Review

. 2025 Jun 20;15(1):85.

doi: 10.1186/s13578-025-01418-6.

Programmed cell death in the cognitive impairment of obstructive sleep apnea

Yanru Ou^{1

2

3

4}, Xiufang Wang^{1

2

3

4}, Dandan Zong^{5

6

7

8}, Ruoyun Ouyang^{9

10

11

12}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
² Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
³ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China.
⁴ Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
⁵ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁶ Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁷ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁸ Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁹ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹⁰ Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹¹ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹² Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.

PMID: 40542440
PMCID: PMC12181853
DOI: 10.1186/s13578-025-01418-6

Review

Programmed cell death in the cognitive impairment of obstructive sleep apnea

Yanru Ou et al. Cell Biosci. 2025.

. 2025 Jun 20;15(1):85.

doi: 10.1186/s13578-025-01418-6.

Authors

Yanru Ou^{1

2

3

4}, Xiufang Wang^{1

2

3

4}, Dandan Zong^{5

6

7

8}, Ruoyun Ouyang^{9

10

11

12}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
² Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
³ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China.
⁴ Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
⁵ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁶ Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁷ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁸ Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. zongdandan0402@csu.edu.cn.
⁹ Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹⁰ Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹¹ Clinical Medical Research Center for Respiratory and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.
¹² Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China. ouyangruoyun@csu.edu.cn.

PMID: 40542440
PMCID: PMC12181853
DOI: 10.1186/s13578-025-01418-6

Abstract

Cognitive impairment (CI) is a significant and extraordinary complication of obstructive sleep apnea (OSA) patients. Programmed cell death (PCD) is an active and ordered process regulated by genes. A growing number of studies find that PCD is responsible for cognitive dysfunction and plays an important role in various neurological diseases, which involve apoptosis, necroptosis, pyroptosis, ferroptosis, and cell death associated with autophagy. However, the influence of PCD on OSA-CI remains unclear. We summarized the relevant studies that discussed the involvement of PCD in the CI of OSA and aimed to clarify the underlying mechanisms. Intermittent hypoxia (IH)-induced PCD had a critical effect on the mechanisms that produced the ultimate neurological deficit in OSA, and the PCD involved mainly included apoptosis, autophagy, ferroptosis, and pyroptosis. IH regulates PCD directly or through specific pathways, and drugs targeting related molecules have the potential to improve cognitive function. These findings enrich the pathogenesis of OSA-CI and provide new therapeutic insights.

Keywords: Cognitive impairment; Intermittent hypoxia; Obstructive sleep apnea; Programmed cell death.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no conflict of interest.

Figures

**Fig. 1**
Regulatory pathways or evidence of programmed cell death in OSA-CI

**Fig. 2**
Possible treatments for OSA-CI

See this image and copyright information in PMC

References

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Programmed cell death in the cognitive impairment of obstructive sleep apnea

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Programmed cell death in the cognitive impairment of obstructive sleep apnea

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