Inflammation in Obstructive Sleep Apnea: A Global Bibliometric Perspective.

Abstract

Purpose: Obstructive sleep apnea (OSA) is increasingly recognized as a systemic disorder in which inflammation plays a pivotal role in its pathophysiology and comorbidities. This study aimed to conduct the first comprehensive bibliometric analysis of global research on inflammation in OSA, in order to map knowledge structures, identify influential contributors, and highlight emerging research trends.

Patients and methods: Publications related to OSA and inflammation were retrieved from the Web of Science Core Collection (WoSCC) (1996-2025). After exclusions, 2,075 articles and reviews were analyzed using bibliometric tools including CiteSpace, VOSviewer, and the bibliometrix R package. Citation frequencies, co-citation networks, and collaboration patterns among countries, institutions, authors, and journals were examined.

Results: The number of publications has shown robust growth (annual rate 12.11%). China and the United States were the leading contributors, with Harvard University, the University of Chicago, and Institut National De La Sante Et De La Recherche Medicale (INSERM) among the most productive institutions. Influential authors included Gozal D, Kheirandish-Gozal L, and Khalyfa A. Sleep and Breathing was the most prolific journal, while Circulation and American Journal of Respiratory and Critical Care Medicine were highly co-cited sources. Highly cited works established the link between intermittent hypoxia, systemic inflammation, and cardiovascular/metabolic consequences. Thematic clusters revealed major research focuses on cardiovascular disease, metabolic syndrome, oxidative stress, neuroinflammation (including microglial activation), and therapeutic strategies such as continuous positive airway pressure (CPAP), adenotonsillectomy, and bariatric surgery. Emerging topics included gut microbiota, vitamin D, and neurodegenerative diseases.

Conclusion: Research on inflammation is evolving from mechanistic insights toward clinical management and interdisciplinary exploration. Looking ahead, priority should be given to biomarker discovery and the development of anti-inflammatory therapeutic strategies. These findings provide a roadmap for targeted research and clinical translation in the field of OSA-related inflammation, ultimately improving patient outcomes.