{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:18Z","timestamp":1786969578948,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004386","name":"Universiti Malaya Research Excellence","doi-asserted-by":"publisher","award":["UMREG066-2024"],"award-info":[{"award-number":["UMREG066-2024"]}],"id":[{"id":"10.13039\/501100004386","id-type":"DOI","asserted-by":"publisher"}]},{"award":["UMREG066-2024"],"award-info":[{"award-number":["UMREG066-2024"]}],"id":[{"id":"https:\/\/ror.org\/00rzspn62","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clocks &amp; Sleep"],"abstract":"<jats:p>Obstructive sleep apnea (OSA) is associated with renin\u2013angiotensin\u2013aldosterone system (RAAS) dysregulation. This study examined the relationship between salivary aldosterone and OSA severity, identified predictors of salivary aldosterone, evaluated the moderating role of mean arterial pressure (MAP), and compared the diagnostic performance of salivary aldosterone with the STOP-BANG questionnaire. This cross-sectional study included 67 adults grouped as healthy or mild OSA (apnea\u2013hypopnea index [AHI] &lt; 15; n = 34) versus moderate-to-severe OSA (AHI \u2265 15; n = 33). Morning salivary aldosterone was measured using enzyme-linked immunosorbent assay. Generalized linear models assessed independent predictors, MAP moderation was tested using PROCESS Model 1, and diagnostic performance was evaluated using receiver operating characteristic analysis. Salivary aldosterone did not differ between OSA severity groups and showed poor diagnostic performance. Age was negatively associated with aldosterone levels, while MAP moderated the relationship between AHI and salivary aldosterone. In contrast, the STOP-BANG questionnaire demonstrated acceptable discriminative ability and significantly higher specificity. Salivary aldosterone is not a reliable standalone OSA screening biomarker. However, MAP moderated the OSA\u2013aldosterone relationship, suggesting potential utility in OSA patients with elevated MAP. Age independently predicted lower aldosterone, likely reflecting age-related RAAS decline. These findings support selective utility of salivary aldosterone in OSA patients with elevated blood pressure.<\/jats:p>","DOI":"10.3390\/clockssleep8030047","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:00:05Z","timestamp":1786964405000},"page":"47","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Salivary Aldosterone as a Biomarker for Obstructive Sleep Apnea: Diagnostic Performance and the Moderating Role of Mean Arterial Pressure\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4439-4881","authenticated-orcid":false,"given":"Ziyuan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Paediatric and Special Care Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5896-2753","authenticated-orcid":false,"given":"May Nak","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Paediatric and Special Care Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9659-2095","authenticated-orcid":false,"given":"Tengku Nurfarhana Nadirah","family":"Tengku Hamzah","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Paediatric and Special Care Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9587-447X","authenticated-orcid":false,"given":"Aida Nur Ashikin","family":"Abd Rahman","sequence":"additional","affiliation":[{"name":"Centre for Paediatric Dentistry & Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3059-7253","authenticated-orcid":false,"given":"Liang Chye","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0188-0727","authenticated-orcid":false,"given":"Mang Chek","family":"Wey","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Paediatric and Special Care Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","unstructured":"Iber, C., Ancoli-Israel, S., Chesson, A., and Quan, S.F. 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