Decoding the autophagic code in obstructive sleep apnea: a multi-organ mechanistic dissection.

Obstructive sleep apnea (OSA) is a sleep-related hypoxia/reoxygenation disorder, characterized by repeated upper airway obstruction during sleep, leading to intermittent hypoxia (IH) and a series of systemic health issues. OSA is considered a chronic systemic disease with a high prevalence that severely impacts patients' quality of life and may lead to cardiovascular and cerebrovascular diseases, lipid metabolism disorders, and even multiple organ damage, posing a significant threat to human health. Autophagy, an important cellular degradation process, relies on the lysosomal pathway to degrade damaged proteins and organelles, maintaining cellular homeostasis and enabling cellular renewal. A growing body of evidence has highlighted the critical influence of autophagy in the pathophysiology of OSA and its associated multi-organ dysfunction. This review aims to elucidate the mechanisms of autophagy involved in OSA and its impact on heart, brain, kidneys, among other organs, discussing IH 's impact on autophagy activity and the potential consequences of autophagy dysregulation in OSA-related organ damage. Furthermore, we propose the therapeutic potential of targeting autophagy as a new strategy for managing OSA and mitigating its systemic effects. Our findings suggest that understanding the interaction between autophagy and OSA may pave the way for novel therapeutic approaches, thereby improving patient outcomes.