Conde, Silvia V.V Conde, SilviaPolotsky, Vsevolod Y.Joseph, VincentKinkead, Richard2023-05-042023-05-042023-12-150022-3751PURE: 59750000PURE UUID: 9b8e070c-f66f-480c-9c59-4f51c794ed32Scopus: 85153213864PubMed: 36988138http://hdl.handle.net/10362/152438Funding Information: R.K.’s contribution to this text was supported by operating grants from the Canadian Institutes of Health Research. V.P. is supported by the National Institutes of Health grants R01HL133100, R01HL128970, R41HL167326, and R61HL156240. Publisher Copyright: © 2023 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.Sleep disordered breathing (SDB) is a complex, sex specific and highly heterogeneous group of respiratory disorders. Nevertheless, sleep fragmentation and repeated fluctuations of arterial blood gases for several hours per night are at the core of the problem; together, they impose significant stress to the organism with deleterious consequences on physical and mental health. SDB increases the risk of obesity, diabetes, depression and anxiety disorders; however, the same health issues are risk factors for SDB. So, which came first, the chicken or the egg? What causes the appearance of the first significant apnoeic events during sleep? These are important questions because although moderate to severe SDB affects ∼500 million adults globally, we still have a poor understanding of the origins of the disease, and the main treatments (and animal models) focus on the symptoms rather than the cause. Because obesity, metabolic dysfunction and stress-related neurological disorders generally appear progressively, we discuss how the development of these diseases can lead to specific anatomical and non-anatomical traits of SDB in males and females while considering the impacts of sex steroids. In light of the growing evidence indicating that the carotid bodies are important sensors of key metabolic and endocrine signals associated with stress and dysmetabolism, we propose that these organs play a key role in the process. (Figure presented.).1845389engcontrol of breathingdiabeteshypoxialeptinobesitysexual dimorphismstressPhysiologySDG 3 - Good Health and Well-beingreview10.1113/JP284113https://www.scopus.com/pages/publications/85153213864