{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:50:29Z","timestamp":1791424229164,"version":"4.3.3"},"reference-count":108,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":189,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005247","name":"University of British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005247","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007229","name":"Harvard University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007229","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008002","name":"Vancouver Coastal Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015752","name":"Lung Association British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015752","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008920","name":"University of Saskatchewan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Sleep Medicine Reviews"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.smrv.2026.102255","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T01:06:10Z","timestamp":1770253570000},"page":"102255","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Circulating markers of biological aging associated with obstructive sleep apnea or insomnia in adults: A systematic review and meta-analysis"],"prefix":"10.1016","volume":"86","author":[{"given":"Tak Hou Calvin","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua B.","family":"Hicks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Izadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshdeep","family":"Marwaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ Hirsch","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Hajipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalijn I.","family":"Conklin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najib T.","family":"Ayas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.smrv.2026.102255_bib1","doi-asserted-by":"crossref","first-page":"7124","DOI":"10.1073\/pnas.78.11.7124","article-title":"The aging process","volume":"78","author":"Harman","year":"1981","journal-title":"Proc Natl Acad Sci USA"},{"key":"10.1016\/j.smrv.2026.102255_bib2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.cell.2022.11.001","article-title":"Hallmarks of aging: an expanding universe","volume":"186","author":"L\u00f3pez-Ot\u00edn","year":"2023","journal-title":"Cell"},{"key":"10.1016\/j.smrv.2026.102255_bib3","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1007\/s11739-023-03397-3","article-title":"Biological age is superior to chronological age in predicting hospital mortality of the critically ill","volume":"18","author":"Ho","year":"2023","journal-title":"Intern Emerg Med"},{"key":"10.1016\/j.smrv.2026.102255_bib4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.pcad.2023.02.005","article-title":"Sleep physiology, pathophysiology, and sleep hygiene","volume":"77","author":"Baranwal","year":"2023","journal-title":"Prog Cardiovasc Dis"},{"key":"10.1016\/j.smrv.2026.102255_bib5","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1164\/rccm.201504-0767ST","article-title":"An official American thoracic society statement: the importance of healthy sleep. Recommendations and future priorities","volume":"191","author":"Mukherjee","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.smrv.2026.102255_bib6","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1038\/nrn895","article-title":"The neurobiology of sleep: genetics, cellular physiology and subcortical networks","volume":"3","author":"Pace-Schott","year":"2002","journal-title":"Nat Rev Neurosci"},{"key":"10.1016\/j.smrv.2026.102255_bib7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"10.1016\/j.smrv.2026.102255_bib8","doi-asserted-by":"crossref","DOI":"10.3390\/life14040425","article-title":"Unraveling the complexities of oxidative stress and inflammation biomarkers in obstructive sleep apnea syndrome: a comprehensive review","volume":"14","author":"Lavalle","year":"2024","journal-title":"Life"},{"key":"10.1016\/j.smrv.2026.102255_bib9","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.molmed.2017.06.006","article-title":"Obstructive sleep apnea and hallmarks of aging","volume":"23","author":"Gaspar","year":"2017","journal-title":"Trends Mol Med"},{"key":"10.1016\/j.smrv.2026.102255_bib10","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1378\/chest.14-0500","article-title":"Intermittent hypoxemia and OSA: implications for comorbidities","volume":"147","author":"Dewan","year":"2015","journal-title":"Chest"},{"key":"10.1016\/j.smrv.2026.102255_bib11","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.5664\/jcsm.11170","article-title":"Obstructive sleep apnea severity, circulating biomarkers, and cancer risk","volume":"20","author":"Hirsch