An overview: Obstructive Sleep Apnea and the Metabolic Syndrome: Should “X” be changed to “Zzz…Zzzz….Zzzzzzzzz….Zzz”?

SummaryObstructive sleep apnea (OSA) is now increasingly being linked as risk factor for cardiovascular disorders and Type 2 diabetes mellitus (T2DM). Although the older reports were open to criticism on the grounds of methodology as well as ignoring the presence of confounding elements, recent studies have shown evidence of an association although there is a need for further long term studies. Whether this is an independent association through a distinct mechanism or through its relationship with the cluster of risk factors associated with the metabolic syndrome, remains to be proven. Some investigators have asked that the OSA be included as an integral part of the metabolic syndrome. This article looks at some of the evidence investigating the relationship between obstructive sleep apnea and the metabolic syndrome. Whilst it would seem premature to change “X” to “Z” it is essential that all physicians rule out co-existent modifiable risk factors in subjects presenting with OSA. The converse is also true and all patients with the presence of all or any of the major risk factors associated with the metabolic syndrome should be investigated, and optimally managed, for the presence of OSA.