Öz
Obstrüktif uyku apne (OSA) sendromu, tekrarlayan üst solunum yolu tıkanıklıkları ve buna bağlı aralıklı hipoksi ataklarıyla karakterize, giderek yaygınlaşan bir uyku bozukluğudur. OSA, kardiyovasküler, metabolik ve nörolojik morbidite ile ilişkilidir. Son yıllarda, aralıklı hipoksinin neden olduğu oksidatif stres ve enflamasyonun OSA patogenezinde merkezi bir rol oynadığına dair güçlü kanıtlar ortaya çıkmıştır. Bu derleme, OSA ile oksidatif stres arasındaki mekanik bağlantıları, biyobelirteçleri, klinik sonuçları ve tedavi yaklaşımlarını özetlemeyi amaçlamaktadır. Gelecekteki araştırma alanları da insan ve hayvan çalışmalarından elde edilen kanıtlar ışığında tartışılacaktır.
Anahtar Kelimeler:
Obstrüktif uyku apnesi, oksidatif stres, reaktif oksijen türleri
Kaynaklar
1
Benkirane O, Mairesse O, Peigneux P. Impact of CPAP therapy on cognition and fatigue in patients with moderate to severe sleep apnea: a longitudinal observational study. Clocks Sleep. 2024;6(4):789-816.
2
Bottignole D, Mutti C, Parrino L, Pezzini A. Sleep and stroke—an overlooked bidirectional influence: why should sleep and vascular neurologists work closer? J Clin Med. 2025;14(20):7420.
3
Reveyaz MA, Peyronnel C, Boëte Q, et al. Oxidative and inflammatory mechanisms induced by intermittent hypoxia leading to vascular alterations in rodents: a systematic review and meta-analysis. Oxid Med Cell Longev. 2026;2026:9967028.
4
Manful CF, Fordjour E, Ikumoinein E, Abbey L, Thomas R. Therapeutic strategies targeting oxidative stress and inflammation: a narrative review. BioChem. 2025;5(4):35.
5
Ruiter-Lopez L, Khan MAS, Wang X, Song BJ. Roles of oxidative stress and autophagy in alcohol-mediated brain damage. Antioxidants. 2025;14(3):302.
6
Wang J, Yu W, Gao M, et al. Impact of obstructive sleep apnea syndrome on endothelial function, arterial stiffening, and serum inflammatory markers: an updated meta-analysis and metaregression of 18 studies. J Am Heart Assoc. 2015;4(11):e002454.
7
Suzuki YJ, Jain V, Park AM, Day RM. Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med. 2006;40(10):1683-1692.
8
Rodríguez-Pérez J, Andreu-Martínez R, Daza R, et al. Oxidative stress and inflammation in hypoxemic respiratory diseases and their comorbidities: molecular insights and diagnostic advances in chronic obstructive pulmonary disease and sleep apnea. Antioxidants. 2025;14(7):839.
9
Sylvester AL, Zhang DX, Ran S, Zinkevich NS. Inhibiting NADPH oxidases to target vascular and other pathologies: an update on recent experimental and clinical studies. Biomolecules. 2022;12(6):823.
10
Chen YS, Tian HX, Rong DC, et al. ROS homeostasis in cell fate, pathophysiology, and therapeutic interventions. Mol Biomed. 2025;6(1):89.
11
Zhang Z, Yang H, Han F, Guo P. Reactive oxygen species as key molecules in the pathogenesis of alcoholic fatty liver disease and nonalcoholic fatty liver disease: future perspectives. Curr Issues Mol Biol. 2025;47(6):464.
12
Jomova K, Alomar SY, Alwasel SH, Nepovimova E, Kuca K, Valko M. Several lines of antioxidant defense against oxidative stress: antioxidant enzymes, nanomaterials with multiple enzyme-mimicking activities, and low-molecular-weight antioxidants. Arch Toxicol. 2024;98(5):1323-1367.
13
Radovic M, Gartzke LP, Wink SE, van der Kleij JA, Politiek FA, Krenning G. Targeting the electron transport system for enhanced longevity. Biomolecules. 2025;15(5):614.
14
Dela Cruz CS, Kang MJ. Mitochondrial dysfunction and damage associated molecular patterns (DAMPs) in chronic inflammatory diseases. Mitochondrion. 2018;41:37-44.
15
Rong Z, Tu P, Xu P, et al. The mitochondrial response to DNA damage. Front Cell Dev Biol. 2021;9:669379.
16
Hüttemann M, Pecina P, Rainbolt M, et al. The multiple functions of cytochrome c and their regulation in life and death decisions of the mammalian cell: From respiration to apoptosis. Mitochondrion. 2011;11(3):369-381.
17
Xiong B, Zhang Y, Liu S, et al. NOX Family: Regulators of Reactive Oxygen Species Balance in Tumor Cells. FASEB J. 2025;39(8):e70565.
