AUTHOR=Dong Na , Yue Hongmei 

TITLE=Advances in immunology of obstructive sleep apnea: mechanistic insights, clinical impact, and therapeutic perspectives

JOURNAL=Frontiers in Immunology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1654450

DOI=10.3389/fimmu.2025.1654450

ISSN=1664-3224

ABSTRACT=Obstructive sleep apnea (OSA) drives immune dysregulation through its hallmark stressors—intermittent hypoxia (IH) and sleep fragmentation (SF). Beyond impaired sleep, OSA acts as a systemic inflammatory trigger that disrupts immune homeostasis and reshapes both innate and adaptive responses. Recent evidence shows that OSA activates hypoxia-inducible factor-1α (HIF-1α), NF-κB signaling, and the NLRP3 inflammasome, promoting chronic inflammation and immune-cell dysfunction. These alterations mechanistically contribute to OSA-associated cardiovascular disease, metabolic disorders, cognitive impairment, and tumor progression. Reframing OSA as an immune-modulating disorder highlights the need for diagnostics and therapies guided by immunology rather than airway management alone.