| Abstract: | Introduction: Obstructive Sleep apnea (OSA) is characterized by intermittent hypoxia during sleep, leading to cognitive impairment. Neurofilament light chain (NFL) is a biomarker for brain nerve damage, it's level increased in peripheral blood in neurodegenerative diseases. The increase in NfL has been hypothesized to be related with sleep loss, sleep architecture change, and intermittent hypoxia. Methods: We recruited 18 adult patients with OSA between October 2023 and December 2023. The patients underwent in-laboratory polysomnographic studies, a smart-phone based psychomotor vigilance test (PVT), and blood test for level of NFL. Endotypic traits including arousal threshold, upper airway collapsibility, loop gain, and upper airway muscle compensation, hypoxic burden, apnea and hypopnea duration were generated using polysomnographic signals. We examined the correlation between PVT results and blood NFL level. We further used multivariate linear regression model to examine the association between endotypic traits of OSA with blood NFL level. Results: The study participants had an average apnea-hypopnea index (AHI) 49.3 ± 27.5/h, and NFL 10.5 ± 8.4 pg/mL. We observed a negative relationship between mean reciprocal reaction time in PVT and NFL level (r = _0.79, p < 0.001). After adjustment for age, sex, and body-mass index, AHI was positively associated with NFL level (β = 0.17, 95% confidence interval = 0.04–0.30, p = 0.02). However, endotypic traits were not associated with NFL level. After additional adjustment for AHI, the proportion of slow-wave sleep was negatively associated with NFL level, whereas rapid-eye movement sleep was positively associated with NFL. Conclusions: NFL level is correlated with worse attention performance among OSA patients. Our findings did not observe an association between hypoxic burden of OSA and neurodegeneration biomarker. Instead, slow-wave sleep deprivation is associated with neurodegeneration in OSA patients. |
