ICJIM
Intercontinental Journal of Internal Medicine

The Intercontinental Journal of Internal Medicine aims to publish issues related to all fields of internal medicine of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Obstructive sleep apnea and comorbidities: a current perspective from diagnosis to treatment
Abstract
Obstructive Sleep Apnea Syndrome (OSAS) is a significant health condition characterized by recurrent upper airway obstructions during sleep, with widespread systemic consequences. This review aims to present a comprehensive overview of OSAS, encompassing its pathophysiological foundations, risk factors, clinical manifestations, associated comorbidities, and contemporary diagnostic and therapeutic strategies. OSAS not only impairs sleep quality but also adversely affects cardiovascular, metabolic, neurocognitive, and psychological health, thereby reducing both lifespan and quality of life. While polysomnography remains the gold standard for diagnosis, home sleep tests and subjective assessment tools are increasingly utilized in clinical practice. Treatment approaches vary depending on disease severity and individual characteristics, ranging from lifestyle modifications and positive airway pressure devices to oral appliances and surgical interventions. In recent years, promising innovations such as neurostimulation and pharmacotherapy have emerged in OSAS management. This review highlights the multidimensional impact of OSAS at both individual and societal levels, emphasizing the need for early diagnosis and integrated treatment strategies.

Keywords : Obstructive sleep apnea, OSAS, comorbidities, diagnosis and treatment

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1. Slowik JM, Sankari A, Collen JF. Obstructive sleep apnea. In StatPearls [Internet]. StatPearls Publishing. 2024.
2. Juginovic, A. Sleep Apnea. In Sleep Science Made Simple: A Clear and Concise Guide. Cham: Springer Nature Switzerland. 2025:125-136.
3. Shakkottai A, Firdaus M. Obstructive Sleep Apnea. In Sleep Disorders in Children: A Primer for Primary Care Providers. Cham: Springer Nature Switzerland. 2025:85-94.
4. Ghavami T, Kazeminia M, Ahmadi N, Rajati F. Global prevalence of obstructive sleep apnea in the elderly and related factors: a systematic review and meta-analysis. J Peri-Anesthes Nurs. 2023;38(6):865-875. doi: 10.1016/j.jopan.2023.01.018
5. Watson N, Yu K, Campbell D, et al. Prevalence and unmet need of obstructive sleep apnea in the United States. Sleep. 2025;48(Suppl 1): A278. doi:10.1093/sleep/zsaf090.0637
6. Cunningham J, Hunter M, Budgeon C, et al. The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton healthy ageing study. J Clin Sleep Med. 2021;17(10):2029-2039. doi:10.5664/jcsm.9378
7. Soltaninejad F, Golastaneh R, Ghahfarokhi PI, Salmasi M, Amra B. Continuous positive airway pressure treatment for sleep apnea in elderly patients: systematic review and meta-analysis. Sleep Breath. 2025;29(3): 210. doi:10.1007/s11325-025-03362-8
8. Kendzerska T, Keys E, Johnson DA. Why sleep apnea deserves priority in public health: a call to action. Eur J Public Health. 2025;35(4):596-597. doi:10.1093/eurpub/ckaf092
9. Lechat B, Manners J, Pinilla L, et al. Global warming may increase the burden of obstructive sleep apnea. Nat Commun. 2025;16(1):5100. doi: 10.1038/s41467-025-60218-1
10. Sarısaltık A, Topuzoğlu A. Screening and assessment of sleep disorders in primary healthcare. ESTÜDAM J Public Health. 2019;4(2):232-243.
11. Lv R, Liu X, Zhang Y, et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduct Target Ther. 2023;8(1):218. doi:10.1038/s41392-023-01496-3
12. Chang A. Upper airway anatomy and collapse in obstructive sleep apnea. Medscape. 2022.
13. Kang YJ, Park CS. Underlying mechanisms of obstructive sleep apnea: a review. Clin Exp Otorhinolaryngol. 2025. doi:10.21053/ceo.2025-00071
14. McNicholas WT, Korkalainen H. Translation of obstructive sleep apnea pathophysiology and phenotypes to personalized treatment: a narrative review. Front Neurol. 2023;14:1239016. doi:10.3389/fneur.2023.1239016
15. Wickramasinghe H. Obstructive sleep apnea (OSA) clinical presentation. Medscape. 2021:14.
16. Karnatovskaia LV, Lee AS, Bender SP, Talmor D, Festic E. Obstructive sleep apnea, obesity, and the development of acute respiratory distress syndrome. J Clin Sleep Med. 2014;10(6):657-662. doi:10.5664/jcsm.3794
