Research status and progress on the relationship between obstructive sleep apnea and pulmonary nodules

Obstructive Sleep Apnea (OSA) is a common sleep-disordered breathing. The intermittent hypoxia and chronic inflammation caused by OSA may promote pathological changes in lung tissue and increase the risk of pulmonary nodules. This article systematically reviews the epidemiological evidence, potential mechanistic pathways, diagnostic challenges, and therapeutic implications of the relationship between OSA and pulmonary nodules. Existing observational studies have shown that the incidence of pulmonary nodules in OSA patients is significantly increased, and the severity of OSA is positively correlated with the risk of malignant nodules. Intermittent hypoxia activates oxidative stress and inflammatory response through HIF-1α/NF-κB signaling pathway, which may be the core mechanism of OSA promoting the occurrence and development of pulmonary nodules. Continuous positive airway pressure (CPAP) treatment can reduce the levels of inflammatory factors and may delay the malignant transformation of pulmonary nodules. However, the existing evidence mainly comes from observational studies, with insufficient control of confounding factors, and the causal relationship needs to be further verified.