Allen","year":"2024","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib12","first-page":"1071","article-title":"Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort","volume":"31","author":"Young","year":"2008","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib13","doi-asserted-by":"crossref","first-page":"6846","DOI":"10.1038\/s41598-020-63761-7","article-title":"Chronic intermittent hypoxia triggers a senescence-like phenotype in human white preadipocytes","volume":"10","author":"Polonis","year":"2020","journal-title":"Sci Rep"},{"key":"10.1016\/j.smrv.2026.102255_bib14","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.cell.2005.01.027","article-title":"Understanding the odd science of aging","volume":"120","author":"Kirkwood","year":"2005","journal-title":"Cell"},{"key":"10.1016\/j.smrv.2026.102255_bib15","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders-third edition: highlights and modifications","volume":"146","author":"Sateia","year":"2014","journal-title":"Chest"},{"key":"10.1016\/j.smrv.2026.102255_bib16","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jsmc.2022.03.003","article-title":"Epidemiology of insomnia: prevalence, course, risk factors, and public health burden","volume":"17","author":"Morin","year":"2022","journal-title":"Sleep Med Clin"},{"key":"10.1016\/j.smrv.2026.102255_bib17","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/sleep\/32.4.491","article-title":"Insomnia with objective short sleep duration is associated with a high risk for hypertension","volume":"32","author":"Vgontzas","year":"2009","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2018-000604","article-title":"Insomnia is associated with an increased risk of type 2 diabetes in the clinical setting","volume":"6","author":"LeBlanc","year":"2018","journal-title":"BMJ Open Diabetes Res Care"},{"key":"10.1016\/j.smrv.2026.102255_bib19","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.chest.2017.01.026","article-title":"Insomnia and risk of cardiovascular disease","volume":"152","author":"Javaheri","year":"2017","journal-title":"Chest"},{"key":"10.1016\/j.smrv.2026.102255_bib20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11357-018-0048-5","article-title":"Sympathetic nervous system as a target for aging and obesity-related cardiovascular diseases","volume":"41","author":"Balasubramanian","year":"2019","journal-title":"GeroScience"},{"key":"10.1016\/j.smrv.2026.102255_bib21","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1172\/JCI66370","article-title":"Telomeres and age-related disease: how telomere biology informs clinical paradigms","volume":"123","author":"Armanios","year":"2013","journal-title":"J Clin Investig"},{"key":"10.1016\/j.smrv.2026.102255_bib22","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1001\/jamainternmed.2021.7804","article-title":"Association of telomere length with risk of disease and mortality","volume":"182","author":"Schneider","year":"2022","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.smrv.2026.102255_bib23","doi-asserted-by":"crossref","DOI":"10.1186\/gb-2013-14-10-r115","article-title":"DNA methylation age of human tissues and cell types","volume":"14","author":"Horvath","year":"2013","journal-title":"Genome Biol"},{"key":"10.1016\/j.smrv.2026.102255_bib24","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.molcel.2012.10.016","article-title":"Genome-wide methylation profiles reveal quantitative views of human aging rates","volume":"49","author":"Hannum","year":"2013","journal-title":"Mol Cell"},{"key":"10.1016\/j.smrv.2026.102255_bib25","doi-asserted-by":"crossref","first-page":"573","DOI":"10.18632\/aging.101414","article-title":"An epigenetic biomarker of aging for lifespan and healthspan","volume":"10","author":"Levine","year":"2018","journal-title":"Aging (Albany NY)"},{"key":"10.1016\/j.smrv.2026.102255_bib26","doi-asserted-by":"crossref","first-page":"303","DOI":"10.18632\/aging.101684","article-title":"DNA methylation GrimAge strongly predicts lifespan and healthspan","volume":"11","author":"Lu","year":"2019","journal-title":"Aging (Albany NY)"},{"key":"10.1016\/j.smrv.2026.102255_bib27","doi-asserted-by":"crossref","DOI":"10.1016\/j.arr.2021.101348","article-title":"A systematic review of biological, social and environmental factors associated with epigenetic clock acceleration","volume":"69","author":"Oblak","year":"2021","journal-title":"Ageing Res Rev"},{"key":"10.1016\/j.smrv.2026.102255_bib28","doi-asserted-by":"crossref","DOI":"10.3390\/genes8120398","article-title":"The mitochondrial basis of aging and age-related disorders","volume":"8","author":"Srivastava","year":"2017","journal-title":"Genes"},{"key":"10.1016\/j.smrv.2026.102255_bib29","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.mito.2020.06.004","article-title":"Thinking outside the nucleus: mitochondrial DNA copy number in health and disease","volume":"53","author":"Castellani","year":"2020","journal-title":"Mitochondrion"},{"key":"10.1016\/j.smrv.2026.102255_bib30","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.mito.2012.10.011","article-title":"Is