{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T09:00:44Z","timestamp":1770627644572,"version":"3.49.0"},"reference-count":42,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Evi-Diethelm-Winteler-Foundation"},{"name":"Swiss National Science Foundation"},{"name":"Human Frontiers Science Program"},{"name":"Z\u00fcrich Exhalomics flagship project of the Z\u00fcrich University Hospital"},{"name":"Heidi-Ras-Foundation"},{"name":"Zurich Exhalomics project"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The direct pathophysiological effects of obstructive sleep apnea (OSA) have been well described. However, the systemic and metabolic consequences of OSA are less well understood. The aim of this secondary analysis was to translate recent findings in healthy subjects on vigilance-state-dependent metabolism into the context of OSA patients and answer the question of how symptomatic OSA influences metabolism and whether these changes might explain metabolic and cardiovascular consequences of OSA. Patients with suspected OSA were assigned according to their oxygen desaturation index (ODI) and Epworth Sleepiness Scale (ESS) score into symptomatic OSA and controls. Vigilance-state-dependent breath metabolites assessed by high-resolution mass spectrometry were used to test for a difference in both groups. In total, 44 patients were eligible, of whom 18 (40.9%) were assigned to the symptomatic OSA group. Symptomatic OSA patients with a median [25%, 75% quartiles] ODI of 40.5 [35.0, 58.8] events\/h and an ESS of 14.0 [11.2, 15.8] showed moderate to strong evidence for differences in 18 vigilance-state-dependent breath compounds compared to controls. These identified metabolites are part of major metabolic pathways in carbohydrate, amino acid, and lipid metabolism. Thus, beyond hypoxia per se, we hypothesize that disturbed sleep in OSA patients persists as disturbed sleep-dependent metabolite levels during daytime.<\/jats:p>","DOI":"10.3390\/ijms232214052","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T02:28:04Z","timestamp":1668479284000},"page":"14052","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Severe Obstructive Sleep Apnea Disrupts Vigilance-State-Dependent Metabolism"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9878-1551","authenticated-orcid":false,"given":"Felix","family":"Schmidt","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9017-6143","authenticated-orcid":false,"given":"Thomas","family":"Gaisl","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Malesevic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Streckenbach","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriane A.","family":"Sievi","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-981X","authenticated-orcid":false,"given":"Esther I.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Zenobi","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology and Toxicology, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm","family":"Kohler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Zurich Centre for Integrative Human Physiology, University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,14]]},"reference":[{"key":"ref_1","unstructured":"Berry, R., Quan, S., and Abreu, A. 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