Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by recurrent upper airway obstruction, leading to intermittent hypoxia, sleep fragmentation, and increased risk of cardiovascular, metabolic, and neurocognitive complications. Chronic intermittent hypoxia (CIH), a hallmark of OSA, contributes significantly to oxidative stress, systemic inflammation, endothelial dysfunction, and neuronal injury. These mechanisms underlie the development of comorbidities such as hypertension, diabetes mellitus, dyslipidemia, and cognitive impairment. While continuous positive airway pressure (CPAP) is the standard treatment, poor adherence highlights the need for adjunctive therapies. Melatonin, a neurohormone with potent antioxidant, anti-inflammatory, and neuroprotective properties, has emerged as a promising therapeutic agent for mitigating CIH-related complications. studies Preclinical demonstrate that melatonin reduces oxidative stress and endothelial inflammation, function, and improves ameliorates metabolic dysfunction, including insulin resistance and lipid dysregulation. Additionally, melatonin has shown potential in preventing CIH-induced cognitive decline by reducing hippocampal oxidative damage, preserving synaptic plasticity, and enhancing neurogenesis. These neuroprotective effects may counteract the cognitive impairments frequently observed in OSA patients. This narrative review examines the impact of melatonin administration on cardiovascular, metabolic, and neurocognitive sequelae of OSA, focusing on its molecular mechanisms of action and therapeutic potential. While preclinical studies provide compelling evidence for its efficacy, clinical trials are needed to establish optimal dosing, safety, and long-term benefits of melatonin therapy in OSA patients. Integrating melatonin as an adjunctive therapy may offer a novel approach to reducing the burden of OSA related diseases.

Dr. Jose Javier S. Lasala, MD is a Filipino physician born on February 1, 1998, in Davao City, Philippines. He completed his Doctor of Medicine degree at the University of the Philippines Manila College of Medicine, graduating Cum Laude in 2025. Prior to medical school, he earned a Bachelor of Science in Psychology, Magna Cum Laude, from the University of the Philippines Diliman in 2020. During his medical training, he also completed a clinical elective in Otorhinolaryngology–Head and Neck Surgery at the National University Hospital, National University of Singapore in 2023.

He obtained his physician license in 2025 after passing the Philippine Physician Licensure Examination with a rating of 87.17%, and previously achieved a 99+ percentile score in the National Medical Admission Test. His academic career has been marked by multiple distinctions, including consistent college scholar recognition and the Gokongwei Brothers Foundation Scholarship during his undergraduate years. He has also participated in national and international academic competitions, including winning the TCS Philippines Sustainathon in 2021 and placing 5th in the TCS Singapore Sustainathon Finals in 2022. Dr. Lasala has contributed to academic literature with publications such as “Melatonin as a Therapeutic Adjunct in Obstructive Sleep Apnea: A Review of Potential Benefits” in Sleep Medicine Research (2025) and “Ectogenesis: Understanding Opportunities, Implications, Concerns, and Ways Forward” in the International Journal of Surgery: Global Health (2024). He is fluent in English and Filipino and continues to pursue academic and clinical excellence in medicine.