Obstructive Sleep Apnea (OSA) and Sex-Specific Responses to N-acetylcysteine (NAC)

Eligibility Criteria

• * Apnea-hypopnea index ≥15 events/hr on portable sleep monitoring
• * HbA1c \<6.5%
• * Body mass index (BMI) ≥40 kg/m2;
• * Diagnosis of diabetes mellitus, defined as the use of any diabetes medication (including glucagon like peptide \[GLP\]-1 agonists) currently or in the previous three months or HbA1c ≥6.5%;
• * Shift work (i.e., working hours that routinely cause sleep initiation after 1:00 a.m.);
• * Another major sleep disorder (i.e., circadian rhythm disorder, any history of narcolepsy, concurrently diagnosed or medication-treated restless legs syndrome, concurrently diagnosed or medication-treated chronic insomnia with the exception of antidepressant therapy);
• * Regular use (more than twice/week) of an opioid/narcotic, benzodiazepine, or prescription sleep medication other than antidepressants currently or within the last month;
• * The use of N-acetylcysteine in any form (oral, intravenous, inhaled) in the last seven days
• * The use of other over-the-counter antioxidant therapies including vitamin C or vitamin E in the preceding 10 days
• * History of reduced ejection fraction heart failure, or chronic cardiac arrhythmia requiring medication or treatment;
• * Unstable or uncontrolled medical or psychiatric comorbidity requiring hospitalization or change in medication during the previous three months;
• * Use of biologics or immune modulators in the last year;
• * Use of systemic steroids during the previous three months;
• * Current tobacco smoking;
• * Inability to sign informed consent;
• * Currently use of positive airway pressure therapy or another OSA treatment (e.g., hypoglossal nerve stimulator, oral device);
• * Recent history of alcoholism or drug abuse (within the last three months)
• * Neurological condition that requires ongoing pharmacological therapy (e.g., Parkinson's disease, Alzheimer's dementia, multiple sclerosis, other degenerative neurological disease).
• * Pregnancy