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Sleep disturbances have been associated with individual components of the metabolic syndrome ("syndrome X"), and, although the concept has been proposed, it is not known whether sleep disturbances actually cluster with features of the metabolic syndrome to produce a unifying trait, "syndrome Z". Therefore, we evaluated a second-order factor model, whereby syndrome Z was described by 5 first-order factors--insulin resistance, obesity, hypertension, dyslipidemia, and sleep disturbance--with the sleep disturbance factor defined using the apnea-hypopnea index, arousal index, percentage of sleep time with oxygen saturation less than 90%, and percentage of slow wave sleep.

Empirical Evidence for “Syndrome Z”: A Hierarchical 5-Factor Model of the Metabolic Syndrome Incorporating Sleep Disturbance Measures