Sleep apnoea, gut dysbiosis and cognitive dysfunction

Deyang, Tenzin; Baig, Awaise Iqbal; Dolkar, Phurbu; Hediyal, Tousif Ahmed; Rathipriya, Annan Gopinath; Bhaskaran, Mahendran; PandiPerumal, Seithikuruppu R.; Monaghan, Tanya M.; Mahalakshmi, Arehally M; Chidambaram, Saravana Babu

Abstract

Sleep disorders are becoming increasingly common, and their distinct effects on physical and mental health require elaborate investigation. Gut dysbiosis (GD) has been reported in sleep-related disorders, but sleep apnoea is of particular significance because of its higher prevalence and chronicity. Cumulative evidence has suggested a link between sleep apnoea and GD. This review highlights the gut–brain communication axis that is mediated via commensal microbes and various microbiota-derived metabolites (e.g. short-chain fatty acids, lipopolysaccharide and trimethyl amine N-oxide), neurotransmitters (e.g. γ-aminobutyric acid, serotonin, glutamate and dopamine), immune cells and inflammatory mediators, as well as the vagus nerve and hypothalamic–pituitary–adrenal axis. This review also discusses the pathological role underpinning GD and altered gut bacterial populations in sleep apnoea and its related comorbid conditions, particularly cognitive dysfunction. In addition, the review examines the preclinical and clinical evidence, which suggests that prebiotics and probiotics may potentially be beneficial in sleep apnoea and its comorbidities through restoration of eubiosis or gut microbial homeostasis that regulates neural, metabolic and immune responses, as well as physiological barrier integrity via the gut–brain axis.

• Journal Article Type: Review
• Acceptance Date: Sep 13, 2023
• Online Publication Date: Oct 8, 2023
• Publication Date: Oct 8, 2023
• Deposit Date: Sep 21, 2023
• Publicly Available Date: Oct 9, 2024
• Journal: The FEBS Journal
• Print ISSN: 1742-464X
• Electronic ISSN: 1742-4658
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/febs.16960
• Keywords: Obstructive sleep apnoea, gut-brain axis, cognition, neuroinflammation, gut dysbiosis
• Public URL: https://nottingham-repository.worktribe.com/output/25365632
• Publisher URL: https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.16960
• Additional Information: This is the accepted version of the following article: Deyang, T., Baig, M.A.I., Dolkar, P., Hediyal, T.A., Rathipriya, A.G., Bhaskaran, M., PandiPerumal, S.R., Monaghan, T.M., Mahalakshmi, A.M. and Chidambaram, S.B. (2023), Sleep apnoea, gut dysbiosis and cognitive dysfunction. FEBS, which has been published in final form at https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.16960