This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital, Taiwan (Certificate number: 201802210B0). The participants were recruited from the sleep center and health examination center of Kaohsiung Chang Gung Memorial Hospital from July 2018 through June 2022. The informed consent was obtained from each subject participating in the study. The adults (aged 20–70 years) who were diagnosed as subject with PS (defined as apnea–hypopnea index (AHI) < 5) or OSA (defined as AHI ≥ 5) after the full night polysomnographic studies in our sleep laboratory were included. The exclusion criteria were ongoing infections, autoimmune disease, use of immunosuppressive agent in the past 6 months, narcolepsy, severe obesity (body mass index [BMI] ≥ 35 kg/m2), and those with a BMI < 21 kg/m2. The patients with OSA and PS were further divided into two subgroups according to EDS (Epworth sleepiness scale (ESS) of more than 10), cognitive dysfunction (Mail-In Cognitive Function Screening Instrument (MCFSI) scale of more than 4), depression (defined as at least 1 of the 2 core symptoms of low mood and loss of interest, or taking antidepressant medication at Psychiatric Clinic), or the presence of subjective daytime fatigue, subjective memory impairment, morning headache, or nocturia (> 2 events/night).
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