The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Quantifying the ventilatory control contribution to sleep apnoea using polysomnography
Open accessAbstract
Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain. Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide. Our method quantified loop gain from baseline polysomnography (correlation versus CPAP-estimated loop gain: n=28; r=0.63, p<0.001), detected the known reduction in loop gain with oxygen (n=11; mean±sem change in loop gain (ΔLG) −0.23±0.08, p=0.02) and acetazolamide (n=11; ΔLG −0.20±0.06, p=0.005), and predicted the OSA response to loop gain-lowering therapy. We validated a means to quantify the ventilatory control contribution to OSA pathogenesis using clinical polysomnography, enabling identification of likely responders to therapies targeting ventilatory control.
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“It may be possible to quantify loop gain directly from inlab or home sleep studies.369–371”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [371]
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Cites
McNicholas, W. T., Strohl, K. P., White, D. P., Levy, P. A., Schmidt, W., Wheatley, J. R., Redline, S. S., Carley, D. W., Buysse, D. J., Young, T. B., et al. (1999) · PubMed · Cited by 3,665
Self-citationAdherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment
Weaver, T. E., & Grunstein, R. R. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200708-119mg · Cited by 1,680
Upper-Airway Stimulation for Obstructive Sleep Apnea
Strollo, P. J., Soose, R. J., Maurer, J. T., de Vries, N., Cornelius, J., Froymovich, O., Hanson, R. D., Padhya, T. A., Steward, D. L., Gillespie, M. B., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1308659 · Cited by 1,299
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-citationUpper-Airway Stimulation for Obstructive Sleep Apnea
Strollo, P. J., Soose, R. J., Maurer, J. T., de Vries, N., Cornelius, J. R., Froymovich, O., Hanson, R. D., Padhya, T. A., Steward, D. L., Gillespie, M. B., et al. (2014) · Survey of Anesthesiology · doi:10.1097/sa.0000000000000069 · Cited by 461
Chemical Control Stability in Patients with Obstructive Sleep Apnea
YOUNES, M., OSTROWSKI, M., THOMPSON, W., LESLIE, C., & SHEWCHUK, W. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.5.2007013 · Cited by 439
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-citationVentilatory Control and Airway Anatomy in Obstructive Sleep Apnea
Wellman, A., Jordan, A. S., Malhotra, A., Fogel, R., Katz, E. S., Schory, K., EDWARDS, J. K., & White, D. P. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200404-510oc · Cited by 317
Self-citationEdwards, B. A., Sands, S. A., Eckert, D. J., White, D. P., Butler, J. P., Owens, R. L., Malhotra, A., & Wellman, A. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2011.223925 · Cited by 298
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Phenotypic approaches to obstructive sleep apnoea – New pathways for targeted therapy
Eckert, D. J. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.12.003 · Cited by 545
Self-citationObstructive sleep apnea: Current perspectives
Osman, A. M., Carter, S. G., Carberry, J. C., & Eckert, D. J. (2018) · Nature and Science of Sleep · doi:10.2147/nss.s124657 · Cited by 441
Self-citationPhenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches
Zinchuk, A. V., Gentry, M. J., Concato, J., & Yaggi, H. K. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.10.002 · Cited by 350
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-citationSands, 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
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Metadata
- Authors
- Terrill, P. I., Edwards, B. A., Nemati, S., Butler, J. P., Owens, R. L., Eckert, D. J., White, D. P., Malhotra, A., Wellman, A., & Sands, S. A.
- Affiliations
- Brigham and Women's Hospital (US)
- University of Southern California (US)
- ORCID
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2014-10-16
- Volume
- 45
- Issue
- 2
- Pages
- 408-418
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- PMC
- PMC4348093
- OpenAlex
- W2147045852
- Cited by
- 289
- References
- 41
- Citations by year
- 2026: 27 · 2025: 34 · 2024: 29 · 2023: 42 · 2022: 23 · 2021: 20 · 2020: 22 · 2019: 21 · 2018: 23 · 2017: 18 · 2016: 22 · 2015: 8
- FWCI
- 10.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- American Heart Association
- Brigham and Women's Hospital
- National Institutes of Health (1r01hl090897-01a2, 1k24hl093218-01a1)
- Medical Research Council
- National Health and Medical Research Council (1064163, 1035115, 1053201, 1049814)
- National Heart, Lung, and Blood Institute (R01-HL090897, P01HL095491, K24 HL-093218, R01HL085188, 1R01HL090897-01A2, 1K24HL093218-01A1, R01HL048531)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- obstructive sleep apnea, ventilation control, loop gain, respiratory drive, polysomnography, arousal, oxygen therapy, acetazolamide, treatment response prediction
- MeSH terms
- Acetazolamide, Adult, Computer Simulation, Female, Humans, Male, Middle Aged, Models, Theoretical, Oscillometry, Oxygen, Patient Compliance, Phenotype, Respiration, Retrospective Studies, Sleep, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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