CHEST Guidelines-Sleep,-Circadian-Disruption,-and-Microbial-Immune-

Sleep,-Circadian-Disruption,-and-Microbial-Immune-

Pdf Summary

The document discusses the burgeoning field of research on the interaction between sleep, circadian disruptions, and the microbiome, especially focusing on how these factors may influence diseases such as obstructive sleep apnea (OSA). The human microbiome is critical due to its vast number of microbial cells affecting biological functions. Recent studies highlight the impact of sleep as an immune enhancer and how sleep and circadian rhythms influence peripheral blood immune cells. OSA, affecting millions globally, is associated with negative metabolic and cardiovascular outcomes stemming from intermittent hypoxia and sleep fragmentation. These outcomes potentially involve alterations in the gut microbiome, a concept that provides new insights into disease mechanisms beyond traditional factors.<br /><br />OSA's relationship with the microbiome is multifaceted, involving factors like intermittent hypoxia and hypercapnia, which alter gut microbial compositions and metabolomic profiles, potentially leading to atherosclerosis. Human and experimental data reveal OSA-induced changes in gut epithelial markers, gut permeability, and an association with hypertension. Notably, transferring microbiota from hypertensive OSA models to normotensive ones induced hypertension, suggesting microbiome manipulation might be a treatment avenue.<br /><br />The document emphasizes the relationship between sleep fragmentation—a hallmark of OSA and other sleep disorders—and metabolic complications. Sleep disruption influences insulin sensitivity, inflammation, and appetite, all linked to microbiome changes. These interactions may contribute to obesity and metabolic derailment.<br /><br />Overall, the research points to an exciting crossroad of immune processes, microbiome dynamics, and sleep/circadian rhythms, urging further exploration into personalized therapies and targeted microbiome interventions. The goal is to unravel the persistent effects of dysbiosis and establish new paradigms for addressing OSA and its comorbidities more effectively. Future studies should explore broader sleep disorder impacts, such as chronic sleep restriction and circadian disruptions, on the microbiome.

Keywords

sleep

circadian disruptions

microbiome

obstructive sleep apnea

immune enhancer

intermittent hypoxia

gut microbiome

metabolic complications

personalized therapies

dysbiosis