Obstructive sleep apnea hypopnea syndrome and metabolic syndrome: a synergistic cardiovascular risk factor.

PURPOSE: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. One risk factor for CVD is metabolic syndrome, which encompasses obesity, hypertension, insulin resistance, proinflammatory state, and prothrombotic state. A lesser-understood risk factor is obstructive sleep apnea hypopnea syndrome (OSAHS). This article explores the physiological consequences of the interaction between OSAHS and metabolic syndrome on the cardiovascular system.

DATA SOURCES: Search terms "metabolic syndrome,"obstructive sleep apnea,"cardiovascular disease,"diabetes,"obesity," and "atherosclerosis," were used. Studies involving children were excluded.

CONCLUSIONS: Both metabolic syndrome and OSAHS have significant impact on the cardiovascular system; however, when both conditions are present together, the impact is synergistic and CVD risk is multiplied. Treatment with continuous positive airway pressure (CPAP) reduces the global burden of CVD risk.

IMPLICATIONS FOR PRACTICE: Providers need to screen patients routinely for both metabolic syndrome and OSAHS. Treatment should include CPAP, weight reduction, oral appliances, and/or upper airway surgeries with concurrent management for metabolic syndrome. Future research should further elucidate the mechanisms of action by which OSAHA and metabolic syndrome contribute to CVD. This understanding can lead to more stringent guidelines on the management of metabolic syndrome and OSAHS.