Perspective:

Obstructive sleep apnea (OSA) is an underdiagnosed condition characterized by recurrent episodes of obstruction of the upper airway, leading to sleep disturbances and intermittent hypoxia during sleep. There is consistent evidence from animal models and clinical studies suggesting that OSA augments metabolic, inflammatory, autonomic, vascular, and cardiac dysfunction of obesity, and exacerbates the metabolic syndrome. Several cohort studies have consistently shown that OSA is associated with increased cardiovascular mortality, independent of obesity. Recognition and treatment of OSA may decrease the cardiovascular risk in obese patients. Based on available evidence, there is an urgent need for more OSA screening in patients with obesity and the metabolic syndrome in a cost-effective way. There is also a need for large randomized clinical studies to define the impact of OSA treatment on metabolic and cardiovascular outcome.