Review

Sleep and Breathing

, Volume 18, Issue 1, pp 13-18

Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism

  • Ajibola Monsur AdedayoAffiliated withDepartment of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center
  • , Oladipupo OlafiranyeAffiliated withDepartment of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center Email author 
  • , David SmithAffiliated withPrimary Care Internal Medicine, Yale University School of Medicine
  • , Alethea HillAffiliated withAdult Health Nursing Department, University of South Alabama
  • , Ferdinand ZiziAffiliated withDepartment of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center
  • , Clinton BrownAffiliated withDepartment of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center
  • , Girardin Jean-LouisAffiliated withDepartment of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities CenterDepartment of Medicine, SUNY Downstate Medical Center, Sleep Disorders Center

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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.

Keywords

Obstructive sleep apnea Chronic intermittent hypoxia (CIH) Dyslipidemia Cardiovascular risks