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Our objective was to assess white matter properties in newly diagnosed and untreated adults with mild to severe OSA. Sixty\u2010five adults aged 55 to 85 were recruited and divided into three groups: control (apnea\u2010hypopnea index \u22645\/hr; <jats:italic>n<\/jats:italic> = 18; 65.2\u2009\u00b1\u20097.2\u2009years old), mild (&gt;5 to \u226415 hr; <jats:italic>n<\/jats:italic> = 27; 64.2\u2009\u00b1\u20095.3\u2009years old) and moderate to severe OSA (&gt;15\/hr; <jats:italic>n<\/jats:italic> = 20; 65.2\u2009\u00b1\u20095.5\u2009years old). Diffusion tensor imaging metrics (fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity, and mean diffusivity) were compared between groups with Tract\u2010Based Spatial Statistics within the white matter skeleton created by the technique. Groups were also compared for white matter hyperintensities volume and the free\u2010water (FW) fraction. Compared with controls, mild OSA participants showed widespread areas of lower diffusivity (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05 corrected) and lower FW fraction (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Participants with moderate to severe OSA showed lower AD in the corpus callosum compared with controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05 corrected). No between\u2010group differences were observed for FA or white matter hyperintensities. Lower white matter diffusivity metrics is especially marked in mild OSA, suggesting that even the milder form may lead to detrimental outcomes. In moderate to severe OSA, competing pathological responses might have led to partial normalization of diffusion metrics.<\/jats:p>","DOI":"10.1002\/hbm.24971","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T08:58:04Z","timestamp":1584089884000},"page":"2686-2701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Cerebral white matter diffusion properties and free\u2010water with obstructive sleep apnea severity in older adults"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9710-5348","authenticated-orcid":false,"given":"Andr\u00e9e\u2010Ann","family":"Baril","sequence":"first","affiliation":[{"name":"Research Centre H\u00f4pital du Sacr\u00e9\u2010Coeur de Montr\u00e9al  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Faculty of Medicine Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"The Framingham Heart Study 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