Obstructive sleep apnea is a chronic condition characterized by recurrent episodes of apneas or hypopneas during sleep leading to intermittent hypoxemia and arousals. The prevalence of the sleep disordered breathing is estimated that almost 50% of men and 24% of women suffer from moderate to severe form of the disorder. Snoring, collapse of upper airways and intermittent hypoxia are main causes of smoldering systemic inflammation in patients suffering from obstructive sleep apnea. The systematic inflammation is considered one of the key mechanisms leading to significant cardiovascular complications. Blood platelets, formerly not even recognized as cells, are currently gaining attention as crucial players in the immune continuum. Platelet surface is endowed with receptors characteristic for cells classically belonging to the immune system, which enables them to recognize pathogens, immune complexes, and interact in a homo- and heterotypic aggregates. Platelets participate in the process of transcellular production of bioactive lipids by delivering both specific enzymes and substrate molecules. Despite their lack of nucleus, platelets synthetize proteins in a stimuli-dependent manner. Atherosclerosis and consequent cardiovascular complications result from disruption in homeostasis of both of the platelet roles: blood coagulation and inflammatory processes modulation. Platelet parameters, routinely evaluated as a part of complete blood count test, were proposed as markers of cardiovascular comorbidity in patients with obstructive sleep apnea. Platelets were found to be excessively activated in this group of patients, especially in obese subjects. Persistent activation results in enhanced spontaneous aggregability and change in cytokine production. Platelet-lymphocyte ratio was suggested as an independent marker for cardiovascular disease in obstructive sleep apnea syndrome and continuous positive air pressure therapy was found to have an impact on platelet parameters and phenotype. In this literature review we summarize the current knowledge on the subject of platelets involvement in obstructive sleep apnea syndrome and consider the possible pathways in which they contribute to cardiovascular comorbidity.

To provide an overview of the mechanistic and epidemiologic evidence linking sleep-related exposures, such as short sleep duration, obstructive sleep apnea, shift work, and insomnia, with type 2 diabetes risk in adults.

Collapsibility of the upper airway has a known anatomical basis that is mediated by an interaction of obesity and craniofacial abnormalities. The pattern of these abnormalities, if detected in a subject's facial image, can help predict the presence of obstructive sleep apnea (OSA). 
 We utilized facial photographs (front and profile) from 376 patients who had undergone an overnight polysomnogram to identify those with and without OSA. 
 Processing the images had 3 steps: landmark identification, feature generation, and automatic classification. Firstly, we used unaligned landmarks and investigated the impact of manually and automatically determined landmarks on the performance of the classification algorithms. Using a feature set calculated from manually determined landmarks ("constrained features") we obtained 67.0% accuracy in identifying OSA (AHI>10) and using automatically determined landmarks we obtained 65.5% accuracy for OSA. Secondly, we aligned the facial landmark coordinates by using an image registration technique utilising linear transformations. Directly using the aligned landmark coordinates ('unconstrained features') by the classification stage as the new feature set resulted in an accuracy of 69.7% in OSA detection using manually determined landmarks and 69.2% using automatically determined landmarks. The performance of our fully automatic system using the unconstrained feature set is comparable to other published systems requiring a manual landmarking process. In conclusion, we demonstrate the feasibility of using automatic landmarking as well as unconstrained features in the successful prediction of OSA using facial landmarks.&#13.

The association between idiopathic intracranial hypertension (IIH) and obstructive sleep apnea syndrome (OSAS) constitutes an interesting point of discussion regarding clinical approaches as well as the underlying pathophysiological mechanisms. Here, the case of a 42-year-old female with malignant IIH and OSAS is illustrated. Initially, the patient was treated with lumboperitoneal shunt surgery. However, OSAS surgery provided total recovery from the recurrent symptoms developing secondary to lumboperitoneal shunt malfunction. The authors point out the importance of identifying OSAS as a crucial causative agent in some IIH subtypes. Future studies are warranted to clarify this underestimated association.

Cardiovascular disease (CVD) is a negative health outcome of Obstructive Sleep Apnoea (OSA). Risk factors associated with OSA development include low physical activity (PA), high body mass index (BMI), and increasing age (>50 years) and weight loss is usually recommended as treatment. This cross-sectional study examined the association between PA, BMI and OSA severity in manual workers. Fifty-five participants, (23 females, 32 males) mean age 55.2, were examined for OSA and completed a PA and anthropometric assessment. On average, OSA severity was mild, PA levels were moderate and 32% of the sample was classified as obese. PA was negatively associated with OSA severity, but BMI strongly independently predicted OSA severity, with no evidence of mediation. As both PA and BMI were significantly associated with OSA in older manual workers, increasing PA should also be a focus of treatment for OSA.