Pathogenic links and mechanistic interactions between sarcopenia and obstructive sleep apnea

Abstract

This study comprehensively explores the pathogenic mechanisms and interconnections between sarcopenia and obstructive sleep apnea (OSA). This study systematically retrieved research on sarcopenia and OSA published between January 2020 and December 2024 through databases such as PubMed and Web of Science. It aims to elucidate the potential bidirectional relationship between sarcopenia and OSA, thereby filling the gap in systematically integrating bidirectional mechanistic interactions. By surveying research progress over the last five years, we illuminate the close association observed in sarcopenia patients with an elevated risk of OSA. Recent findings in neuro-muscular transmission, central nervous system regulation, and respiratory control have identified potential mechanisms underlying sarcopenia, including abnormalities in neuromuscular transmission and dysregulation of the central nervous system’s control over respiration. Simultaneously, investigations into the reciprocal impact of OSA on sarcopenia suggest that respiratory interruptions can contribute to muscle dysfunction, exacerbating the progression of sarcopenia. At the physiological level, alterations in oxygenation status and oxidative stress are considered crucial players in the development of both conditions. A profound understanding of the independent pathogenic mechanisms of sarcopenia and OSA, as well as their intricate interconnections, lays the groundwork for future research directions. This review aims to guide the development of more effective treatment strategies and enhance the quality of life for patients by elucidating the complex network of relationships between sarcopenia and OSA.

Keywords: Sarcopenia; Obstructive sleep apnea; Pathogenic mechanisms; Neuromuscular transmission; Central nervous system; Respiratory control; Neuromuscular dysfunction; Hypoxia; Oxidative stress; Inflammation

Core Tip: This review investigates the interconnected pathologies of sarcopenia and obstructive sleep apnea, with a focus on neuromuscular transmission abnormalities, central nervous system dysregulation, and oxidative stress. These shared mechanisms highlight the complex interplay between muscle dysfunction and respiratory control, suggesting areas for therapeutic intervention. By clearly distinguishing between established associations and causal relationships, this study highlights the complex interplay between muscular dysfunction and respiratory control, thereby providing guidance for future therapeutic approaches.