18
Anaya-Morua W, Villafan-Bernal JR, Ramírez-Moreno E, et al. Total antioxidant capacity in obese and non-obese subjects and its association with anthropo-metabolic markers: a systematic review and meta-analysis. Antioxidants. 2023;12(8):1512.
19
de la Lastra JMP, Andrés CMC, Munguira EB, Juan CA, Pérez-Lebeña E. Pathophysiology of reactive oxygen species (ROS). Arch Toxicol. 2026;100(2):475-513.
20
Ruan Y, Jiang S, Musayeva A, Gericke A. Oxidative Stress and Vascular Dysfunction in the Retina: Therapeutic Strategies. Antioxidants. 2020; 9(8):761. https://doi.org/10.3390/antiox9080761
21
Mastino P, Rosati D, de Soccio G, et al. Oxidative stress in obstructive sleep apnea syndrome: putative pathways to hearing system impairment. Antioxidants. 2023;12(7):1430.
22
Chen C, Lü JM, Yao Q. Hyperuricemia-Related Diseases and Xanthine Oxidoreductase (XOR) Inhibitors: An Overview. Med Sci Monit. 2016;22:2501-2512. Published 2016 Jul 17.
23
Ma B, Guo B, Chen Z, Li Y. SIRT1 regulates hypoxia-induced oxidative stress in cardiomyocytes via PI3K/MTOR signaling. Cell Mol Biol. 2022;68(2):48-53.
24
Ong G, Logue SE. Unfolding the Interactions between Endoplasmic Reticulum Stress and Oxidative Stress. Antioxidants. 2023; 12(5):981. https://doi.org/10.3390/antiox12050981
25
Fadaei R, Safari-Faramani R, Hosseini H, et al. Increased the circulating levels of malondialdehyde in patients with obstructive sleep apnea: a systematic review and meta-analysis. Sleep Breath. 2021;25(4):1753-1760.
26
Song YR, Kim JK, Lee HS, Kim SG, Choi EK. Serum levels of protein carbonyl, a marker of oxidative stress, are associated with overhydration, sarcopenia and mortality in hemodialysis patients. BMC Nephrol. 2020;21(1):281. Published 2020 Jul 16.
27
Jelska A, Polecka A, Zahorodnii A, Olszewska E. The role of oxidative stress and the potential therapeutic benefits of Aronia melanocarpa supplementation in obstructive sleep apnea syndrome: a comprehensive literature review. Antioxidants. 2024;13(11):1300.
28
Rossman MJ, Gioscia-Ryan RA, Santos-Parker JR, et al. Inorganic Nitrite Supplementation Improves Endothelial Function With Aging: Translational Evidence for Suppression of Mitochondria-Derived Oxidative Stress. Hypertension. 2021;77(4):1212-1222.
29
Lavalle S, Masiello E, Iannella G, et al. Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review. Life (Basel). 2024;14(4):425. Published 2024 Mar 22.
30
Młynarska E, Bojdo K, Frankenstein H, et al. Endothelial dysfunction as the common pathway linking obesity, hypertension and atherosclerosis. Int J Mol Sci. 2025;26(20):10096.
31
Myszko M, Bychowski J, Skrzydlewska E, Łuczaj W. The Dual Role of Oxidative Stress in Atherosclerosis and Coronary Artery Disease: Pathological Mechanisms and Diagnostic Potential. Antioxidants. 2025; 14(3):275. https://doi.org/10.3390/antiox14030275
32
Zhao X, An X, Yang C, Sun W, Ji H, Lian F. The crucial role and mechanism of insulin resistance in metabolic disease. Front Endocrinol (Lausanne). 2023;14:1149239. Published 2023 Mar 28.
33
Meszaros M, Bikov A. Obstructive Sleep Apnoea and Lipid Metabolism: The Summary of Evidence and Future Perspectives in the Pathophysiology of OSA-Associated Dyslipidaemia. Biomedicines. 2022; 10(11):2754. https://doi.org/10.3390/biomedicines10112754
34
Şerban M, Toader C, Covache-Busuioc R-A. The Redox Revolution in Brain Medicine: Targeting Oxidative Stress with AI, Multi-Omics and Mitochondrial Therapies for the Precision Eradication of Neurodegeneration. International Journal of Molecular Sciences. 2025; 26(15):7498. https://doi.org/10.3390/ijms26157498
35
Luong TV, Hoang TA, Tran DH, et al. Continuous positive airway pressure therapy for patients with obstructive sleep apnea and coronary artery disease. World J Cardiol. 2025;17(10):107750.
36
Maniaci A, Iannella G, Cocuzza S, et al. Oxidative Stress and Inflammation Biomarker Expression in Obstructive Sleep Apnea Patients. J Clin Med. 2021;10(2):277. Published 2021 Jan 13.
37
Davinelli S, Medoro A, Savino R, Scapagnini G. Sleep and Oxidative Stress: Current Perspectives on the Role of NRF2. Cell Mol Neurobiol. 2024;44(1):52. Published 2024 Jun 25.
