The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Is there a threshold that triggers cortical arousals in obstructive sleep apnea
Open accessAbstract
STUDY OBJECTIVES: To determine whether there is a consistent epiglottic pressure value that predicts respiratory arousal from sleep. METHODS: Thirty-one patients with obstructive sleep apnea underwent overnight polysomnography while instrumented with an epiglottic catheter to measure airway pressures. Nadir epiglottic pressures during respiration events (obstructive apneas/hypopneas) terminated with or without arousals were compared. The events were selected by two methods, (1) 20 events with/without arousals were randomly selected, and (2) Events were sampled in pairs (one terminated with arousal and one without arousal) to minimize the effect of sleep duration/stage on the measurement. RESULTS: A total of 1,317 respiratory events were analyzed. There was substantial variability in nadir epiglottic pressure within an individual and among different individuals. The average pressure of 20 randomly selected events with arousals was (-21.2 ± 11.2, ranged -6.68 to -63.34 cm H2O). The nadir epiglottic pressure during respiratory events in NREM stage 2 sleep terminated with arousals was more negative compared with those terminated without arousals using both sampling methods (-23.5 vs. -18.5 cm H2O, p = 0.007 and -20.3 vs. -16.3 cm H2O, p < 0.001). CONCLUSIONS: There were very different levels of epiglottic pressures that preceded arousals within and among individuals. However, cortical arousals are associated with a level of more negative epiglottic pressure compared to events terminated without arousal, findings which support the concept of a respiratory arousal threshold. CLINICAL TRIAL REGISTRATION: The study used existing data to study methodology (from clinical trial "The Impact of Arousal Threshold in Obstructive Sleep Apnea" https://clinicaltrials.gov/show/NCT02264353) and it is not a clinical trial.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some data suggest that a low arousal threshold may be a risk factor for failure of upper airway surgery to achieve a surgical cure.
“Some data suggest that a low arousal threshold may be a risk factor for failure of UA surgery to achieve a surgical cure.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [416]
The Introduction (page unavailable) says a low arousal threshold might predispose patients to repetitive apnea rather than stable breathing. That supports the proposed physiological risk, but the paper does not address whether a low threshold predicts failure of upper-airway surgery to achieve a cure. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201303-0448oc · Cited by 1,173
Self-citationRole of Arousals in the Pathogenesis of Obstructive Sleep Apnea
Younes, M. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200307-1023oc · Cited by 456 · cited 1×
“On the other hand, recurrent arousals lead to sleep fragmentation, daytime symptoms, autonomic activation, and impairment in memory consolidation [15].”
BackgroundThe Influence of Increasing Ventilatory Effort on Arousal from Sleep
Gleeson, K., Zwillich, C. W., & White, D. P. (1990) · American Review of Respiratory Disease · doi:10.1164/ajrccm/142.2.295 · Cited by 411
Eckert, D. J., Owens, R. L., Kehlmann, G. B., Wellman, A., Rahangdale, S., Yim-Yeh, S., White, D. P., & Malhotra, A. (2011) · Clinical Science · doi:10.1042/cs20100588 · Cited by 367
Self-citationArousal from sleep: implications for obstructive sleep apnea pathogenesis and treatment
Eckert, D. J., & Younes, M. K. (2013) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00649.2013 · Cited by 328
Clinical Predictors of the Respiratory Arousal Threshold in Patients with Obstructive Sleep Apnea
Edwards, B. A., Eckert, D. J., McSharry, D. G., Sands, S. A., Desai, A., Kehlmann, G., Bakker, J. P., Genta, P. R., Owens, R. L., White, D. P., et al. (2014) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201404-0718oc · Cited by 312
Self-citationRespiratory Arousal From Sleep: Mechanisms and Significance
Berry, R. B., & Gleeson, K. (1997) · Sleep · doi:10.1093/sleep/20.8.654 · Cited by 308
Sands, S. A., Edwards, B. A., Terrill, P. I., Taranto-Montemurro, L., Azarbarzin, A., Marques, M., Hess, L. B., White, D. P., & Wellman, A. (2018) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201707-1435oc · Cited by 291
Self-citationA Genetically Defined Circuit for Arousal from Sleep during Hypercapnia
Kaur, S., Wang, J., Ferrari, L. L., Thankachan, S., Kroeger, D., Venner, A., Lazarus, M., Wellman, A., Arrigoni, E., Fuller, P. M., et al. (2017) · Neuron · doi:10.1016/j.neuron.2017.10.009 · Cited by 158
Eckert, D. J., Malhotra, A., Wellman, A., & White, D. P. (2014) · SLEEP · doi:10.5665/sleep.3596 · Cited by 154
Self-citationArousal Intensity is a Distinct Pathophysiological Trait in Obstructive Sleep Apnea
Amatoury, J., Azarbarzin, A., Younes, M. K., Jordan, A. S., Wellman, A., & Eckert, D. J. (2016) · SLEEP · doi:10.5665/sleep.6304 · Cited by 105
Termination of Respiratory Events with and without Cortical Arousal in Obstructive Sleep Apnea
Jordan, A. S., Eckert, D. J., Wellman, A., Trinder, J. A., Malhotra, A., & White, D. P. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201106-0975oc · Cited by 99
Self-citationEffect of Ethanol on the Arousal Response to Airway Occlusion during Sleep in Normal Subjects
Berry, R. B., Bonnet, M. H., & Light, R. W. (1992) · American Review of Respiratory Disease · doi:10.1164/ajrccm/145.2_pt_1.445 · Cited by 99
Younes, M. K., Loewen, A. H. S., Ostrowski, M., Laprairie, J., Maturino, F., & Hanly, P. J. (2011) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00312.2011 · Cited by 85
Ratnavadivel, R., Stadler, D. L., Windler, S., Bradley, J., Paul, D., McEvoy, R. D., & CATCHESIDE, P. G. (2009) · Thorax · doi:10.1136/thx.2008.112953 · Cited by 70
Arousal Responses during Overnight Polysomnography and their Reproducibility in Healthy Young Adults
Azarbarzin, A., Ostrowski, M., Younes, M. K., Keenan, B. T., Pack, A. I., Staley, B. A., & Kuna, S. T. (2015) · SLEEP · doi:10.5665/sleep.4916 · Cited by 47
Neural Respiratory Drive and Arousal in Patients with Obstructive Sleep Apnea Hypopnea
Xiao, S., Wu, Y., He, B., Steier, J. S., Moxham, J., Polkey, M. I., & Luo, Y. (2014) · European Respiratory Journal · doi:10.1183/13993003/erj.44.suppl_58.232 · Cited by 26
Flagged first, then by citations
Cited by
Sorted by citations
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Self-citation
Metadata
- Authors
- Li, Y., Orr, J., Jen, R., Sands, S. A., DeYoung, P., Smales, E., Edwards, B., Owens, R. L., & Malhotra, A.
- Affiliations
- Beijing Tongren Hospital (CN)
- University of California San Diego (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Malhotra, Atul
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-02-22
- Volume
- 42
- Issue
- 6
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC6559175
- OpenAlex
- W2916853473
- Semantic Scholar
- 39ed378a547737289000ecaac9d3387246fdfa2d
- Cited by
- 14
- References
- 17
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 2
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (R01 HL085188, K24 HL132105)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, cortical arousal, arousal threshold, airway pressure, sleep-disordered breathing
- MeSH terms
- Adult, Arousal, Epiglottis, Female, Humans, Male, Middle Aged, Respiration, Sleep Stages, Polysomnography, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
