A recent expert review, published in Sleep Medicines Reviews, advances the viewpoint that this anatomic perspective, while important, captures only part of the picture. The paper brings together evidence from across sleep medicine, cardiology, neuroscience, obesity research, bio-computation, and advanced medical imaging to propose a systems-based, functional view of sleep apnoea, and one that focuses on the underlying physiological mechanisms and long-term outcomes rather than anatomy alone.
The review synthesises a wide body of existing research to explore how complex biological processes interact in sleep apnoea, and how this interaction may help explain its links to heart disease, brain health and obesity.
A two-way relationship with obesity
One of the central themes of the review is the close, two-way relationship between sleep apnoea and obesity. Excess body fat, particularly visceral fat stored deep in the abdomen, increases the likelihood of airway collapse during sleep. At the same time, disrupted sleep alters metabolism, and hormone appetite regulation increasing the risk of weight gain over time. This interplay thus positions sleep apnoea within a broader cardiometabolic context, with implications for health systems globally, given the obesity pandemic.
'Sleep apnoea needs to be understood as part of a wider physiological framework,' said Betty Raman, Wellcome Clinical Career Development Fellow and Associate Professor of Cardiovascular Medicine in the Oxford Centre for Clinical Magnetic Resonance Research, and a co-author of the review.
'Looking at this complex disorder through a systems and functional lens helps explain why it so often coexists with cardiometabolic disease, and why single-factor approaches can fall short.'
Read the full story on the Radcliffe Department of Medicine website.