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Background: Circulating nuclear factor-κB (NF-κB)–dependent genes, particularly tumor necrosis factor-α (TNF-α), are elevated in obstructive sleep apnea syndrome (OSAS) and likely contribute to cardiovascular disease. Furthermore, TNF-α is associated with excessive daytime sleepiness. We investigated the predictors of TNF-α and related genes in large, well-selected cohorts of subjects with OSAS and control subjects.

Methods: We performed a prospective study of 30 subjects who did not have OSAS (22 nonsleepy normal control subjects and 8 sleepy nonapneic subjects who snored), 36 subjects with mild to moderate OSAS, and 31 subjects with severe OSAS; all subjects were male. Groups were matched for age, body mass index, and other relevant variables. Subjects had no other disease and were not regularly taking medication. All had serum for TNF-α and related assays drawn after polysomnography. A …