mitochondrial DNA content a potential biomarker of mitochondrial dysfunction?","volume":"13","author":"Malik","year":"2013","journal-title":"Mitochondrion"},{"issue":"Pt 2","key":"10.1016\/j.smrv.2026.102255_bib31","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1042\/bj3480425","article-title":"Increase of mitochondria and mitochondrial DNA in response to oxidative stress in human cells","volume":"348","author":"Lee","year":"2000","journal-title":"Biochem J"},{"key":"10.1016\/j.smrv.2026.102255_bib32","doi-asserted-by":"crossref","DOI":"10.1016\/j.bbadis.2023.166815","article-title":"SIRT1 and SIRT6: the role in aging-related diseases","volume":"1869","author":"You","year":"2023","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"10.1016\/j.smrv.2026.102255_bib33","doi-asserted-by":"crossref","DOI":"10.1016\/j.mad.2020.111215","article-title":"SIRT1 and aging related signaling pathways","volume":"187","author":"Chen","year":"2020","journal-title":"Mech Ageing Dev"},{"key":"10.1016\/j.smrv.2026.102255_bib34","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1038\/srep00070","article-title":"SRT1720 improves survival and healthspan of obese mice","volume":"1","author":"Minor","year":"2011","journal-title":"Sci Rep"},{"key":"10.1016\/j.smrv.2026.102255_bib35","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1038\/s41556-018-0235-8","article-title":"Autophagy and the cell biology of age-related disease","volume":"20","author":"Leidal","year":"2018","journal-title":"Nat Cell Biol"},{"key":"10.1016\/j.smrv.2026.102255_bib36","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/s43587-021-00098-4","article-title":"Autophagy in healthy aging and disease","volume":"1","author":"Aman","year":"2021","journal-title":"Nat Aging"},{"key":"10.1016\/j.smrv.2026.102255_bib37","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/36285","article-title":"Mutation of the mouse klotho gene leads to a syndrome resembling ageing","volume":"390","author":"Kuro-o","year":"1997","journal-title":"Nature"},{"key":"10.1016\/j.smrv.2026.102255_bib38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15280\/jlm.2015.5.1.1","article-title":"Biological role of anti-aging protein klotho","volume":"5","author":"Kim","year":"2015","journal-title":"J Lifestyle Med"},{"key":"10.1016\/j.smrv.2026.102255_bib39","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1126\/science.1112766","article-title":"Suppression of aging in mice by the hormone Klotho","volume":"309","author":"Kurosu","year":"2005","journal-title":"Science"},{"key":"10.1016\/j.smrv.2026.102255_bib40","article-title":"Pathobiology of the Klotho antiaging protein and therapeutic considerations","volume":"3","author":"Prud'homme","year":"2022","journal-title":"Front Aging"},{"key":"10.1016\/j.smrv.2026.102255_bib41","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/gerona\/glab308","article-title":"Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults","volume":"77","author":"Kresovich","year":"2022","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"10.1016\/j.smrv.2026.102255_bib42","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"Bmj"},{"key":"10.1016\/j.smrv.2026.102255_bib44","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/985258","article-title":"Cardiovascular complications of sleep apnea: role of oxidative stress","volume":"2014","author":"Badran","year":"2014","journal-title":"Oxid Med Cell Longev"},{"key":"10.1016\/j.smrv.2026.102255_bib45","year":"2021","journal-title":"Study quality assessment tools"},{"key":"10.1016\/j.smrv.2026.102255_bib48","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1513\/AnnalsATS.201510-718OC","article-title":"Telomere shortening in middle-aged men with sleep-disordered breathing","volume":"13","author":"Boyer","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"10.1016\/j.smrv.2026.102255_bib49","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1080\/01902148.2021.2001607","article-title":"Continuous positive airway pressure affects mitochondrial function and exhaled PGC1-\u03b1 levels in obstructive sleep apnea","volume":"47","author":"Lin","year":"2021","journal-title":"Exp Lung Res"},{"key":"10.1016\/j.smrv.2026.102255_bib50","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.resp.2016.03.001","article-title":"Effects of nasal CPAP on exhaled SIRT1 and tumor necrosis factor-\u03b1 in patients with obstructive sleep apnea","volume":"228","author":"Lin","year":"2016","journal-title":"Respir Physiol Neurobiol"},{"key":"10.1016\/j.smrv.2026.102255_bib51","doi-asserted-by":"crossref","DOI":"10.1111\/jsr.14274","article-title":"Sleep is associated with telomere shortening: a population-based longitudinal study","volume":"34","author":"Tempaku","year":"2025","journal-title":"J Sleep Res"},{"key":"10.1016\/j.smrv.2026.102255_bib52","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1513\/AnnalsATS.202007-771OC","article-title":"Association