TNF and obesity due to melanocortin 4 receptor deficiency: The development of OSAS may be influenced by fat deposits in the upper airway and the area around the thoracic cavity.[38] Furthermore, elevated visceral adipose tissue may secrete inflammatory cytokines including TNF-α, IL-6, and IL-1, which might interfere with sleep-wake cycles.[39,40] The 2 most researched cytokines linked to obesity are TNF-a and IL-6, which are found in higher concentrations in the adipose tissue and serum of obese individuals.[41] Research has demonstrated heightened somnolence in obese participants without sleep disorders.