TNF and inflammatory response: 30,31 OSA is linked to vascular inflammation and the activation of endothelial cell adhesion molecules (CAMs), particularly through TNFα signaling pathways.32 ICAM-1, VCAM-1, and E-selectin levels correlates with BMI of OSA patients and E-selectin is independently associated with the apnea-hypopnea index.33 Furthermore the relationship between OSA and systemic inflammation is well acknowledged in humans and short neck dogs, notably through alterations in the levels of VEGF-A and CCL2.34–36