of obstructive sleep apnea with the aging process","volume":"18","author":"Pinilla","year":"2021","journal-title":"Ann Am Thorac Soc"},{"key":"10.1016\/j.smrv.2026.102255_bib53","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1007\/s00784-018-2560-5","article-title":"Effect of oral appliance on circulating leukocyte telomere length and SIRT1 in obstructive sleep apnea","volume":"23","author":"Lin","year":"2019","journal-title":"Clin Oral Invest"},{"key":"10.1016\/j.smrv.2026.102255_bib54","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsz089","article-title":"Obstructive sleep apnea, nighttime arousals, and leukocyte telomere length: the Multi-Ethnic Study of Atherosclerosis","volume":"42","author":"Carroll","year":"2019","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib55","doi-asserted-by":"crossref","DOI":"10.1152\/ajpheart.00197.2017","article-title":"Moderate-to-severe obstructive sleep apnea is associated with telomere lengthening","volume":"313","author":"Polonis","year":"2017","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"10.1016\/j.smrv.2026.102255_bib56","doi-asserted-by":"crossref","first-page":"559","DOI":"10.5665\/sleep.5526","article-title":"Insomnia and telomere length in older adults","volume":"39","author":"Carroll","year":"2016","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib57","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.biopsych.2016.07.008","article-title":"Epigenetic aging and immune senescence in women with insomnia symptoms: findings from the women's health initiative Study","volume":"81","author":"Carroll","year":"2017","journal-title":"Biol Psychiatry"},{"key":"10.1016\/j.smrv.2026.102255_bib58","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1089\/rej.2014.1586","article-title":"A nested case-controlled comparison of telomere length and psychological functioning in breast cancer survivors with and without insomnia symptoms","volume":"17","author":"Garland","year":"2014","journal-title":"Rejuvenation Res"},{"key":"10.1016\/j.smrv.2026.102255_bib59","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1093\/aje\/kwz134","article-title":"A cross-sectional analysis of telomere length and sleep in the women's health initiative","volume":"188","author":"Grieshober","year":"2019","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.smrv.2026.102255_bib60","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.sleh.2019.12.003","article-title":"Association of sleep quality with telomere length, a marker of cellular aging: a retrospective cohort study of older adults in the United States","volume":"6","author":"Iloabuchi","year":"2020","journal-title":"Sleep Health"},{"key":"10.1016\/j.smrv.2026.102255_bib61","doi-asserted-by":"crossref","first-page":"157","DOI":"10.5665\/sleep.3328","article-title":"Telomere length is associated with sleep duration but not sleep quality in adults with human immunodeficiency virus","volume":"37","author":"Lee","year":"2014","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib62","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.bbi.2014.12.011","article-title":"Tired telomeres: poor global sleep quality, perceived stress, and telomere length in immune cell subsets in obese men and women","volume":"47","author":"Prather","year":"2015","journal-title":"Brain Behav Immun"},{"key":"10.1016\/j.smrv.2026.102255_bib63","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5665\/sleep.3308","article-title":"Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults","volume":"37","author":"Cribbet","year":"2014","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib64","doi-asserted-by":"crossref","DOI":"10.4061\/2011\/721390","article-title":"Shorter leukocyte telomere length in midlife women with poor sleep quality","volume":"2011","author":"Prather","year":"2011","journal-title":"J Aging Res"},{"key":"10.1016\/j.smrv.2026.102255_bib65","first-page":"65","article-title":"Exploring the relationship between DNA methylation age measures and psychoneurological symptoms in women with early-stage breast cancer","volume":"31","author":"Yang","year":"2022","journal-title":"Support Care Cancer"},{"key":"10.1016\/j.smrv.2026.102255_bib66","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.03042-2021","article-title":"Epigenetic age acceleration in obstructive sleep apnoea is reversible with adherent treatment","volume":"59","author":"Cortese","year":"2022","journal-title":"Eur Respir J"},{"key":"10.1016\/j.smrv.2026.102255_bib67","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.ebiom.2019.11.020","article-title":"Association between sleep disordered breathing and epigenetic age acceleration: evidence from the Multi-Ethnic Study of Atherosclerosis","volume":"50","author":"Li","year":"2019","journal-title":"EBioMedicine"},{"key":"10.1016\/j.smrv.2026.102255_bib68","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s13058-020-01368-6","article-title":"Telomere