REVIEW ARTICLES
Obstructive Sleep Apnea and Circadian Rhythms
Obstrüktif Uyku Apnesi ve Sirkadiyen Ritimler
Received Date : 23 May 2023
Accepted Date : 08 Jun 2023
Available Online : 13 Jun 2023
Aynur ALİYEVAa,b
aDivision of Otorhinolaryngology-Head and Neck Surgery, The Cincinnati Children’s Medical Center Hospital, Ohio, USA
bNeuroscience Doctoral Program, Yeditepe University, İstanbul, Türkiye
Doi: 10.24179/kbbbbc.2023-98095 - Makale Dili: EN
KBB ve BBC Dergisi. 2023;31(3):179-88
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Obstructive sleep apnea (OSA) is a sleep disorder characterized
by recurrent episodes of partial or complete obstruction of the
upper airway during sleep. Circadian rhythms are natural biological
rhythms that follow a 24-hour cycle and are synchronized with external
cues, primarily the alternating patterns of light and darkness. The relationship
between sleep apnea and circadian rhythms is complex and
multifaceted. Disruptions in circadian rhythms can impact sleep quality
and overall sleep-wake regulation. In the case of sleep apnea, the
recurrent episodes of partial or complete obstruction of the upper airway
during sleep can lead to disruptions in the normal sleep pattern.
Sleep fragmentation and sleep apnea-related factors, such as intermittent
hypoxia and oxidative stress, can directly affect the molecular and
cellular mechanisms underlying circadian rhythms. Clinical and basic
research studies have provided further evidence of the relationship between
circadian rhythm and OSA. These studies highlight the importance
of the circadian clock in regulating breathing, metabolism, and
hormone secretion, the impact of OSA on melatonin secretion, blood
pressure, and glucose metabolism, and propose it as a potential therapeutic
target for sleep apnea and associated metabolic disorders. Understanding
the relationship between OSA and circadian rhythms is
important for managing and treating sleep apnea and its associated comorbidities.
This review paper explores the molecular and systemic aspects
of the circadian rhythm, their relationship with OSA, and the
potential implications for disease development and treatment in literature
highlights.
Keywords: Obstructive sleep apnea; sleep disorders; circadian rhythm
ÖZET
Obstrüktif uyku apnesi [obstructive sleep apnea (OSA)], uyku
sırasında üst solunum yollarının kısmi veya tam tıkanıklığına bağlı olarak
tekrarlayan epizodlardan oluşan bir uyku bozukluğudur. Sirkadiyen
ritimler, doğal biyolojik ritimlerdir ve 24 saatlik bir döngüyü takip
ederler. Bu ritimler, dış çevre faktörleri ile özellikle ışık ve karanlık
arasındaki değişimlerle senkronize olurlar. OSA ve sirkadiyen ritimler
arasındaki ilişki karmaşık ve çok yönlüdür. Sirkadiyen ritimlerin bozulması,
uyku kalitesini ve genel uyku-uyanıklık düzenini etkileyebilir.
Uyku apnesi durumunda, uyku sırasında üst solunum yollarının tekrarlayan
tıkanma epizodları normal uyku düzenini bozabilir. Uyku parçalanması
ve uyku apnesine bağlı faktörler, örneğin aralıklı hipoksi
durumu ve altta yatan oksidatif stres, sirkadiyen ritimlerin temeldeki
moleküler ve hücresel mekanizmalarını doğrudan etkileyebilir. Klinik
ve temel araştırmalar, sirkadiyen ritim ile OSA arasındaki ilişki hakkında
çeşitli bulgular ortaya koymuştur. Bu çalışmalar; solunum, metabolizma
ve hormon salgısı düzenlemesinde sirkadiyen ritmin
önemini, OSA’nın melatonin salgısı, kan basıncı ve glukoz metabolizması
üzerindeki etkisini vurgulamaktadır. Ayrıca bu çalışmalar, sirkadiyen
ritmi, uyku apnesi ve ilişkili metabolik bozukluklar için
potansiyel bir terapötik hedef olarak önermektedir. OSA ve sirkadiyen
ritimler arasındaki ilişkinin anlaşılması, uyku apnesi ve ilişkili komorbiditelerin
yönetimi ve tedavisi açısından önemlidir. Bu derleme makalesi,
sirkadiyen ritmin moleküler ve sistemik yönlerini, OSA ile
ilişkisini, hastalık gelişimi ve tedavisi açısından potansiyel sonuçları
literatür eşliğinde araştırmaktadır.
Anahtar Kelimeler: Obstrüktif uyku apnesi; uyku bozuklukları; sirkadiyen ritim
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