38
Aliyeva A, Hashimli R, Yılmaz B. Hematological Biomarkers of the Obstructive Sleep Apnea Syndrome: A Machine Learning-Based Diagnostic and Prognostic Model. Journal of Clinical Medicine. 2025; 14(23):8437. https://doi.org/10.3390/jcm14238437
39
Paz Y Mar HL, Hazen SL, Tracy RP, et al. Effect of Continuous Positive Airway Pressure on Cardiovascular Biomarkers: The Sleep Apnea Stress Randomized Controlled Trial. Chest. 2016;150(1):80-90.
40
Zhu Q, Luo Q, Wang Z, Chen S, Chen G, Huang S. Effects of continuous positive airway pressure therapy on inflammatory markers in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials. Sleep Breath. 2025;29(2):182.
41
Li D, Pan JH, Huang XF, Liao YQ, et al. The effect of melatonin on oxidative stress indicators in animal models of fibrosis: a systematic review and meta-analysis. Free Radic Biol Med. 2022;195.
42
Darenskaya M, Cloete KJ, Rychkova L, et al. Oxidative Stress, Antioxidant Cofactor Micronutrients, and Cognitive Outcomes in Childhood Obesity: Mechanisms, Evidence, and Therapeutic Opportunities. Int J Mol Sci. 2025;26(24):12012. Published 2025 Dec 13.
43
Kaštelan S, Kozina L, Alaber M, et al. Neuro-ophthalmological disorders associated with obstructive sleep apnoea. Int J Mol Sci. 2025;26(14):6649.
44
Meyer EJ, Wittert GA. Approach the Patient With Obstructive Sleep Apnea and Obesity. J Clin Endocrinol Metab. 2024;109(3):e1267-e1279.
45
Thirupathi A, Wang M, Lin JK, et al. Effect of Different Exercise Modalities on Oxidative Stress: A Systematic Review. Biomed Res Int. 2021;2021:1947928. Published 2021 Feb 11.
46
Salvagno M, Sterchele ED, Zaccarelli M, Mrakic-Sposta S, Welsby IJ, Taccone FS. Oxidative stress and cerebral vascular tone: the role of reactive oxygen and nitrogen species. Int J Mol Sci. 2024;25(5):3007.
47
Kumar Rajendran N, George BP, Chandran R, Tynga IM, Houreld N, Abrahamse H. The Influence of Light on Reactive Oxygen Species and NF-кB in Disease Progression. Antioxidants. 2019; 8(12):640. https://doi.org/10.3390/antiox8120640
48
Fiedorczuk P, Polecka A, Walasek M, Olszewska E. Potential Diagnostic and Monitoring Biomarkers of Obstructive Sleep Apnea-Umbrella Review of Meta-Analyses. J Clin Med. 2022;12(1):60. Published 2022 Dec 21.
49
Woźniak Ł, Mierzejewska ŻA, Borys J, Ratajczak-Wrona W, Antonowicz B. Oxidative Stress and Biomarkers in Craniofacial Fractures Healing: From Lipid Peroxidation to Antioxidant Therapies. Antioxidants. 2025; 14(9):1070. https://doi.org/10.3390/antiox14091070
50
Askland K, Wright L, Wozniak DR, Emmanuel T, Caston J, Smith I. Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev. 2020;4(4):CD007736. Published 2020 Apr 7.
51
Kong AS, Lai KS, Hee CW, Loh JY, Lim SHE, Sathiya M. Oxidative Stress Parameters as Biomarkers of Cardiovascular Disease towards the Development and Progression. Antioxidants (Basel). 2022;11(6):1175. Published 2022 Jun 15.
52
Wang Y, Zhang SX, Gozal D. Reactive oxygen species and the brain in sleep apnea. Respir Physiol Neurobiol. 2010;174(3):307-316.
53
Kargar B, Zamanian Z, Hosseinabadi MB, Gharibi V, Moradi MS, Cousins R. Understanding the role of oxidative stress in the incidence of metabolic syndrome and obstructive sleep apnea. BMC Endocr Disord. 2021;21(1):77. Published 2021 Apr 21.
54
Friščić T, Perčić M, Vidović D, Štajduhar A, Galić E. Impact of CPAP Therapy on New Inflammation Biomarkers. J Clin Med. 2022;11(20):6113. Published 2022 Oct 17.
55
Georgoulis M, Yiannakouris N, Tenta R, et al. A weight-loss Mediterranean diet/lifestyle intervention ameliorates inflammation and oxidative stress in patients with obstructive sleep apnea: results of the “MIMOSA” randomized clinical trial. Eur J Nutr. 2021;60(7):3799-3810.
56
Marinelli A, Portacci A, Bikov A, et al. Role of free radicals in the pathophysiology of OSA: a narrative review of a double-edged sword. J Clin Med. 2025;14(13):4752.