lengths in women treated for breast cancer show associations with chemotherapy, pain symptoms, and cognitive domain measures: a longitudinal study","volume":"22","author":"Alhareeri","year":"2020","journal-title":"Breast Cancer Res"},{"key":"10.1016\/j.smrv.2026.102255_bib69","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.sleh.2021.02.002","article-title":"Postpartum sleep loss and accelerated epigenetic aging","volume":"7","author":"Carroll","year":"2021","journal-title":"Sleep Health"},{"key":"10.1016\/j.smrv.2026.102255_bib70","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1038\/mp.2014.70","article-title":"Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter","volume":"20","author":"Puterman","year":"2015","journal-title":"Mol Psychiatr"},{"key":"10.1016\/j.smrv.2026.102255_bib71","doi-asserted-by":"crossref","first-page":"604","DOI":"10.14336\/AD.2016.0215","article-title":"Oxidative stress-induced telomere length shortening of circulating leukocyte in patients with obstructive sleep apnea","volume":"7","author":"Kim","year":"2016","journal-title":"Aging Dis"},{"key":"10.1016\/j.smrv.2026.102255_bib72","doi-asserted-by":"crossref","first-page":"767","DOI":"10.5665\/sleep.5624","article-title":"Association between snoring and leukocyte telomere length","volume":"39","author":"Shin","year":"2016","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib73","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s11325-014-1110-x","article-title":"The association between leukocyte telomere lengths and sleep instability based on cardiopulmonary coupling analysis","volume":"19","author":"Kwon","year":"2015","journal-title":"Sleep Breath"},{"key":"10.1016\/j.smrv.2026.102255_bib74","doi-asserted-by":"crossref","first-page":"2930","DOI":"10.18632\/aging.203993","article-title":"Association between sleep parameters and longitudinal shortening of telomere length","volume":"14","author":"Jin","year":"2022","journal-title":"Aging (Albany NY)"},{"key":"10.1016\/j.smrv.2026.102255_bib75","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1089\/ars.2014.5955","article-title":"Can mitochondrial dysfunction be a predictive factor for oxidative stress in patients with obstructive sleep apnea?","volume":"21","author":"Kim","year":"2014","journal-title":"Antioxidants Redox Signal"},{"key":"10.1016\/j.smrv.2026.102255_bib76","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.sleep.2023.11.011","article-title":"Association of sleep quality and mitochondrial DNA copy number in healthy middle-aged adults","volume":"113","author":"Han","year":"2024","journal-title":"Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib77","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s13148-024-01706-x","article-title":"The association between sleep quality and accelerated epigenetic aging with metabolic syndrome in Korean adults","volume":"16","author":"Lee","year":"2024","journal-title":"Clin Epigenet"},{"key":"10.1016\/j.smrv.2026.102255_bib78","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s40001-023-01051-4","article-title":"Autophagy impairment in patients with obstructive sleep apnea modulates intermittent hypoxia-induced oxidative stress and cell apoptosis via hypermethylation of the ATG5 gene promoter region","volume":"28","author":"Chen","year":"2023","journal-title":"Eur J Med Res"},{"key":"10.1016\/j.smrv.2026.102255_bib79","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00408-015-9790-y","article-title":"Effect of nasal CPAP on SIRT1 and endothelial function in obstructive sleep apnea syndrome","volume":"193","author":"Chen","year":"2015","journal-title":"Lung"},{"key":"10.1016\/j.smrv.2026.102255_bib80","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.14336\/AD.2018.0204","article-title":"Stronger Association between insomnia symptoms and shorter telomere length in old HIV-infected patients compared with uninfected individuals","volume":"9","author":"Ding","year":"2018","journal-title":"Aging Dis"},{"key":"10.1016\/j.smrv.2026.102255_bib81","doi-asserted-by":"crossref","first-page":"383","DOI":"10.5664\/jcsm.9574","article-title":"Changes in telomere length and serum neurofilament light chain levels in female patients with chronic insomnia disorder","volume":"18","author":"Ren","year":"2022","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib82","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/4569614","article-title":"Folic acid supplementation suppresses sleep deprivation-induced telomere dysfunction and senescence-associated secretory phenotype (SASP)","volume":"2019","author":"Zhang","year":"2019","journal-title":"Oxid Med Cell Longev"},{"key":"10.1016\/j.smrv.2026.102255_bib83","doi-asserted-by":"crossref","DOI":"10.31083\/j.jin2309180","article-title":"Lectin YKL-40 level and telomere length