TNF and obstructive sleep apnea syndrome: In individuals with OSA, the episodes of oxygen desaturation and arousals1 involve synergistic processes, including sympathetic activation, oxidative stress, and systemic infammation, with higher serum levels of catecholamines and proatherogenic mediators, such as interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP)1,4,5,6.