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Urinary Metabolomic Profiling in Obstructive Sleep Apnoea Hypopnoea Syndrome.
Scott O'Rourke1, Tina Kramaric2, Andrine Vangberg2
1Department of Respiratory Medicine, Prince Philip Hospital, Hywel Dda University Health Board, Llanelli, UK.
Journal of Sleep Research
|February 2, 2026
Summary
Urinary metabolomics can diagnose obstructive sleep apnea hypopnea syndrome (OSAHS) and monitor treatment. A specific metabolite, octadecanamide, distinguishes OSAHS patients, while CPAP therapy alters other metabolite levels.
Area of Science:
- Metabolomics
- Sleep Medicine
- Biomarker Discovery
Background:
- Obstructive sleep apnea hypopnea syndrome (OSAHS) is linked to cardiometabolic risks.
- Current diagnostic methods for OSAHS can be invasive or lack specificity.
- Identifying reliable biomarkers for OSAHS diagnosis and monitoring is crucial.
Purpose of the Study:
- To investigate the urinary metabolome in OSAHS patients.
- To identify urinary biomarkers differentiating OSAHS from non-OSAHS individuals.
- To assess the impact of continuous positive airway pressure (CPAP) therapy on urinary metabolites.
Main Methods:
- Observational, prospective, longitudinal study of 70 patients.
- OSAHS diagnosis based on apnea-hypopnea index and Epworth Sleepiness Score.
- Untargeted urinary metabolomic profiling using high-throughput flow-infusion electrospray high-resolution mass spectrometry (FIE-MS).
Main Results:
- A panel of metabolites, including glycerophospholipids, acylcarnitines, and fatty acids, was identified.
- Octadecanamide accurately differentiated OSAHS from non-OSAHS (accuracy 0.86).
- CPAP treatment significantly reduced metabolite levels, notably 2-anilino-6-cyclohexylmethoxypurine (AUC 0.93).
Conclusions:
- Urinary metabolomics provides a non-invasive method for OSAHS diagnosis and monitoring.
- Metabolite profiles reflect pathways of chronic intermittent hypoxia, oxidative stress, and inflammation.
- These biomarkers may help identify patients at increased cardiometabolic risk and guide personalized treatments.
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