Pulak Kumar Dey, Md. Touhidul Islam Khan, Md. S.M.Lutfor Rahman,Md. Zakir Hossain Sarker, Md. Abdus Shakur Khan, Md. Abdur Rouf,Mohammed Shahedur Rahman Khan, Bashir Ahmed, Md. Khairul Anam,Md. Abu Raihan, Md.Ali Hossain

Abstract:
Background & objective: Obstructive sleep apnea (OSA) is characterized by
recurrent episodes of partial or complete upper airway obstruction during sleep and
is manifested as a reduction (hypopnea) or cessation (apnea) of airflow with ongoing
respiratory effort and are associated with frequent disruptions of sleep. It has immense
importance in terms of its complications like obesity, hypertension, insulin resistance,
altered lipid profile leading to metabolic syndrome (MS). The present study was
undertaken to find the association between metabolic syndrome and OSA.
Patients & Methods: This case-control analytical study was conducted on 84
consecutive subjects. Of them 54 were cases (excessive day-time somnolence not
explained by any other factors with at least any two of the symptoms like choking/
gasping during sleep, recurrent awakening from sleep, unrefreshing sleep, daytime
fatigue, or impaired concentration) and 30 were controls. Metabolic syndrome
was diagnosed based on WHO criteria. In polysomnographic study if AHI was
found < 5 no OSA was considered, AHI 5-15 was mild,15-30 was moderate and
AHI >30 was regarded as severe type of OSA.
Result: More than three-quarters (77.6%) of metabolic syndromes (MS) were
observed to be associated with OSA compared to 11.5% of the subjects who had
not metabolic syndrome. The severity of MS increased sharply with types of
OSA, 85% with moderate type while 96% cases of severe OSA had metabolic
syndrome. Among 4 variables (Age, sex, obesity and OSA which were found
significantly associated with MS in univariate analysis), age of the subjects and
OSA were observed to be the independent predictors of MS in multivariate
analyses. The older subjects (50 years and more) were 2.6 (95% CI = 1.3 – 4.1)
times more prone to have MS than their younger counterparts (p = 0.021). Likewise
the subjects having OSA was 7.4(95% CI = 2.3 – 20.9) times more likely to have
MS than the subjects without OSA (p < 0.001).
Conclusion: Obstructive sleep apnoea is associated with metabolic syndrome
and should be treated early to prevent its complications.
Key words: OSA, Metabolic syndrome, Polysomnography, CPAP, BMI.

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