Targeting aldosterone in sleep apnea: opening a new therapeutic era

Obstructive sleep apnea (OSA) is far more than a nightly disturbance – it is a highly prevalent disorder marked by recurrent airway collapse, intermittent hypoxia, and fragmented sleep that fuel sympathetic overactivity and profound daytime fatigue [1]. With nearly one billion adults worldwide estimated to be affected, and over 400 million living with moderate-to-severe disease, OSA has emerged as a global health challenge with major implications for cardiovascular and metabolic health [2]. Its burden extends beyond obesity, driving hypertension and impaired glucose regulation [1], yet it often remains hidden, particularly in women and younger patients [3,4]. Continuous positive airway pressure (CPAP) remains the cornerstone of first-line management, but real-world evidence shows that less than half of patients maintain high adherence over the long term [5], underscoring the urgent need for alternative or complementary strategies