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However, relationships between OSA and ketone body metabolism require further investigation. Thus, in this study, we investigated relationships between breath acetone levels and OSA manifestations (e.g., hypoxia and arousal events).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline characteristics were collected from 66 eligible participants, and breath acetone levels were measured before and after polysomnography (PSG). Participants were categorized into two groups using the apnea-hypopnea index (AHI): normal-to-mild (&lt;\u200915 events\/h) and moderate-to-severe (\u2265\u200915 events\/h) OSA groups. Differences in baseline characteristics, PSG parameters, and breath acetone levels between the two groups were analyzed. Next, correlations analyses and multivariable regression models adjusted for baseline characteristics were performed to examine relationships between alterations in breath acetone levels and various sleep parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were observed between the two groups in baseline characteristics, sleep quality indices and the overnight difference in acetone levels (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Additionally, the overnight difference in acetone levels exhibited significant negative correlations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) with the AHI, arousal index (ArI), and snoring index. In regression models adjusted for confounding factors, this overnight acetone difference remained significantly and negatively associated with both AHI and ArI values (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present observations provide insight into potential links between overnight breath acetone alterations and OSA manifestations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-025-04021-0","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:49:28Z","timestamp":1764226168000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Associations between breath acetone overnight dynamics and obstructive sleep apnea manifestations"],"prefix":"10.1186","volume":"25","author":[{"given":"Yen-Hao","family":"Su","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Jung","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Te","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Chien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Ying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnab","family":"Majumdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiunn-Horng","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang-Yun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Hao","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chun","family":"Kuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Chien","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Ling","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Yu","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"issue":"8","key":"4021_CR1","doi-asserted-by":"publisher","first-page":"e1000132","DOI":"10.1371\/journal.pmed.1000132","volume":"6","author":"NM Punjabi","year":"2009","unstructured":"Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O\u2019Connor GT, et al. 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