17. Khan M, Muhammad S, Udhapay S, et al. Correlation of obstructive sleep apnea and aldosterone levels in patients with primary hyperaldosteronism. SN Comprehensiv Clin Med. 2024;7(1):16.
18. Lyons MM, Auckley DH, Mokhlesi B, et al. Physicians-in-training and advanced practice providers perceptions in managing perioperative obstructive sleep apnea: a multi-institutional survey. J Clin Sleep Med. 2025;21(5):765-773. doi:10.5664/jcsm.11528
19. Kraiwattanapong J, Rattanaarun K, Cunteerasup A, Papassornsiri T, Balankura T, Pavarajarn S. Clinical characteristics and treatment preferences of obstructive sleep apnea. Sci Rep. 2025;15(1):18976. doi:10. 1038/s41598-025-03816-9
20. Fuchs FD, Fuchs SC, Martinez D. Obstructive sleep apnea-hypertension link: almost there? J Thorac Dis. 2017;9(10):3537-3540. doi:10.21037/jtd. 2017.08.162
21. Yaman M. Investigation of the association between the SIRT1/rs7895833 promoter variant and SIRT1 protein levels in obstructive sleep apnea. Unpublished Master’s Thesis, Bursa Uludağ University. 2025.
22. Koçak M. Association of promoter polymorphisms of matrix metalloproteinase-1 (-1607?G/2G), -3 (-1171?5A/6A), and -9 (-1562?C/T) with obstructive sleep apnea syndrome. Master’s thesis, Balikesir University, Turkey. 2019.
23. Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol (1985). 2005;99(4):1592-1599. doi:10.1152/japplphysiol.00587.2005
24. Niedermeyer E, da Silva FL. Electroencephalography: basic principles, clinical applications, and related fields. Lippincott Williams & Wilkins. 2025.
25. Malhotra A, White DP. Obstructive sleep apnoea. Lancet. 2002; 360(9328):237-245. doi:10.1016/S0140-6736(02)09464-3
26. Javaheri S, Dempsey JA. Central sleep apnea. Compr Physiol. 2013;3(1): 141-163. doi:10.1002/cphy.c110057
27. American Academy of Sleep Medicine. International Classification of Sleep Disorders (3rd ed.). Darien, IL: American Academy of Sleep Medicine. 2014.
28. Ferguson KA, Cartwright R, Rogers R, Schmidt-Nowara W. Oral appliances for snoring and obstructive sleep apnea: a review. Sleep. 2006;29(2):244-262. doi:10.1093/sleep/29.2.244
29. Epstein LJ, Kristo D, Strollo PJ Jr, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263-276.
30. Schwab RJ, Badr SM, Epstein LJ, et al. An official American Thoracic Society statement: continuous positive airway pressure adherence tracking systems. The optimal monitoring strategies and outcome measures in adults. Am J Respir Crit Care Med. 2013;188(5):613-620. doi: 10.1164/rccm.201307-1282ST
31. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2019;15(2):335-343. doi:10.5664/jcsm.7640
32. Caples SM, Rowley JA, Prinsell JR, et al. Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis. Sleep, 2010;33(10):1396-1407. doi:10.1093/sleep/33. 10.1396
33. Li KK, Powell NB, Riley RW, Troell R, Guilleminault C. Overview of phase I surgery for obstructive sleep apnea syndrome. Ear Nose Throat J. 1999;78(11):836-845. doi:10.1177/014556139907801107
34. Schiefer M, Gamble J, Baskin J, Strohl K. Hypoglossal nerve stimulation in a rabbit model of obstructive sleep apnea reduces apneas and improves oxygenation. J Appl Physiol (1985). 2020;129(3):442-448. doi:10.1152/japplphysiol.00828.2019
35. Martinez S, Veirano F, Constandinou TG, Silveira F. Trends in volumetric-energy efficiency of implantable neurostimulators: a review from a circuits and systems perspective. IEEE Trans Biomed Circuits Syst. 2023;17(1):2-20. doi:10.1109/TBCAS.2022.3228895
36. Perger E, Bertoli S, Lombardi C. Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits. Expert Rev Respir Med. 2023;17(8):663-673. doi:10.1080/17476348.2023.2241353
37. Wang W, Chen Z, Zhang W, et al. Fusion of millimeter-wave radar and pulse oximeter data for low-burden diagnosis of obstructive sleep apnea-hypopnea syndrome. ArXiv Preprint ArXiv:2501. 2025:15264. doi: 10.48550/arXiv.2501.15264
Article available in :
Volume 3, Issue 3, 2025
Page : 64-72
https://doi.org/10.51271/ICJIM-0061
Article Information
Received : 01 Ağu 2025
Accepted : 26 Ağu 2025
Published : 29 Ağu 2025
Corresponding Author :

Ümmühan Tuğba Tümüklü: Department of Pulmonology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkiye

[email protected]
Citation : Tümüklü ÜT, Seyfikli Z. Obstructive sleep apnea and comorbidities: a current perspective from diagnosis to treatment. Intercont J Int Med. 2025;3(3):64-72.

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