abnormalities.
- To explore pathogenetic mechanisms, including hypoxia signaling, underlying the OSA-circadian connection.
Main Methods:
- Review of existing literature on obstructive sleep apnea and circadian rhythm regulation.
- Critical evaluation of studies investigating the association between OSA and circadian rhythm abnormalities.
- Presentation of pathogenetic mechanisms, focusing on hypoxia signaling.
Main Results:
- Altered circadian gene expression patterns are observed in patients with OSA.
- Obstructive respiratory events can induce circadian dysregulation via sleep disturbance and intermittent hypoxia.
- A bidirectional relationship between OSA and circadian rhythm dysregulation is proposed.
Conclusions:
- Circadian rhythm dysregulation may play a significant role in OSA comorbidities.
- Treating OSA as a circadian rhythm disorder could lead to novel diagnostic and therapeutic approaches.
- Further research is required to integrate circadian system targeting into clinical OSA management.
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