Introduction: Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with many risk factors, but its pathophysiology is still not fully understood. Iron overload in brain regions isa hallmark of many neurodegenerative processes

Objectives: The aim of this study is to evaluate iron deposition in the brain of the patients with OSAHS.

Methods: All participants underwent a multi-recording sleep study and a brain magnetic resonance imaging (MRI) including: pre- and post-contrast T1-weighted, T2-weighted, FLAIR, and SWI at 3T

Results: The study involved 26 patients with moderate to severe OSAHS [mean age 57.54±13.176 years (61.5% male)] and 34 healthy volunteers [mean age 57.59±10.79 years (58.8% men)]. MRIs showed that iron deposits in the brainstem were present in 65.4% of patients and 11.8% of the control group respectively (p<0.001), in the globus pallidus in 73.1% of patients and 11.8% of the control group (p<0.001), in the cerebellum in 46.2% of the patients and 8.8% of the control group (p<0.001) and in the temporal lobe in 30.8% of the patients andnone of the healthy volunteers (p<0.001). Furthermore, none of the patients and healthy controls had iron depositionsin the frontal, parietal and occipital lobe. OSAHS patients had a significantly higher degree of total brain iron deposition compared to the control group (p<0.001).

Conclusions: Our study revealed a statistically significant association of OSAHS with increased iron deposition in the brain. The correlation of OSAHS with increased iron deposition in the brainstem needs further research as it plays an important role in breathing control.