Research Progress and Clinical Practice in the Comorbidity Management of Obstructive Sleep Apnea Hypopnea Syndrome and Obesity Hypopnea Syndrome

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and Obesity Hypoventilation Syndrome (OHS) are core components of the obesity-related respiratory disease spectrum, and their comorbidity has become a major challenge in the global public health field. This review systematically summarizes the epidemiological characteristics, pathophysiological mechanisms, diagnostic criteria, diagnostic technologies and treatment strategies of OSAHS-OHS comorbidity, with a focus on the cutting-edge progress of digital therapeutics and metabolic intervention, as well as the historical evolution and current status of clinical management. We also conduct an in-depth analysis of the unresolved controversies and practical challenges in the current clinical management of this comorbidity. OSAHS-OHS comorbid patients have a significantly higher risk of cardiovascular complications than those with a single disease, and chronic intermittent hypoxia (CIH) forms a vicious cycle with obesity through multiple pathophysiological pathways. The combination of multi-dimensional assessment tools and portable monitoring devices has improved the screening efficiency of OSAHS-OHS comorbidity, and the selection of respiratory support therapies such as continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) depends on patient phenotypes. Digital therapeutics and novel metabolic intervention drugs have shown promising clinical value in the management of this comorbidity. The multidisciplinary collaboration model is the key to improving the prognosis of comorbid patients, while current clinical management is still faced with challenges such as policy lag, ethical controversies and uneven resource allocation. Future research should focus on individualized therapeutic targets, the integration of digital technologies and the optimization of health policies to achieve precise and efficient management of OSAHS-OHS comorbidity.