Obstructive sleep apnoea (OSA) is characterized by repetitive interruptions of breathing, causing
Chronic Intermittent Hypoxia (CIH) that can be involved in the development and progression of cardiovascular
diseases. There is evidence showing a close relationship between OSA and atherosclerosis,
even in patients who do not show co-morbidities such as hypertension, diabetes, high levels of lowdensity
lipoprotein cholesterol (LDL-C), cigarette smoking and obesity, which can activate the endothelium.
This endothelium activation due to CIH and specific to OSA seems to be dependent on a different
pathway. The current first line therapy for OSA is the application of the continuous positive airway pressure
(CPAP), but it alone is not enough to reduce cardiometabolic risk in patients with OSA. In contrast,
statins, via their pleiotropic property, might be able to change inflammation and early atherosclerosis,
lipid profile and cardiovascular outcomes in OSA. The role of statins in OSA patients with or without any
co-morbidities could potentially prevent coronary vascular risk and stroke and in the future, represent an
additional treatment option along with CPAP therapy. Strengthening the prevention strategies against
atherosclerosis in OSA should be one of the focal aims for healthcare programs of the future.