are indicators of insomnia disorder","volume":"23","author":"Li","year":"2024","journal-title":"JIN"},{"key":"10.1016\/j.smrv.2026.102255_bib84","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.rmed.2010.03.025","article-title":"Telomere shortening in sleep apnea syndrome","volume":"104","author":"Barcel\u00f3","year":"2010","journal-title":"Respir Med"},{"key":"10.1016\/j.smrv.2026.102255_bib85","doi-asserted-by":"crossref","DOI":"10.3390\/antiox9080738","article-title":"Is sleep associated with the S-Klotho anti-aging protein in sedentary middle-aged adults? The FIT-AGEING study","volume":"9","author":"Moch\u00f3n-Benguigui","year":"2020","journal-title":"Antioxidants"},{"key":"10.1016\/j.smrv.2026.102255_bib86","doi-asserted-by":"crossref","first-page":"69216","DOI":"10.18632\/oncotarget.12293","article-title":"The effect of the severity of obstructive sleep apnea syndrome on telomere length","volume":"7","author":"Tempaku","year":"2016","journal-title":"Oncotarget"},{"key":"10.1016\/j.smrv.2026.102255_bib87","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.5664\/jcsm.7532","article-title":"Long sleep duration, insomnia, and insomnia with short objective sleep duration are independently associated with short telomere length","volume":"14","author":"Tempaku","year":"2018","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib88","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11055-023-01386-9","article-title":"Changes in relative telomere length in patients with obstructive sleep apnea syndrome on the background of CPAP therapy: a pilot study","volume":"53","author":"Madaeva","year":"2023","journal-title":"Neurosci Behav Physiol"},{"key":"10.1016\/j.smrv.2026.102255_bib89","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s10517-023-05961-5","article-title":"The state of the LPO\u2014AOD system and the relative length of telomeric repeats in the chromosomes of blood leukocytes in obstructive sleep apnea syndrome","volume":"176","author":"Madaeva","year":"2023","journal-title":"Bull Exp Biol Med"},{"key":"10.1016\/j.smrv.2026.102255_bib90","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.sleep.2013.11.779","article-title":"The history of sleep apnea is associated with shorter leukocyte telomere length: the helsinki birth cohort study","volume":"15","author":"Savolainen","year":"2014","journal-title":"Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib91","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.682739","article-title":"The effect of the severity of obstructive sleep apnea on leukocyte telomere length, 25 hydroxy vitamin D, and parathyroid hormonal concentrations in Asian Indians","volume":"12","author":"Bhatt","year":"2021","journal-title":"Front Neurol"},{"key":"10.1016\/j.smrv.2026.102255_bib92","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/geronb\/gbz077","article-title":"Premature aging among trauma survivors-the longitudinal implications of sleep disruptions on telomere length and cognitive performance","volume":"76","author":"Aloni","year":"2021","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"10.1016\/j.smrv.2026.102255_bib93","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12931-015-0205-7","article-title":"Mitochondrial DNA alteration in obstructive sleep apnea","volume":"16","author":"Lacedonia","year":"2015","journal-title":"Respir Res"},{"key":"10.1016\/j.smrv.2026.102255_bib94","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/s42003-019-0605-1","article-title":"Digital phenotyping by consumer wearables identifies sleep-associated markers of cardiovascular disease risk and biological aging","volume":"2","author":"Teo","year":"2019","journal-title":"Commun Biol"},{"key":"10.1016\/j.smrv.2026.102255_bib95","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsz139","article-title":"Delayed sleep-onset and biological age: late sleep-onset is associated with shorter telomere length","volume":"42","author":"Wynchank","year":"2019","journal-title":"Sleep"},{"key":"10.1016\/j.smrv.2026.102255_bib96","doi-asserted-by":"crossref","first-page":"3275","DOI":"10.1007\/s11255-023-03693-z","article-title":"Improving sleep quality is essential for enhancing soluble Klotho levels in hemodialysis patients","volume":"55","author":"Topal","year":"2023","journal-title":"Int Urol Nephrol"},{"key":"10.1016\/j.smrv.2026.102255_bib97","series-title":"Statistical power analysis for the behavioral sciences","author":"Cohen","year":"1988"},{"key":"10.1016\/j.smrv.2026.102255_bib98","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s13148-025-01860-w","article-title":"Sleep disturbances, shift work, and epigenetic ageing in working-age adults: findings from the Young Finns study","volume":"17","author":"Autio","year":"2025","journal-title":"Clin Epigenet"},{"key":"10.1016\/j.smrv.2026.102255_bib99","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.sleep.2017.09.034","article-title":"The