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Biomedicines
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Obstructive Sleep Apnea: Mechanisms, Comorbidities, and Optimization of Emerging and...
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Obstructive Sleep Apnea: Mechanisms, Comorbidities, and Optimization of Emerging and Established Therapies

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 25 February 2026 | Viewed by 587

Special Issue Editors

Dr. Ivana Pavlinac Dodig

E-Mail Website
Guest Editor
Department of Neuroscience, University of Split School of Medicine, Sleep Medicine Center, 21000 Split, Croatia
Interests: obstructive sleep apnea (OSA); sleep disorders; sleep-disordered breathing; oxidative stress in sleep apnea, inflammation and sleep apnea; cardiovascular comorbidities of OSA; biomarkers for sleep apnea; therapeutic targets for OSA; translational research in sleep medicine; neurocognitive impairment related to sleep disorders
Dr. Renata Pecotic

E-Mail Website
Guest Editor
Department of Neuroscience, University of Split School of Medicine, Sleep Medicine Center, 21000 Split, Croatia
Interests: obstructive sleep apnea; anesthetics; sleep medicine; phrenic nerve recording; long-term facilitation

Special Issue Information

Dear Colleagues,

Obstructive sleep apnea (OSA) is a prevalent, yet underdiagnosed, sleep-related breathing disorder characterized by intermittent upper airway obstruction and fragmented sleep. It involves complex and multifactorial pathophysiological mechanisms that contribute to diverse clinical phenotypes and a wide range of systemic effects. Recent research has enhanced our understanding of OSA’s heterogeneity, including its pathophysiological mechanisms that lead to strong associations with cardiovascular, metabolic, and neurocognitive comorbidities, as well as its impact on daytime functioning and overall quality of life.

Despite these advances, important challenges remain. A deeper understanding of the underlying mechanisms of and the interactions between OSA and its comorbid conditions is still needed. At the same time, effective management continues to be hindered by the limitations of current therapies, most notably, suboptimal adherence to continuous positive airway pressure (CPAP), the gold-standard treatment. These challenges underscore the importance of improved disease phenotyping, the identification of reliable biomarkers, and the exploration of novel therapeutic targets, as well as efforts to optimize both established and emerging treatment strategies.

This Special Issue aims to provide a comprehensive overview of current research on OSA, focusing on disease mechanisms, comorbidities, and the optimization of emerging and established therapies. We welcome manuscripts addressing molecular and physiological mechanisms, novel diagnostic or prognostic biomarkers, translational studies, and personalized treatment approaches, including innovations to improve therapy adherence.

By integrating multidisciplinary perspectives, this Special Issue seeks to advance clinically relevant research and support the development of more effective, individualized management pathways for patients living with OSA.

Dr. Ivana Pavlinac Dodig
Dr. Renata Pecotic
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • obstructive sleep apnea
  • sleep-disordered breathing
  • pathophysiology
  • cardiometabolic comorbidities
  • precision medicine
  • CPAP
  • sleep diagnostics
  • biomarkers
  • neurocognitive impairment
  • new therapies

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Published Papers (1 paper)

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38 pages, 2786 KiB  
Systematic Review
Obstructive Sleep Apnea and Outcomes in Cardiac Surgery: A Systematic Review with Meta-Analytic Synthesis (PROSPERO CRD420251049574)
by Andrei Raul Manzur, Alina Gabriela Negru, Andreea-Roxana Florescu, Ana Lascu, Iulia Raluca Munteanu, Ramona Cristina Novaconi, Nicoleta Sorina Bertici, Alina Mirela Popa and Stefan Mihaicuta
Biomedicines 2025, 13(7), 1579; https://doi.org/10.3390/biomedicines13071579 - 27 Jun 2025
Viewed by 463
Abstract
Background: Obstructive sleep apnea (OSA) is a prevalent but frequently underdiagnosed comorbidity in patients undergoing cardiac surgery, including coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve repair or replacement (MVR). This systematic review and meta-analytic synthesis investigates the [...] Read more.
Background: Obstructive sleep apnea (OSA) is a prevalent but frequently underdiagnosed comorbidity in patients undergoing cardiac surgery, including coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve repair or replacement (MVR). This systematic review and meta-analytic synthesis investigates the relationship between OSA and postoperative morbidity and mortality, with particular attention to the predictive utility of established screening instruments. Methods: A systematic search of the PubMed database was conducted (April 2025), identifying 724 articles published in the last ten years. Seventeen primary studies met the inclusion criteria for qualitative synthesis, and four additional studies were included in the meta-analyses. Outcomes assessed included atrial fibrillation, major adverse cardiac and cerebrovascular events (MACCE), acute kidney injury (AKI), respiratory complications, pneumonia, hospital length of stay (LOS), and mortality. Risk of bias was assessed qualitatively based on study design and reporting limitations. This review was registered in the PROSPERO database under registration number CRD420251049574. Results: Meta-analyses demonstrated significantly elevated odds of atrial fibrillation (OR = 2.44, 95% CI: 1.46–4.07), major adverse cardiac and cerebrovascular events (OR = 2.06, 95% CI: 1.61–2.63), acute kidney injury (OR = 2.24, 95% CI: 1.67–3.01), and respiratory complications (OR = 1.15, 95% CI: 1.05–1.25) among patients with OSA. Additionally, OSA was associated with a significantly prolonged hospital length of stay (standardized mean difference [SMD] = 0.62, 95% CI: 0.46–0.78) and a marginal increase in pneumonia risk (OR = 1.07, 95% CI: 1.00–1.15). Evidence regarding stroke, intensive care unit (ICU) stay, and mortality was inconsistent or underpowered. Conclusions: Across core outcomes, findings were consistent across multiple studies involving a large patient population. Obstructive sleep apnea is a clinically consequential risk factor in cardiac surgery, associated with increased perioperative complications and prolonged hospitalization. These findings support the integration of routine OSA screening into preoperative risk assessment protocols. Further prospective, multicenter trials are warranted to assess the efficacy of perioperative management strategies, including continuous positive airway pressure (CPAP) therapy, in improving surgical outcomes. Full article
(This article belongs to the Special Issue Obstructive Sleep Apnea: Mechanisms, Comorbidities, and Optimization of Emerging and Established Therapies)
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