Obstructive Sleep Apnea and Its Place in the Cardiovascular-Kidney-Metabolic Syndrome Continuum

Obstructive sleep apnea (OSA) is a common yet underdiagnosed condition strongly linked to the cardiovascular-kidney-metabolic (CKM) syndrome continuum, a systemic disorder characterized by interconnected metabolic, renal, and cardiovascular abnormalities. Despite overlapping risk factors, particularly obesity, current CKM staging does not formally include OSA as a potential modifier of CKM progression from early stages. Here, we conducted a narrative review revealing that OSA shares demographic and biological substrates with CKM syndrome, independently associates with cardiovascular, metabolic, and renal dysfunction through multiple shared mechanisms, and responds to intervention, including lifestyle changes, positive airway pressure, and pharmacotherapy. Integrating systematic OSA screening and management into CKM assessment, especially at early stages, may enhance risk stratification and enable personalized preventive care. This approach shows potential in mitigating disease progression and improving quality of life across the CKM spectrum. These findings support recognizing OSA as an important factor in CKM progression and highlight the potential benefits of its early identification to mitigate disease burden and improve patient outcomes.