Obstructive sleep apnea is linked to inflammatory changes and motor impairment in Parkinson's disease

Obstructive sleep apnea (OSA) is prevalent among patients with Parkinson's disease (PD), yet its contribution to neuroinflammation and disease progression remains poorly understood. This study investigated the association between OSA severity, sleep parameters, and systemic cytokine/chemokine profiles in PD.

In this cross-sectional study, 48 patients underwent clinical evaluation, polysomnography (PSG), and multiplex cytokine profiling. Participants were classified as PD+OSA⁺ or PD+OSA^- based on PSG, with additional stratification by OSA severity. Multivariate and network analyzes were applied to identify inflammatory signatures.

OSA was diagnosed in 54.2% of PD patients and was associated with older age, poorer quality of life, and higher UPDRS-II/III scores (p < 0.05). The PD+OSA⁺ group exhibited reduced REM sleep, increased arousals, and higher oxygen desaturation indices. Cytokine analysis revealed that moderate-to-severe OSA was associated with a mixed Th1/Th2 inflammatory axis involving IL-6, TNF-α, IFN-γ, IL-13, CCL2, CXCL1, and IL-4, while mild OSA was associated with innate activation and chemotaxis (IL-1β, IL-18, CXCL10, GM-CSF). Network modeling demonstrated dense cytokine connectivity in PD+OSA⁺, suggesting systemic immune reorganization driven by intermittent hypoxia.

OSA is a prevalent disorder in PD, affecting over half of the patients, and is linked to sleep fragmentation and a proinflammatory environment driven by Th1/Th2 and chemokine signaling, which may contribute to worsening motor and non-motor symptoms.