Functional dyspepsia and obstructive sleep apnea syndrome: the links and therapy

Abstract

Functional dyspepsia (FD) and obstructive sleep apnea syndrome (OSAS) are prevalent conditions that often coexist, linked by shared risk factors and overlapping mechanisms such as circadian disruption, autonomic imbalance, inflammation, gut–brain axis dysfunction, and microbiome alterations. Evidence suggests a bidirectional relationship: sleep fragmentation in OSAS can worsen gastrointestinal symptoms, while FD contributes to poor sleep quality, amplifying symptom burden and reducing quality of life. A search of biomedical databases identified epidemiological, mechanistic, and clinical studies exploring this association. Overlapping presentations create diagnostic challenges, underscoring the value of integrated gastrointestinal and sleep assessment tools. Management benefits from combined approaches, integrating continuous positive airway pressure and other OSAS therapies with gastrointestinal interventions, lifestyle modification, and emerging options such as melatonin and microbiome-targeted treatments. Future priorities include the development of biomarker, treatment algorithms, and precision-based strategies to improve outcomes. This review aims to synthesize current evidence on FD–OSAS interplay and outline its clinical and research implications.