EVALUATION OF THE RELATIONSHIP BETWEEN OBSTRUCTIVE SLEEP APNEA (OSA) AND GASTROINTESTINAL DISEASES: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.5281/zenodo.21939558Keywords:
Obstructive sleep apnea, Gastroesophageal reflux, Inflammatory bowel diseases, Gastrointestinal diseasesAbstract
Introduction: Obstructive sleep apnea (OSA) is characterized by recurrent episodes of upper airway collapse during sleep, leading to hypoxemia, daytime sleepiness, and activation of the sympathetic nervous system. An association between OSA and several gastrointestinal diseases has been suggested, particularly gastroesophageal reflux disease (GERD), although the available evidence remains limited. The aim of this systematic review was to evaluate the relationship between OSA and gastrointestinal diseases, including GERD, gastritis, gastric ulcer, and inflammatory bowel disease (IBD). Methodology: A systematic search of PubMed, EMBASE, and Web of Science was conducted, including studies published within the last ten years. Cohort, cross-sectional, clinical trials, and Mendelian randomization studies were included, while narrative reviews, case reports, and studies with overlapping populations were excluded. Study selection, data extraction, and risk of bias assessment were independently performed by two reviewers using STROBE-MR, ROBINS-I, and the JBI checklist, as appropriate. The protocol was registered in PROSPERO (CRD420250654169). Results: Eight studies were included. Most reported a significant association between OSA and GERD, supported by Mendelian randomization studies suggesting a bidirectional causal relationship. Associations with gastroduodenal ulcer and inflammatory bowel disease were also observed, although with less consistent evidence. Discussion: The available evidence suggests a significant association between OSA and gastrointestinal diseases, particularly GERD. Methodological heterogeneity and risk of bias limit the certainty of the evidence, which ranges from moderate to very low. Conclusion: There is a consistent association between OSA and GERD, with genetic evidence suggesting possible bidirectional causality, whereas evidence for other gastrointestinal conditions remains limited.
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Copyright (c) 2026 Camila Oñate Cheuquepán, Florencia Espinoza Veloso, Miguel Valdebenito Barraza (Autor/a)
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