In this issue of CHEST (see page 829), Schäfer and colleagues report on a consecutive sample of men who had been referred for suspected sleep apnea-hypopnea syndrome (SAHS) and were subjected to overnight polysomnography, anthropomorphic measurements reflecting obesity and body fat distribution, and blood testing for various cardiovascular risk factors as well as the measurement of serum leptin levels. They found significant associations between apnea-hypopnea index (AHI) and the following: body weight, body mass index (BMI), the sum of fat skin folds, and the percentage of body fat; levels of fasting blood glucose, uric acid, and fibrinogen; and leptin levels. The correlation of AHI with leptin levels disappeared when it was corrected for collinearities with indexes of obesity. The authors found no correlation between AHI and hypertension, smoking, age, and dyslipidemia. These data comprise the latest contribution to an expanding literature relating sleep-disordered breathing with the so-called metabolic syndrome, a constellation of obesity and metabolic abnormalities that are associated with increased cardiovascular morbidity. This increasing body of evidence suggests that the metabolic syndrome may be a “final common pathway” linking SAHS with vascular disease.