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 StatesOne risk factor for CVD is metabolic syndrome, which encompasses obesity, hypertension, insulin resistance, proinflammatory state, and prothrombotic stateA 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 systemData sources: Search terms "metabolic syndrome,""obstructive sleep apnea,""cardiovascular disease,""diabetes,""obesity," and "atherosclerosis," were usedStudies involving children were excludedConclusions: 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 multipliedTreatment with continuous positive airway pressure (CPAP) reduces the global burden of CVD riskImplications for practice: Providers need to screen patients routinely for both metabolic syndrome and OSAHSTreatment should include CPAP, weight reduction, oral appliances, and/or upper airway surgeries with concurrent management for metabolic syndromeFuture research should further elucidate the mechanisms of action by which OSAHA and metabolic syndrome contribute to CVDThis understanding can lead to more stringent guidelines on the management of metabolic syndrome and OSAHS