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Review
. 2023 Mar 13;24(6):5478.
doi: 10.3390/ijms24065478.

Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea

Piero Giuseppe Meliante  1 , Federica Zoccali  1 , Francesca Cascone  1 , Vanessa Di Stefano  1 , Antonio Greco  1 , Marco de Vincentiis  1 , Carla Petrella  2 , Marco Fiore  2 , Antonio Minni  1   3 , Christian Barbato  2
Affiliations
Review

Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea

Piero Giuseppe Meliante et al. Int J Mol Sci. .

Abstract

Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions.

Keywords: CPAP; OSA; OSAS; biomarkers; cognitive; intermittent hypoxia; obstructive sleep apnea syndrome; oxidative stress.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of cardiovascular risk in OSAS.
See this image and copyright information in PMC

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