Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review

Abstract

Background: Obstructive sleep apnea syndrome (OSAS), affecting approximately 1 billion adults globally, is characterized by recurrent airway obstruction during sleep, leading to oxygen desaturation, elevated carbon dioxide levels, and disrupted sleep architecture. OSAS significantly impacts quality of life and is associated with increased morbidity and mortality, particularly in the cardiovascular and cognitive domains. The cyclic pattern of intermittent hypoxia in OSAS triggers oxidative stress, contributing to cellular damage. This review explores the intricate relationship between OSAS and oxidative stress, shedding light on molecular mechanisms and potential therapeutic interventions. Methods: A comprehensive review spanning from 2000 to 2023 was conducted using the PubMed, Cochrane, and EMBASE databases. Inclusion criteria encompassed English articles focusing on adults or animals and reporting values for oxidative stress and inflammation biomarkers. Results: The review delineates the imbalance between pro-inflammatory and anti-inflammatory factors in OSAS, leading to heightened oxidative stress. Reactive oxygen species biomarkers, nitric oxide, inflammatory cytokines, endothelial dysfunction, and antioxidant defense mechanisms are explored in the context of OSAS. OSAS-related complications include cardiovascular disorders, neurological impairments, metabolic dysfunction, and a potential link to cancer. This review emphasizes the potential of antioxidant therapy as a complementary treatment strategy. Conclusions: Understanding the molecular intricacies of oxidative stress in OSAS is crucial for developing targeted therapeutic interventions. The comprehensive analysis of biomarkers provides insights into the complex interplay between OSAS and systemic complications, offering avenues for future research and therapeutic advancements in this multifaceted sleep disorder.

Impact of Intermittent Hypoxia Related to Obstructive Sleep Apnoea Syndrome on Low-Grade Inflammation in Hypertensive Patients: Potential Implications for Cardiovascular Risk

“…In addition, in hypertensive patients with moderate to severe OSAS, this central role played by intermittent hypoxia in the occurrence of low-grade inflammation could be explained by the fact that unlike hypopnoeas associated with micro-arousals, only hypopnoeas associated with oxygen desaturation appear to be involved in the development of cardiovascular risk factors [63]. Pathophysiologically, this occurrence of low-grade inflammation associated only with obstructive respiratory events inducing intermittent hypoxia may explain the activation of several deleterious mechanisms (induction of oxidative stress, reactive oxygen species production, activation of critical proinflammatory transcription factors, elevated expression of proinflammatory cytokines and chemokines, recruitment and infiltration of proinflammatory M1 macrophages) favouring inadequate activation of the inflammatory cascade [16,17,64]. Thus, in this study, we demonstrated the existence of a particular subtype of hypertensive patients at high cardiovascular risk characterised by the presence of low-grade inflammation induced by high intermittent hypoxia related to moderate to severe OSAS, which justifies systematic screening for this pathology in hypertensive patients with low-grade inflammation [65].…”

Oral Health Implications of Obstructive Sleep Apnea: A Literature Review

“…Malocclusion, which can be brought on by these changes in tooth position, may contribute to the onset or worsening of OSA [83]. Furthermore, continuous positive airway pressure (CPAP) therapy should be considered when managing OSA over the long term [84]. Dental adverse effects from CPAP have been linked to modifications in occlusal relationships and bites.…”