Obstructive Sleep Apnea and Parkinson's Disease: Bidirectional Clinical and Pathophysiologic Links

Obstructive sleep apnea (OSA) and Parkinson's disease (PD) are highly prevalent conditions with significant global health impacts. OSA affects 17-34% of middle-aged adults, while more than 10 million worldwide have PD. Clinical studies demonstrate a bidirectional relationship, with the OSA prevalence being higher among PD patients suggesting that hypoxia and sleep fragmentation contribute to worsening motor and cognitive symptoms. Conversely, PD-associated neurodegeneration impairs respiratory control, exacerbating OSA. Diagnostic differentiation is particularly challenging due to overlapping symptoms, such as sleep disturbances, cognitive decline, and autonomic dysfunction. Emerging neuromodulation therapies, including deep brain stimulation and hypoglossal nerve stimulation, show dual therapeutic potential. The interplay between OSA and PD draws attention to the need for integrated diagnostic and therapeutic approaches. Additional longitudinal studies to evaluate their cause-effect relationship and identify neuroimaging and biochemical biomarkers to elucidate novel pathophysiologic clues can potentially identify novel therapeutic targets.