Abstract: Nonalcoholic fatty liver disease (NAFLD) has become a major health issue in western countries in parallel with the dramatic
increase in the prevalence of obesity and all obesity related conditions, including respiratory diseases as obstructive sleep apneahypopnea
syndrome (OSAHS). Interestingly, the severity of the liver damage in obesity-relatedNAFLD has been associatedwith the
concomitant presence of OSAHS. In the presence of obesity, the proinflammatory state in these patients together with intermittent
episodes of hypoxia, characteristic of OSAHS pathogenesis,may lead to an enhanced inflammatory response mediated by a positive
feedback loop mechanism that implicates HIF-1 and NF????.Thus, the severity of liver involvement in obese NAFLD patients with a
concomitant diagnosis of OSAHS could be explained. In this review, we focus on the molecularmechanisms underlying the hepatic
response to chronic intermittent hypoxia and its interaction with innate immunity in obesity-related NAFLD.