OBESITY AND OBSTRUCTIVE SLEEP APNEA: A BIDIRECTIONAL RELATIONSHIP - LITERATURE REVIEW

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ABSTRACT Introduction: Obstructive sleep apnea (OSA) and obesity are highly prevalent comorbidities with profound implications for public health. OSA is a sleep -related breathing disorder characterized by episodes of complete (apnea) or partial (hypopnea) collapse of the upper airways, leading to decreased oxygen desaturation or awakening during sleep. Obesity is a major epidemic of the 21st century, contributing to dyslipidemia, hypertension, and type 2 diabetes. It affects almost a quarter of adults worldwide and is strongly linked to cardiometabolic diseases. OSA and obesity are highly prevalent comorbidities, associated with a significant social burden and a strain on the healthcare system. Objectives: This study aims to analyze cu rrent evidence of the bidirectional relationship between obesity and OSA (Obstructive Sleep Apnea). Materials and Methods: A narrative literature review was conducted based on studies published in the PubMed database in the last two years. The search was p erformed using the descriptors "obesity" and "obstructive sleep apnea." Original articles, clinical trials, systematic reviews, meta -analyses, and randomized controlled trials with a direct approach to the topic were included. Results: Obesity and overweig ht in the adult population are associated with the severity of OSA. OSA can be asymptomatic, but most patients develop a variety of symptoms, including night awakenings, nocturia, non -restorative sleep, daytime sleepiness and fatigue, difficulty concentrat ing, and chronic morning headaches. Sleep deprivation exacerbates components of metabolic syndrome, including insulin resistance and dyslipidemia, further perpetuating weight gain. Similarly, obesity- induced sleep disturbances lead to pro-inflammatory states, vascular dysfunction, and sympathetic hyperactivation, exacerbating cardiometabolic risks. Weight loss improves the apnea -hypopnea index, symptoms, and cardiometabolic markers. Conclusion: The bidirectional relationship between obesity and OSA highlights the importance of integrating the assessment and management of this sleep disorder into obesity treatment strategies, using personalized and interdisciplinary approaches.