Obstructive sleep apnea and seizures: pathophysiological mechanisms and clinical implications: a narrative review
Abstract
PURPOSE: Obstructive sleep apnea (OSA) is a common sleep disorder characterized by recurrent upper airway obstructions leading to sleep fragmentation and intermittent hypoxia. This review aims to explore the complex relationship between OSA and seizures, focusing on potential molecular mechanisms and the need for better understanding to improve clinical management. METHODS: A narrative literature review was conducted by searching PubMed, Scopus, and Web of Science using keywords such as “obstructive sleep apnea,” “seizures,” “epilepsy,” “molecular mechanisms,” and “hypoxia.” Articles from database inception to December 31, 2025 were considered, with emphasis on studies from the past five years. Inclusion criteria included English-language peer-reviewed articles relevant to the topic; exclusion criteria encompassed duplicates, non-relevant studies, and low-quality reports. No formal quality assessment tool was used, as this is a narrative review, but sources were selected based on methodological rigor and journal reputation to ensure reproducibility and transparency. RESULTS: Evidence indicates that OSA exacerbates seizures through mechanisms such as sleep deprivation, chronic intermittent hypoxia, neuroinflammation, oxidative stress, and alterations in molecular markers like HMGB1, microRNAs, and melatonin. Recent studies highlight neuroinflammatory pathways and intermittent hypoxia as key links, with OSA treatment potentially reducing seizure frequency. Prevalence of OSA in…
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