We have recently demonstrated that circulating exosomes from patients suffering from the obesity hypoventilation syndrome (OHS), the most severe form of OSA, or from mice exposed to either long-term IH or SF, promote reduced insulin sensitivity in naïve adipocytes in vitro, and that the exosome cargo biological effects are attenuated when exosomes are obtained after adherent and effective treatment with continuous positive pressure ventilation (CPAP) [11]. Here, INS is linked to obstructive sleep apnea syndrome.