{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:11:29Z","timestamp":1790503889198,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate the rate of periodic breathing (PB) and factors associated with the emergence or persistence of PB in patients with\u00a0obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) remote monitoring data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study on 775 patients who had used the same model CPAP machine for at least 1\u00a0year as of September 1, 2020. The data were analyzed online using the dedicated analysis system. Using exporter software, average apnea\/hypopnea index (AHI), average central apnea index (CAI), and average the rate of PB time (PB%) were cited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 618 patients analyzed\u00a0(age 61.7\u2009\u00b1\u200912.2\u00a0years, male 89%, BMI 27.2\u2009\u00b1\u20094.9), the average duration of CPAP use was 7.5\u2009\u00b1\u20094.0\u00a0years. The median PB% in stable patients\u00a0was low at 0.32%, and only 149 patients (24%) had a PB% above 1%. Multiple regression analysis of factors for the development of PB showed that the most important factor was atrial fibrillation (Af) with a coefficient of 0.693 (95% CI; 0.536 to 0.851), followed by QRS duration with a\u00a0coefficient of 0.445 (95% CI; 0.304 to 0.586), followed by history of heart failure, male\u00a0sex, comorbid hypertension, obesity, and age. The average PB% for paroxysmal Af was significantly lower than that for persistent and permanent Af.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The median PB% in stable patients\u00a0on CPAP treatment was low at 0.32%, with only\u00a024% of patients having PB%\u2009\u2265\u20091%. Persistent Af and an increase in QRS duration were found to be important predictors of increased PB%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>UMIN000042555 2021\/01\/01.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-021-02510-0","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T18:06:16Z","timestamp":1634234776000},"page":"1181-1191","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Periodic breathing in patients with stable obstructive sleep apnea on long-term continuous positive airway pressure treatment: a retrospective study using CPAP remote monitoring data"],"prefix":"10.1007","volume":"26","author":[{"given":"Kimimasa","family":"Saito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Takamatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"2510_CR1","unstructured":"Darien IL (2014) International classification of sleep disorders, 3rd edition (ICSD-3) American Academy of Sleep Medicine"},{"key":"2510_CR2","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1056\/NEJMoa1506459","volume":"373","author":"MR Cowie","year":"2015","unstructured":"Cowie MR, Woehrle H, Wegscheider K, Angermann C, d\u2019Ortho MP, Erdmann E, Levy P, Simonds AK, Somers VK, Zannad F, Teschler H (2015) Adaptive servo-ventilation for central sleep apnea in systolic heart failure. N Engl J Med 373:1095\u20131105","journal-title":"N Engl J Med"},{"key":"2510_CR3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.ijcard.2020.03.078","volume":"315","author":"M Gorbachevski","year":"2020","unstructured":"Gorbachevski M, Spiesshoefer J, Arzt M, Oldenburg O, Becker S, Tuleta I, Emdin M, Passino C, Sciarrone P, Boentert M, Giannoni A (2020) Adaptive servo-ventilation therapy does not favourably alter sympatho-vagal balance in sleeping patients with systolic heart failure and central apnoeas: Preliminary data. Int J Cardiol 315:59\u201366","journal-title":"Int J Cardiol"},{"key":"2510_CR4","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1007\/s11325-018-1764-x","volume":"23","author":"J Spiesshoefer","year":"2019","unstructured":"Spiesshoefer J, Spieker M, Klose S, Keymel S, Boentert M, Kr\u00fcger S, Horn P, Kelm M, Westenfeld RP (2019) Reduction of sleep-disordered breathing following effective percutaneous mitral valve repair with the MitraClip system. Sleep Breath 23:815\u2013824","journal-title":"Sleep Breath"},{"issue":"10142","key":"2510_CR5","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/S0140-6736(18)31381-3","volume":"392","author":"M Light","year":"2018","unstructured":"Light M, Orr JE, Malhotra A, Owens RL (2018) Continuous positive airway pressure device detects atrial fibrillation induced central sleep apnoea. Lancet 392(10142):160","journal-title":"Lancet"},{"issue":"6","key":"2510_CR6","doi-asserted-by":"publisher","first-page":"923","DOI":"10.5664\/jcsm.7852","volume":"15","author":"CN Schmickl","year":"2019","unstructured":"Schmickl CN, Heckman E, Owens RL, Thomas RJ (2019) The respiratory signature: a novel concept to leverage continuous positive airway pressure therapy as an early warning system for exacerbations of common diseases such as heart failure. J Clin Sleep Med 15(6):923\u2013927","journal-title":"J Clin Sleep Med"},{"issue":"8","key":"2510_CR7","doi-asserted-by":"publisher","first-page":"e00666","DOI":"10.1002\/rcr2.666","volume":"8","author":"A Prigent","year":"2020","unstructured":"Prigent A, Serandour AL, Luraine R, Poineuf JS, Bosseau C, P\u00e9pin JL (2020) Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP-treated patient. Respirol Case Rep 