Therapeutic nutrition strategies for the shared pathophysiology of obesity and sleep-disordered breathings

Abstract

Sleep-disordered breathings (SDBs) represent both a significant complication and exacerbating factor of obesity, creating a bidirectional relationship that worsens insulin resistance and metabolic dysfunction. The interplay between obesity and SDBs involves complex multisystem pathophysiology encompassing upper airway obstruction, metabolic dysregulation, HPA axis disturbances, intermittent hypoxia, and chronic low-grade inflammation. While their precise causal relationship requires further investigation, the shared pathological pathways present valuable clinical intervention targets. Dietary modification emerges as a particularly promising cost-effective approach due to its ability to simultaneously address multiple mechanistic pathways underlying both conditions. This review comprehensively examines the clinical connections between obesity and various SDBs manifestations, analyzes their common pathogenic mechanisms, and evaluates five key dietary patterns with particular focus on their constituent nutrients’ modes of action. The synthesized evidence provides new insights into the obesity-SDBs comorbidity while establishing a framework for developing targeted nutritional interventions in clinical practice.