0669 Oxidative Stress in Hypersomnia Patients: Correlation with Sleep Onset REM Period

Abstract Introduction Glutathione is the most abundant cell antioxidants. The ratio of reduced and oxidized glutathione (GSH, GSSG) has been used as a marker for oxidative stress and reduced glutathione levels contributes to the onset and progression of many diseases. In sleep research field, oxidative stress has been studied mostly in sleep apnea syndrome and sleep deprivation but not in hypersomnia. Since GSSG is one of the sleep promoting substances, we hypothesized that oxidative stress contributed to the pathophysiology of hypersomnia and examined the relationship between glutathione and sleep variables in sleepy subjects. Methods Participants were patients visiting outpatient clinic for sleep disorders in Koishikawa Tokyo Hospital, Institute of Neuropsychiatry and underwent diagnostic PSG-MSLT from June 2020 to Nov 2023. Written informed consents were obtained. We selected 280 patients (25.6±9.3 years old, f/m=148/132) without medication at sleep study and slept more than 5.5 hours during nocturnal PSG. Fasting blood samples were collected at 7am before MSLT and RBC fraction were stored at -80 degree until use. RBC were deproteinized with perchloric acid and supernatant after centrifugation was measured by HPLC-ECD with boron-doped diamond electrode. GSH proportion of the total glutathione [GSH/(GSH+GSSG)] were calculated and correlation with sleep variables and ESS score were investigated. To adjust possible confounders, regression analyses were performed using Logit transformed GSH proportion as objective variable. Results We found that GSH proportion showed negative correlation with age (P<.001) and sex differences (lower in female). We also found that GSH proportion showed positive correlation with presence/absence of SOREMP on MSLT(P=.007) and negative correlation with ESS score (P=.046). Correlation with SOREMP remained significant after adjusting the HLA -DQB1*06:02 status. Conclusion Our data showed that those with higher oxidative stress have higher ESS score and those without SOREMP on MSLT showed higher oxidative stress. Subgroup analysis showed that those without SOREMP and HLA-DQB1*06:02 have higher oxidative stress compared to others. SOREMP on MSLT is a diagnostic marker for Narcolepsy type 1 but SOREMP can be observed in general population. Our data could provide biochemical basis for the occurrence SOREMP. Support (if any)