FOXM1 and obstructive sleep apnea syndrome: These findings verified that exosomal miR-320b, once taken up by cardiomyocytes, can inhibit cardiomyocyte survival and proliferation by downregulating FOXM1, suggesting that miR-320b downregulation in plasma exosomes of severe OSA patients without cardiac complications may serve as a compensatory mechanism to preserve cardiomyocyte viability in response to OSA-induced cardiac stress.