Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism

Abstract

Introduction Over the past half century, evidence has been accumulating on the emergence of obstructive sleep apnea (OSA), the most prevalent sleep-disordered breathing, as a major risk factor for cardiovascular disease. A significant body of research has been focused on elucidating the complex interplay between OSA and cardiovascular risk factors, including dyslipidemia, obesity, hypertension, and diabetes mellitus that portend increased morbidity and mortality in susceptible individuals. Conclusion Although a clear causal relationship of OSA and dyslipidemia is yet to be demonstrated, there is increasing evidence that chronic intermittent hypoxia, a major component of OSA, is independently associated and possibly the root cause of the dyslipidemia via the generation of stearoyl-coenzyme A desaturase-1 and reactive oxygen species, peroxidation of lipids, and sympathetic system dysfunction. The aim of this review is to highlight the relationship between OSA and dyslipidemia in the development of atherosclerosis and present the pathophysiologic mechanisms linking its association to clinical disease. Issues relating to epidemiology, confounding factors, significant gaps in research and future directions are also discussed.

Dyslipidemia: another brick in the wall. A feasible link in the OSA–cardiovascular disease axis

“…In this issue of Sleep and Breathing, Adedayo and colleagues present a review paper describing the possible links between OSA and dyslipidemia [7]. Several review and original papers has been published to elucidate the underlying mechanism between OSA and metabolic syndrome/dyslipidemia (PubMed indicates 208 references!…”

Obstructive sleep apnea and dyslipidemia: pathophysiological mechanisms

“…1 of our paper [2]. However, the point is noted that OSA may be independently associated with insulin resistance and type-2 diabetes as well.…”

“…Dear Editor, We read with great interest the letter to the editor entitled "Obstructive sleep apnea and dyslipidemia: importance of the liver axis" [1] in response to our recent paper addressing dyslipidemia in obstructive sleep apnea (OSA) [2]. The authors emphasized the importance of the liver axis in the pathogenesis of OSA-induced dyslipidemia and referenced the theoretical possibility of the liver as a potential target for intervention.…”

“…Of note, we discussed multiple pathways including activation of the sympathetic autonomic nervous system that have been proposed for OSA-induced dyslipidemia [2], but most importantly, we emphasized that a direct cause and effect relationship is yet to be established. Therefore, there is a need for more studies to precisely define the relationship between OSA and dyslipidemia and determine potential targets for intervention.…”

Predictors of Obstructive Sleep Apnea Risk among Blacks with Metabolic Syndrome

“…Obstructive sleep apnea (OSA) is characterized by recurring sleep disruptions, intermittent hypercapnia and hypoxia, resulting in increased sympathetic nerve activity, oxidative stress and hemodynamic changes [1,2]. Oxidative stress has been shown to reduce vasodilatation and increase platelet adhesion, leading to metabolic dysfunction, systemic inflammation, and hypercoagulation [3].…”