CPAP Treatment in the Coexistence of Obstructive Sleep Apnea Syndrome and Metabolic Syndrome, Results of One Year Follow up (Continuous Positive Airway Pressure) (Clinical Report‪)‬

INTRODUCTION OSAS has been independently associated with an increased prevalence of MS (1). MS can be closely linked to a generalized metabolic disorder called insulin resistance in which the normal actions of insulin are impaired. Excess body fat (particularly abdominal obesity) and physical inactivity promote the development of insulin resistance, but some individuals also are genetically predisposed to insulin resistance (2). Increased insulin resistance seems to play a key role in developing other metabolic abnormalities (3). Hyperinsulinemia raises blood pressure (4) and, furthermore, in the insulin resistance syndrome, the main pathophysiology may probably be a dissociation of intermediate metabolic effects of insulin and its growth-promoting effects, especially at the vascular epithelium (5). The presence of increased insulin resistance has repeatedly been reported in patients with OSAS (6,7). Nocturnal hypoxemia due to repeated apneas, hypopneas and microarousals throughout the night in patients with OSAS leads to an increase in sympathetic activation (8). It has been suggested that increased sympathetic activation could mediate development of insulin resistance (3). Also insulin resistance causes development of other components of metabolic syndrome via impairing vascular reactivity and leading dislipidemia (9).