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Introduction Metabolic Syndrome (MetS), defined by central obesity, hypertension, dyslipidemia, and hyperglycemia, is closely linked to disrupted sleep architecture and disorders such as Obstructive Sleep Apnea (OSA). Shared risk factors establish a bidirectional relationship between MetS and sleep disturbances, with their coexistence further impairing lung function and sleep quality. This study aimed to assess the impact of MetS on pulmonary function and sleep parameters in OSA patients.Material and Methods This cross-sectional study involved 38 clinically diagnosed OSA patients from AIIMS, New Delhi, stratified by the presence of Metabolic Syndrome (MetS) as per standard criteria Dynamic and static lung volumes were assessed using whole-body plethysmography following ERS guidelines. Sleep parameters were derived from overnight polysomnography.Results Demographic profile and sleep parameters of both the goups (table 1) and Dynamic and static lung volumes (table 2) are tabulated.AHI showed a significant negative correlation with HDL (r = –0.3176, p = 0.0430) and a positive correlation with waist circumference (r = 0.3993, p = 0.0097). CMI was inversely correlated with TLC% (r = –0.3566, p = 0.0303). Desaturation during sleep correlated negatively with FVC% (r = –0.3505, p = 0.0310) and positively with AHI (r = 0.3432, p = 0.0349) and HbA1c (r = 0.3521, p = 0.0302).Conclusion Patients with OSA and coexisting MetS showed significantly reduced lung volumes, with greater oxygen desaturation indicating worsened respiratory compromise. Correlations of AHI with HDL and waist circumference, and of CMI with TLC%, highlight the roles of dyslipidemia and visceral obesity in OSA severity. Desaturation was linked to lower FVC%, higher AHI, and elevated HbA1c, suggesting associations with impaired lung function, disease severity, and poor glycemic control. These findings indicate that MetS exacerbates pulmonary dysfunction in OSA via metabolic, mechanical, and inflammatory pathways affecting sleep quality and lung function.Abstract P49 Table 1Demographic profile and sleep parameters in OSA Patients with and without MetSAbstract P49 Table 2Static and dynamic lung functionv parameters in OSA patients with and without MetS