8(8):e00666","journal-title":"Respirol Case Rep"},{"issue":"4","key":"2510_CR8","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1016\/j.chest.2016.05.022","volume":"150","author":"E Van Ryswyk","year":"2016","unstructured":"Van Ryswyk E, Anderson CS, Antic NA (2016) Opioids and sleep-disordered breathing. Chest 150(4):934\u2013944","journal-title":"Chest"},{"issue":"11","key":"2510_CR9","doi-asserted-by":"publisher","first-page":"2271","DOI":"10.1111\/acer.13217","volume":"40","author":"S Chakravorty","year":"2016","unstructured":"Chakravorty S, Chaudhary NS, Brower KJ (2016) Alcohol dependence and its relationship with insomnia and other sleep disorders. Alcohol Clin Exp Res 40(11):2271\u20132282","journal-title":"Alcohol Clin Exp Res"},{"issue":"12","key":"2510_CR10","doi-asserted-by":"publisher","first-page":"e005899","DOI":"10.1161\/JAHA.116.005899","volume":"6","author":"M Arzt","year":"2017","unstructured":"Arzt M, Oldenburg O, Graml A, Erdmann E, Teschler H, Wegscheider K, Woehrle SA, H, (2017) Phenotyping of sleep-disordered breathing in patients with chronic heart failure with reduced ejection fraction-the SchlaHF registry. J Am Heart Assoc 6(12):e005899. https:\/\/doi.org\/10.1161\/JAHA.116.005899","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"2510_CR11","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.hrtlng.2018.09.003","volume":"48","author":"A Tinoco","year":"2019","unstructured":"Tinoco A, Mortara DW, Hu X, Sandoval CP, Pelter MM (2019) ECG derived Cheyne-Stokes respiration and periodic breathing are associated with cardiorespiratory arrest in intensive care unit patients. Heart Lung 48(2):114\u2013120","journal-title":"Heart Lung"},{"issue":"1","key":"2510_CR12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/S0954-6111(98)90027-0","volume":"92","author":"MM Khalil","year":"1998","unstructured":"Khalil MM, Rifaie OA (1998) Electrocardiographic changes in obstructive sleep apnoea syndrome. Respir Med 92(1):25\u201327","journal-title":"Respir Med"},{"issue":"4","key":"2510_CR13","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1007\/s11325-016-1326-z","volume":"20","author":"Y Kwon","year":"2016","unstructured":"Kwon Y, Picel K, Adabag S, Vo T (2016) Sleep-disordered breathing and daytime cardiac conduction abnormalities on 12-lead electrocardiogram in community-dwelling older men. Sleep Breath 20(4):1161\u20131168","journal-title":"Sleep Breath"},{"issue":"11","key":"2510_CR14","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.5664\/jcsm.3166","volume":"9","author":"SB Montesi","year":"2013","unstructured":"Montesi SB, Bakker JP, Macdonald M et al (2013) Air leak during CPAP titration as a risk factor for central apnea. J Clin Sleep Med 9(11):1187\u20131191","journal-title":"J Clin Sleep Med"},{"issue":"1","key":"2510_CR15","doi-asserted-by":"publisher","first-page":"zsy195","DOI":"10.1093\/sleep\/zsy195","volume":"42","author":"S Javaheri","year":"2019","unstructured":"Javaheri S, McKane SW, Cameron N, Germany RE, Malhotra A (2019) In patients with heart failure the burden of central sleep apnea increases in the late sleep hours. Sleep 42(1):zsy195. https:\/\/doi.org\/10.1093\/sleep\/zsy195","journal-title":"Sleep"},{"issue":"9","key":"2510_CR16","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.5665\/sleep.2960","volume":"36","author":"NR Ward","year":"2013","unstructured":"Ward NR, Roldao V, Cowie MR et al (2013) The effect of respiratory scoring on the diagnosis and classification of sleep disordered breathing in chronic heart failure. Sleep 36(9):1341\u20131348","journal-title":"Sleep"},{"issue":"3","key":"2510_CR17","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1007\/s11325-011-0575-0","volume":"16","author":"T Bitter","year":"2012","unstructured":"Bitter T, Westerheide N, Hossain SM, Prinz C, Horstkotte D, Oldenburg O (2012) Symptoms of sleep apnoea in chronic heart failure\u2013results from a prospective cohort study in 1,500 patients. Sleep Breath 16(3):781\u2013791","journal-title":"Sleep Breath"},{"issue":"4","key":"2510_CR18","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1164\/ajrccm.160.4.9903020","volume":"160","author":"DD Sin","year":"1999","unstructured":"Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD (1999) Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med 160(4):1101\u20131106","journal-title":"Am J Respir Crit Care Med"},{"issue":"7","key":"2510_CR19","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.5665\/sleep.5962","volume":"239","author":"LM Donovan","year":"2016","unstructured":"Donovan LM, Kapur VK (2016) Prevalence and characteristics of central compared to obstructive sleep apnea: analyses from the sleep heart health study cohort. Sleep 239(7):1353\u20131359","journal-title":"Sleep"},{"key":"2510_CR20","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/5584_2018_146","volume":"1067","author":"K Terziyski","year":"2018","unstructured":"Terziyski K, Draganova A (2018) Central sleep apnea with Cheyne-Stokes breathing in heart failure - from research to clinical practice and beyond. Adv Exp Med Biol 1067:327\u2013351","journal-title":"Adv Exp Med Biol"},{"issue":"12","key":"2510_CR21","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1093\/sleep\/28.12.1543","volume":"28","author":"RS