Background: Sleep-related breathing disorders, particularly obstructive sleep apnea (OSA), pose significant challenges in anesthesia practice. Understanding the relationship between OSA and anesthesia is crucial for ensuring safe perioperative management. Objectives: review the latest updates about obstructive sleep apnea, and how it affects the field of anesthesia as a crucial coexisting disease. furthermore, how to establish peri-operative strategies to manage OSA cases. Conclusions: Effective perioperative management of OSA patients requires a multidisciplinary approach, including collaboration between anesthesia providers, sleep specialists, and other healthcare professionals. Preoperative screening and evaluation, careful selection of anesthetic techniques and agents, and the implementation of non-pharmacological interventions such as continuous positive airway pressure (CPAP) therapy are essential. Future research should focus on precision medicine approaches, biomarkers, predictive models, novel monitoring technologies, and standardized protocols to further optimize perioperative care for OSA patients. By addressing these challenges and advancing knowledge, anesthesia practice can enhance the safety and outcomes of OSA patients undergoing surgery.