ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1648807
This article is part of the Research TopicThe Advance on Sleep Disorder: Mechanisms and InterventionsView all 11 articles
Elevated remnant cholesterol impairs sleep characteristics in individuals with newly diagnosed moderate-to-severe obstructive sleep apnea: a crosssectional case-control study
Provisionally accepted
- Affiliated Nanhua Hospital, University of South China, Hengyang, China
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Background: Although obstructive sleep apnea (OSA) is widely recognized as a common contributor to disruptions in sleep and lipid metabolism, there is still a lack of concrete evidence to substantiate this correlation. Remnant cholesterol (RC) is increasingly being acknowledged as a lipid-related risk factor for many diseases; however, its role in sleep remains uncertain.We aimed to assess whether RC is associated with OSA disease events and to determine the impact of RC on sleep parameters.This cross-sectional case-control study recruited141patients recently diagnosed with moderate-to-severe OSA (based on overnight polysomnography) and 47 healthy participants who served as controls. We performed a PSG assessment and collected sleep parameters and biochemical, demographic, and clinical data.Results: Compared to controls (19.1%), patients with OSA exhibited a significantly higher prevalence of elevated RC (36.1%). Patients with OSA had higher serum RC levels than controls (0.37 (0.19-0.56) vs 0.45 (0.255-0.78) mmol/L; P = 0.013). Compared to patients with OSA without elevated serum RC, those with high RC levels exhibited statistically significant differences in wake frequency; the percentage time in non-rapid eye movement stage 1 (NREM1, N1), N2%, and N3 sleep; Apnea-Hypopnea Index (AHI); Oxygen Desaturation Index (ODI); Breathing-related arousal index. (BAI); and average SpO2. Pearson correlation analysis showed that the serum RC concentration in patients with OSA was positively correlated with wake frequency, percentage time in N1, AHI, ODI, and BAI, whereas it was negatively correlated with percentage time in N2 and N3 and mean nocturnal oxygen saturation.For the first time, we found that elevated RC levels are highly prevalent and significantly associated with impaired sleep architecture and respiratory parameters in patients with newly diagnosed OSA. Therefore, serum RC assessment should be included in the workup for the diagnosis of OSA.
Keywords: obstructive sleep apnea, Remnant cholesterol, apnea-hypopnea index, Oxygen desaturation index, Polysomnography
Received: 17 Jun 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Yanling, Fengying, Ping and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhang Ping, Affiliated Nanhua Hospital, University of South China, Hengyang, China
Chen Li, Affiliated Nanhua Hospital, University of South China, Hengyang, China
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