OBJECTIVES~Main objective: To assess if six months of treatment with CPAP, associated with conventional treatment, improves the lipid profile of patients with dyslipidemia and mild-moderate apnea-hypopnea syndrome (OSA).~Secondary objectives:~Determine the additional effect of CPAP on insulin resistance and dyslipidemia in patients with mild-moderate OSA.~Assess the impact of CPAP treatment in reducing cardiovascular risk in patients with dyslipidemia and mild-moderate OSA.~Analyze the impact of supplemental CPAP treatment on glycemic control and the concentration of hsCRP in patients with dyslipidemia and mild-moderate OSA.~Establish the impact of supplemental CPAP treatment on quality of life related to health of patients with dyslipidemia and mild-moderate OSA.~Evaluate the effect of CPAP on inflammatory cytokines, oxidative stress biomarkers, sympathetic tone and regulating hormones intake in patients with dyslipidemia and mild-moderate OSA.~Correlate CPAP induced changes in lipid levels with the changes produced in the basal inflammatory response, oxidative stress, sympathetic activity and intake regulating hormones.~Compare the effect of CPAP with promotion of daily physical activity on lipid profile in patients with dyslipidemia and mild-moderate OSA.~Identify the subgroup of patients with uncontrolled dyslipidemia and mild-moderate OSA in wich six months of treatment with CPAP achieve a more pronounced reduction in blood lipids.~DESIGN Randomized, parallel group, non-blind, controlled clinical trial with conventional treatment.~STUDY POPULATION 35-75 year old subjects, diagnosed with dyslipidemia in last six months and in stable treatment during the last month with diet, cholesterol lowering drug, and cholesterol LDL levels> 100 mg / dl in the last two successive visits clinics.~Sample size. 38 patients who completed the test in each treatment arm.~TREATMENT~Patients will be randomized to one of the following treatment arms form:~hygiene and dietary recommendations.~lifestyle intervention (more strict and promotion of daily physical activity and dietary control).~Treatment with positive airway pressure (CPAP).~ENDPOINTS Efficacy endpoints.~Primary endpoint: LDL-cholesterol.~Total cholesterol, HDL-cholesterol, triglycerides and C-reactive protein high sensitivity (hsCRP).~Systemic Biomarkers: inflammatory (IL-6, IL-8 and TNF-α), oxidative stress (8-isoprostane), endothelial damage (endothelin, VCAM-1 and ICAM-1), sympathetic activity (neuropeptide Y) and appetite-regulating hormones (leptin, orexin A / hypocretin-1 and ghrelin).~Fasting glucose, glycated hemoglobin (HbA1c), fasting insulin and HOMA and QUICKI indexes, TSH.~Clinical questionnaires: SF-12, EuroQoL, FOSQ and IPAQ.~Security endpoints.~Notification of clinical adverse events.~Compliance with CPAP (average hours use per day).~Epworth Sleepiness Questionnaire.~Development of cardiovascular events.~STATISTICAL PROCEDURES Data will be expressed as mean ± standard deviation, median (interquartile range) or percent, depending on type and distribution. For comparison between groups, or t-Student test, or the Mann-Whitney U-test or chi-square test will be used, as appropriate. The relationships between variables will be analyzed by Pearson correlation and multiple linear regression.~The treatment effect will be evaluated by analysis of variance for repeated measures with post-hoc multiple comparisons, using the Bonferroni test. A model of multiple logistic regression will be applied to determine the variables associated with treatment response. P values will be considered statistically significant <0.05.
OBJECTIVES Main objective: To assess if six months of treatment with CPAP, associated with conventional treatment, improves the lipid profile of patients with dyslipidemia and mild-moderate apnea-hypopnea syndrome (OSA).~Secondary objectives:~Determine the additional effect of CPAP on insulin resistance and dyslipidemia in patients with mild-moderate OSA.~Assess the impact of CPAP treatment in reducing cardiovascular risk in patients with dyslipidemia and mild-moderate OSA.~DESIGN Randomized, parallel group, non-blind, controlled clinical trial with conventional treatment.~STUDY POPULATION 35-75 year old subjects, diagnosed with dyslipidemia in last six months and in stable treatment during the last month with diet, cholesterol lowering drug, and cholesterol LDL levels> 100 mg / dl in the last two successive visits clinics.~Sample size. 38 patients who completed the test in each treatment arm.~TREATMENT~Patients will be randomized to one of the following treatment arms form:~hygiene and dietary recommendations.~lifestyle intervention (more strict and promotion of daily physical activity and dietary control).~Treatment with positive airway pressure (CPAP).~ENDPOINTS:~Efficacy endpoints.~Primary endpoint: LDL-cholesterol.~Total cholesterol, HDL-cholesterol, triglycerides and C-reactive protein high sensitivity (hsCRP).~Systemic Biomarkers: inflammatory (IL-6, IL-8 and tumor necrosis factor (TNF)-α), oxidative stress (8-isoprostane), endothelial damage (endothelin, vascular cell adhesion molecule 1 (VCAM-1) and Intercellular Adhesion Molecule 1 (ICAM-1)), sympathetic activity (neuropeptide Y) and appetite-regulating hormones (leptin, orexin A / hypocretin-1 and ghrelin).~Fasting glucose, glycated hemoglobin (HbA1c), fasting insulin and Homeostasis Model Assessment (HOMA) index and quantitative insulin sensitivity check index (QUICKI), thyroid-stimulating hormone (TSH).~Clinical questionnaires: short-form (SF)-12, EuroQoL, Functional Outcomes of Sleep Questionnaire (FOSQ) and International physical activity questionnaire (IPAQ).~Security endpoints.~Notification of clinical adverse events.~Compliance with CPAP (average hours use per day).~Epworth Sleepiness Questionnaire.~Development of cardiovascular events.