Leung","year":"2005","unstructured":"Leung RS, Huber MA, Rogge T, Maimon N, Chiu KL, Bradley TD (2005) Association between atrial fibrillation and central sleep apnea. Sleep 28(12):1543\u20131546","journal-title":"Sleep"},{"key":"2510_CR22","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.ijcard.2019.03.033","volume":"289","author":"A Giannoni","year":"2019","unstructured":"Giannoni A, Raglianti V, Taddei C (2019) Cheyne-Stokes respiration related oscillations in cardiopulmonary hemodynamics in patients with heart failure. Int J Cardiol 289:76\u201382","journal-title":"Int J Cardiol"},{"issue":"1","key":"2510_CR23","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1183\/09031936.02.00214502","volume":"19","author":"G Lorenzi-Filho","year":"2002","unstructured":"Lorenzi-Filho G, Azevedo ER, Parker JD, Bradley TD (2002) Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure. Eur Respir J 19(1):37\u201340","journal-title":"Eur Respir J"},{"issue":"10","key":"2510_CR24","first-page":"164","volume":"106","author":"T Bitter","year":"2009","unstructured":"Bitter T, Langer C, Vogt J, Lange M, Horstkotte D, Oldenburg O (2009) Sleep-disordered breathing in patients with atrial fibrillation and normal systolic left ventricular function. Dtsch Arztebl Int 106(10):164\u2013170","journal-title":"Dtsch Arztebl Int"},{"issue":"7","key":"2510_CR25","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1164\/rccm.201508-1523OC","volume":"193","author":"AM May","year":"2016","unstructured":"May AM, Blackwell T, Stone PH (2016) Central sleep-disordered breathing predicts incident atrial fibrillation in older men. Am J Respir Crit Care Med 193(7):783\u2013791","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"2510_CR26","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1007\/s11325-015-1300-1","volume":"20","author":"T Bitter","year":"2016","unstructured":"Bitter T, Fox H, Schmalgemeier H et al (2016) Acute improvement of pulmonary hemodynamics does not alleviate Cheyne-Stokes respiration in chronic heart failure-a randomized, controlled, double-blind, crossover trial. Sleep Breath 20(2):795\u2013804","journal-title":"Sleep Breath"},{"issue":"2","key":"2510_CR27","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1046\/j.1365-2869.2003.00343.x","volume":"12","author":"M Christ","year":"2003","unstructured":"Christ M, Grimm W, Rostig S et al (2003) Association of right ventricular dysfunction and Cheyne-Stokes respiration in patients with chronic heart failure. J Sleep Res 12(2):161\u2013167","journal-title":"J Sleep Res"},{"issue":"1","key":"2510_CR28","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.jacc.2004.03.040","volume":"44","author":"AM Sinha","year":"2004","unstructured":"Sinha AM, Skobel EC, Breithardt OA (2004) Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure. J Am Coll Cardiol 44(1):68\u201371","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"2510_CR29","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.jchf.2016.02.013","volume":"4","author":"J Joseph","year":"2016","unstructured":"Joseph J, Claggett BC, Anand IS et al (2016) QRS duration is a predictor of adverse outcomes in heart failure with preserved ejection fraction. JACC Heart Fail 4(6):477\u2013486","journal-title":"JACC Heart Fail"},{"key":"2510_CR30","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s41782-017-0015-8","volume":"1","author":"AS BaHammam","year":"2017","unstructured":"BaHammam AS (2017) Treatment-emergent central sleep apnea (complex sleep apnea). Sleep Vigilance 1:53\u201356. https:\/\/doi.org\/10.1007\/s41782-017-0015-8","journal-title":"Sleep Vigilance"},{"issue":"1","key":"2510_CR31","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s11325-011-0486-0","volume":"16","author":"M Westhoff","year":"2012","unstructured":"Westhoff M, Arzt M, Litterst P (2012) Prevalence and treatment of central sleep apnoea emerging after initiation of continuous positive airway pressure in patients with obstructive sleep apnoea without evidence of heart failure. Sleep Breath 16(1):71\u201378. https:\/\/doi.org\/10.1007\/s11325-011-0486-0","journal-title":"Sleep Breath"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-021-02510-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-021-02510-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-021-02510-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T12:02:20Z","timestamp":1661515340000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-021-02510-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,14]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["2510"],"URL":"https:\/\/doi.org\/10.1007\/s11325-021-02510-0","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,14]]},"assertion":[{"value":"6 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board (IRB) of Medical Corporation MSC (#20002, UMIN00000042555) and was carried out in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors agree with the publication of our manuscript. Our manuscript is not under consideration for publication in any other journal. If accepted, the authors agree that the paper will not be published elsewhere in the same or a similar form, in English, or in any other language, without written consent of the copyright holder.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}