association between obstructive sleep apnea and shortened telomere length: a systematic review and meta-analysis","volume":"48","author":"Huang","year":"2018","journal-title":"Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib100","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2025.1294105","article-title":"Assessment of the causal association between obstructive sleep apnea and telomere length: a bidirectional mendelian randomization study","volume":"16","author":"Xie","year":"2025","journal-title":"Front Genet"},{"key":"10.1016\/j.smrv.2026.102255_bib101","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1513\/AnnalsATS.202309-777OC","article-title":"All obstructive sleep apnea events are not created equal: the relationship between event-related hypoxemia and physiologic response","volume":"21","author":"Hajipour","year":"2024","journal-title":"Ann Am Thorac Soc"},{"key":"10.1016\/j.smrv.2026.102255_bib102","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1093\/gerona\/glab016","article-title":"Associations of age, sex, race\/ethnicity, and education with 13 epigenetic clocks in a nationally representative U.S. sample: the health and retirement study","volume":"76","author":"Crimmins","year":"2021","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"10.1016\/j.smrv.2026.102255_bib103","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.coemr.2021.03.021","article-title":"Sleep and biological aging: a short review","volume":"18","author":"Carroll","year":"2021","journal-title":"Curr Opin Endocr Metab Res"},{"key":"10.1016\/j.smrv.2026.102255_bib104","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s40520-022-02310-w","article-title":"The impact of insomnia on frailty and the hallmarks of aging","volume":"35","author":"Carvalhas-Almeida","year":"2023","journal-title":"Aging Clin Exp Res"},{"key":"10.1016\/j.smrv.2026.102255_bib105","doi-asserted-by":"crossref","DOI":"10.1016\/j.smrv.2025.102073","article-title":"The association between sleep quality and telomere attrition: a systematic review and meta-analysis comprising 400,212 participants","volume":"80","author":"Fostitsch","year":"2025","journal-title":"Sleep Med Rev"},{"key":"10.1016\/j.smrv.2026.102255_bib106","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.sleep.2024.02.043","article-title":"The association of sleep duration and leukocyte telomere length in middle-aged and young-old adults: a cross-sectional study of UK Biobank","volume":"117","author":"Zhang","year":"2024","journal-title":"Sleep Med"},{"key":"10.1016\/j.smrv.2026.102255_bib107","doi-asserted-by":"crossref","first-page":"6247","DOI":"10.1038\/s41598-024-56316-7","article-title":"Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study","volume":"14","author":"You","year":"2024","journal-title":"Sci Rep"},{"key":"10.1016\/j.smrv.2026.102255_bib108","doi-asserted-by":"crossref","first-page":"7439","DOI":"10.1038\/s41598-024-84957-1","article-title":"Sleep traits causally affect epigenetic age acceleration: a Mendelian randomization study","volume":"15","author":"Zhao","year":"2025","journal-title":"Sci Rep"},{"key":"10.1016\/j.smrv.2026.102255_bib109","article-title":"The association between sleep quality and telomere length: a systematic literature review","volume":"28","author":"Sabot","year":"2023","journal-title":"Brain Behav Immun Health"},{"key":"10.1016\/j.smrv.2026.102255_bib110","doi-asserted-by":"crossref","DOI":"10.1088\/1752-7155\/10\/2\/026005","article-title":"Study of mitochondrial DNA alteration in the exhaled breath condensate of patients affected by obstructive lung diseases","volume":"10","author":"Carpagnano","year":"2016","journal-title":"J Breath Res"},{"key":"10.1016\/j.smrv.2026.102255_bib111","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1038\/s41591-018-0092-9","article-title":"Senolytics improve physical function and increase lifespan in old age","volume":"24","author":"Xu","year":"2018","journal-title":"Nat Med"}],"container-title":["Sleep Medicine Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1087079226000274?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1087079226000274?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:57:34Z","timestamp":1791421054000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1087079226000274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":108,"alternative-id":["S1087079226000274"],"URL":"https:\/\/doi.org\/10.1016\/j.smrv.2026.102255","relation":{},"ISSN":["1087-0792"],"issn-type":[{"value":"1087-0792","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Circulating markers of biological aging associated with obstructive sleep apnea or insomnia in adults: A systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"Sleep Medicine Reviews","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.smrv.2026.102255","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"102255"}}