Multisystem Involvement Associated With Sleep Disordered Breathing

Obstructive sleep apnea (OSA) is defined by repetitive episodes of partial or complete upper airway obstruction during sleep, leading to hypopneas or apneas respectively despite continued respiratory effort. Epidemiological estimates suggest that OSA affects approximately one billion individuals worldwide, with a higher prevalence in men than in women. The condition is primarily marked by intermittent hypoxia and sleep fragmentation, both of which contribute to a wide range of physiological, medical, and psychological consequences. These include increased sympathetic nervous system activity, oxidative stress, systemic inflammation, and downstream neurological, cardiovascular, and metabolic complications that ultimately accelerate biological aging and increase overall mortality. Among the cardiovascular end‐organ manifestations of OSA, hypertension, coronary artery disease, atrial fibrillation, and stroke are now well documented. OSA is also strongly associated with metabolic dysfunction, including insulin resistance, dyslipidemia, steatosis of the liver, and Type 2 diabetes. In addition, sleep apnea leads to excessive daytime sleepiness, impaired alertness and vigilance, memory deficits, and executive dysfunction. These impairments increase the risk of motor vehicle and workplace accidents and contribute to diminished quality of life and increased healthcare costs. Here, we provide an overview of the systemic consequences of sleep apnea and examine the mechanisms linking the disorder to altered physiological function. We also explore the psychological outcomes associated with OSA and highlight the substantial societal and economic burden imposed by untreated diseases on healthcare systems and on society at large.