Obstructive sleep apnea (OSA) is a common and increasingly recognized disorder with complex systemic implications [1]. Beyond intermittent hypoxia and sleep fragmentation, OSA has been linked to cardiovascular, metabolic, neurocognitive and oncologic morbidity [2–5]. Continuous positive airway pressure (CPAP) remains the cornerstone therapy for moderate-to-severe OSA, with well-documented physiological and clinical benefits [6]. However, interindividual variability in disease expression and treatment response suggests the presence of a complex and heterogeneous pathophysiological framework that is only beginning to be elucidated [4].
