Obstructive sleep apnea and metabolic dysfunction in polycystic ovary syndrome

Obstructive sleep apnea (USA) is an underrecognized, yet significant factor in the pathogenesis of metabolic derangements in polycystic ovary syndrome (PCOS). Recent findings suggest that there may be two subtypes of PCOS, i.e. PCOS with or without USA, and these two subtypes may be associated with distinct metabolic and endocrine alterations. PCOS women with USA may be at much higher risk for diabetes and cardiovascular disease than PCOS women without USA and may benefit from therapeutic interventions targeted to decrease the severity of USA. The present chapter will review what is currently known about the roles of sex steroids and adiposity in the pathogenesis of USA, briefly review the metabolic consequences of USA as well as the metabolic abnormalities associated with PCOS, review the prevalence of USA in PCOS and finally present early findings regarding the impact of treatment of USA on metabolic measures in PCOS. (C) 2010 Elsevier Ltd. All rights reserved.