{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:52:46Z","timestamp":1781653966682,"version":"3.54.5"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Sleep Med"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is reported to be more prevalent in posttraumatic stress disorder (PTSD) compared to the general population for unknown reasons. Most prior studies have assessed military populations who commonly possess other OSA risk factors. This study aimed to determine whether: 1) OSA prevalence is increased in young adults with PTSD symptoms exposed to non-military traumas; and 2) the ventilatory response to arousal from sleep - an OSA pathogenic trait - differs according to PTSD symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals with a range of PTSD symptoms (PTSD symptom checklist for DSM-5, PCL-5) completed an overnight sleep study. OSA prevalence and the ventilatory response to brief spontaneous arousals were compared between those with Likely PTSD (trauma exposure, intrusions and PCL-5\u2009&gt;\u200933), Subsyndromal PTSD (trauma exposure, intrusions and PCL-5 15-33) and No PTSD (PCL-5\u2009&lt;\u200915).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data were obtained in 60 individuals, 18 with Likely PTSD, 19 Subsyndromal PTSD and 23 No PTSD. The number found to have OSA (4 in Likely PTSD, 3 in Subsyndromal PTSD and 1 in No PTSD,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.21) and the mean apnea-hypopnea index did not differ between groups (p\u2009&lt;\u2009.98). The ventilatory response to arousal was assessed in 29 individuals without OSA who had good nasal pressure traces and was significantly larger in individuals with Likely PTSD and subsyndromal PTSD than No PTSD (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although these young individuals with Likely PTSD did not commonly have OSA, the ventilatory response to arousal was elevated, which when combined with other OSA risk factors may predispose to OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Brief summary<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Current Knowledge\/Study Rationale<\/jats:title>\n                    <jats:p>Obstructive sleep apnea has been reported to be much more common in military veterans with posttraumatic stress disorder (PTSD) than in the general population. Whether this is a result of factors specific to military veterans or due to other reasons was unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Impact<\/jats:title>\n                    <jats:p>This study found that young adults with non-military trauma exposure and likely PTSD did not have elevated rates of OSA. However, their ventilatory response to brief spontaneous arousal from sleep was elevated, which may contribute to OSA development when other risk factors are present (older age, obesity etc) and may also represent a PTSD-specific OSA treatment pathway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44470-026-00050-6","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T20:21:18Z","timestamp":1778185278000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The ventilatory response to arousal from sleep is elevated in young individuals with post-traumatic stress disorder symptoms"],"prefix":"10.1007","volume":"22","author":[{"given":"Maya T.","family":"Schenker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darsh","family":"Cherian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhe","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilith","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Avraam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergal","family":"J. O\u2019Donoghue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim L.","family":"Felmingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-9766","authenticated-orcid":false,"given":"Amy S.","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"issue":"6","key":"50_CR1","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1016\/j.jpsychores.2013.09.004","volume":"75","author":"WR Pigeon","year":"2013","unstructured":"Pigeon WR, Campbell CE, Possemato K, Ouimette P. Longitudinal relationships of insomnia, nightmares, and PTSD severity in recent combat veterans. J Psychosom Res. 2013;75(6):546\u201350. https:\/\/doi.org\/10.1016\/j.jpsychores.2013.09.004.","journal-title":"J Psychosom Res"},{"issue":"4","key":"50_CR2","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1176\/appi.ajp.2012.12040432","volume":"170","author":"A Germain","year":"2013","unstructured":"Germain A. Sleep disturbances as the hallmark of PTSD: where are we now? Am J Psychiatry. 2013;170(4):372\u201382. https:\/\/doi.org\/10.1176\/appi.ajp.2012.12040432.","journal-title":"Am J Psychiatry"},{"key":"50_CR3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.sleep.2017.04.020","volume":"36","author":"Y Zhang","year":"2017","unstructured":"Zhang Y, Weed JG, Ren R, Tang X, Zhang W. Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: a meta-analysis. Sleep Med. 2017;36:125\u201332. https:\/\/doi.org\/10.1016\/j.sleep.2017.04.020.","journal-title":"Sleep Med"},{"issue":"1","key":"50_CR4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s11325-017-1618-y","volume":"22","author":"AA El-Solh","year":"2018","unstructured":"El-Solh AA, Adamo D, Kufel T. Comorbid insomnia and sleep apnea in veterans with post-traumatic stress disorder. Sleep Breath. 2018;22(1):23\u201331. https:\/\/doi.org\/10.1007\/s11325-017-1618-y.","journal-title":"Sleep Breath"},{"issue":"4","key":"50_CR5","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1023\/A:1013029819358","volume":"14","author":"B Krakow","year":"2001","unstructured":"Krakow B, Germain A, Warner TD, et al. The relationship of sleep quality and posttraumatic stress to potential sleep disorders in sexual assault survivors with nightmares, insomnia, and PTSD. J Trauma Stress. 2001;14(4):647\u201365. https:\/\/doi.org\/10.1023\/A:1013029819358.","journal-title":"J Trauma Stress"},{"issue":"11","key":"50_CR6","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1016\/s0006-3223(00)01087-8","volume":"49","author":"B Krakow","year":"2001","unstructured":"Krakow B, Melendrez D, Pedersen B, et al. Complex insomnia: insomnia and sleep-disordered breathing in a consecutive series of crime victims with nightmares and PTSD. Biol Psychiatry. 2001;49(11):948\u201353. https:\/\/doi.org\/10.1016\/s0006-3223(00)01087-8.","journal-title":"Biol Psychiatry"},{"issue":"7","key":"50_CR7","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1097\/00005053-200207000-00004","volume":"190","author":"B Krakow","year":"2002","unstructured":"Krakow B, Melendrez D, Johnston L, et al. Sleep-disordered breathing, psychiatric distress, and quality of life impairment in sexual assault survivors. J Nerv Ment Dis. 2002;190(7):442\u201352. https:\/\/doi.org\/10.1097\/00005053-200207000-00004.","journal-title":"J Nerv Ment Dis"},{"issue":"10","key":"50_CR8","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1016\/j.biopsych.2007.01.007","volume":"62","author":"M Habukawa","year":"2007","unstructured":"Habukawa M, Uchimura N, Maeda M, Kotorii N, Maeda H. Sleep findings in young adult patients with posttraumatic stress disorder. Biol Psychiatry. 2007;62(10):1179\u201382. https:\/\/doi.org\/10.1016\/j.biopsych.2007.01.007.","journal-title":"Biol Psychiatry"},{"issue":"9918","key":"50_CR9","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S0140-6736(13)60734-5","volume":"383","author":"AS Jordan","year":"2014","unstructured":"Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736\u201347. https:\/\/doi.org\/10.1016\/S0140-6736(13)60734-5.","journal-title":"Lancet"},{"key":"50_CR10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.sleep.2024.02.006","volume":"115","author":"EJ Brooker","year":"2024","unstructured":"Brooker EJ, Landry SA, Mann D, et al. The obstructive sleep apnoea endotypes are similar in elderly trauma-exposed veterans with and without diagnosed PTSD. Sleep Med. 2024;115:48\u201354. https:\/\/doi.org\/10.1016\/j.sleep.2024.02.006.","journal-title":"Sleep Med"},{"issue":"5","key":"50_CR11","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1152\/japplphysiol.00135.2024","volume":"137","author":"EJ Tjondrorahardja","year":"2024","unstructured":"Tjondrorahardja EJ, Poon TTS, Avraam J, Schenker M, Felmingham KL, Jordan AS. Breathlessness, but not breathing instability, varies with posttraumatic stress symptoms in university students. J Appl Physiol. 2024;137(5):1458\u201369. https:\/\/doi.org\/10.1152\/japplphysiol.00135.2024.","journal-title":"J Appl Physiol"},{"key":"50_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1355442","volume":"15","author":"K Leech","year":"2024","unstructured":"Leech K, Stapleton P, Patching A. A roadmap to understanding interoceptive awareness and post-traumatic stress disorder: a scoping review. Front Psychiatry. 2024;15:1355442. https:\/\/doi.org\/10.3389\/fpsyt.2024.1355442.","journal-title":"Front Psychiatry"},{"key":"50_CR13","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jpsychires.2017.10.019","volume":"96","author":"M Kellner","year":"2018","unstructured":"Kellner M, Muhtz C, Nowack S, Leichsenring I, Wiedemann K, Yassouridis A. Effects of 35% carbon dioxide (CO2) inhalation in patients with post-traumatic stress disorder (PTSD): a double-blind, randomized, placebo-controlled, cross-over trial. J Psychiatr Res. 2018;96:260\u20134. https:\/\/doi.org\/10.1016\/j.jpsychires.2017.10.019.","journal-title":"J Psychiatr Res"},{"issue":"7","key":"50_CR14","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1016\/j.jpsychires.2011.01.009","volume":"45","author":"C Muhtz","year":"2011","unstructured":"Muhtz C, Yassouridis A, Daneshi J, Braun M, Kellner M. Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD). J Psychiatr Res. 2011;45(7):989\u201393. https:\/\/doi.org\/10.1016\/j.jpsychires.2011.01.009.","journal-title":"J Psychiatr Res"},{"issue":"2","key":"50_CR15","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/j.chest.2020.02.074","volume":"158","author":"CN Schmickl","year":"2020","unstructured":"Schmickl CN, Li Y, Orr JE, et al. Effect of venlafaxine on apnea-hypopnea index in patients with sleep apnea: a randomized, double-blind crossover study. Chest. 2020;158(2):765\u201375. https:\/\/doi.org\/10.1016\/j.chest.2020.02.074.","journal-title":"Chest"},{"issue":"4","key":"50_CR16","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.biopsych.2014.03.028","volume":"77","author":"KA McLaughlin","year":"2015","unstructured":"McLaughlin KA, Koenen KC, Friedman MJ, et al. Subthreshold posttraumatic stress disorder in the world health organization world mental health surveys. Biol Psychiatry. 2015;77(4):375\u201384. https:\/\/doi.org\/10.1016\/j.biopsych.2014.03.028.","journal-title":"Biol Psychiatry"},{"issue":"8","key":"50_CR17","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1176\/ajp.154.8.1114","volume":"154","author":"MB Stein","year":"1997","unstructured":"Stein MB, Walker JR, Hazen AL, Forde DR. Full and partial posttraumatic stress disorder: findings from a community survey. Am J Psychiatry. 1997;154(8):1114\u20139. https:\/\/doi.org\/10.1176\/ajp.154.8.1114.","journal-title":"Am J Psychiatry"},{"issue":"4","key":"50_CR18","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.genhosppsych.2004.04.005","volume":"26","author":"PS Ciechanowski","year":"2004","unstructured":"Ciechanowski PS, Walker EA, Russo JE, Newman E, Katon WJ. Adult health status of women HMO members with posttraumatic stress disorder symptoms. Gen Hosp Psychiatry. 2004;26(4):261\u20138. https:\/\/doi.org\/10.1016\/j.genhosppsych.2004.04.005.","journal-title":"Gen Hosp Psychiatry"},{"issue":"2","key":"50_CR19","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1378\/chest.15-0693","volume":"149","author":"CJ Lettieri","year":"2016","unstructured":"Lettieri CJ, Williams SG, Collen JF. OSA syndrome and posttraumatic stress disorder: clinical outcomes and impact of positive airway pressure therapy. Chest. 2016;149(2):483\u201390. https:\/\/doi.org\/10.1378\/chest.15-0693.","journal-title":"Chest"},{"issue":"11","key":"50_CR20","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1093\/sleep\/33.11.1495","volume":"33","author":"AA El-Solh","year":"2010","unstructured":"El-Solh AA, Ayyar L, Akinnusi M, Relia S, Akinnusi O. Positive airway pressure adherence in veterans with posttraumatic stress disorder. Sleep. 2010;33(11):1495\u2013500. https:\/\/doi.org\/10.1093\/sleep\/33.11.1495.","journal-title":"Sleep"},{"key":"50_CR21","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","volume":"34","author":"CV Senaratna","year":"2017","unstructured":"Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev. 2017;34:70\u201381. https:\/\/doi.org\/10.1016\/j.smrv.2016.07.002.","journal-title":"Sleep Med Rev"},{"issue":"6","key":"50_CR22","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/jts.22059","volume":"28","author":"CA Blevins","year":"2015","unstructured":"Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489\u201398. https:\/\/doi.org\/10.1002\/jts.22059.","journal-title":"J Trauma Stress"},{"issue":"10","key":"50_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0161645","volume":"11","author":"AR Ashbaugh","year":"2016","unstructured":"Ashbaugh AR, Houle-Johnson S, Herbert C, El-Hage W, Brunet A. Psychometric validation of the English and French versions of the posttraumatic stress disorder checklist for DSM-5 (PCL-5). PLoS One. 2016;11(10):e0161645. https:\/\/doi.org\/10.1371\/journal.pone.0161645.","journal-title":"PLoS One"},{"issue":"11","key":"50_CR24","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1037\/pas0000254","volume":"28","author":"MJ Bovin","year":"2016","unstructured":"Bovin MJ, Marx BP, Weathers FW, et al. Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders\u2013fifth edition (PCL-5) in veterans. Psychol Assess. 2016;28(11):1379\u201391. https:\/\/doi.org\/10.1037\/pas0000254.","journal-title":"Psychol Assess"},{"issue":"4","key":"50_CR25","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1177\/1073191104269954","volume":"11","author":"MJ Gray","year":"2004","unstructured":"Gray MJ, Litz BT, Hsu JL, Lombardo TW. Psychometric properties of the life events checklist. Assessment. 2004;11(4):330\u201341. https:\/\/doi.org\/10.1177\/1073191104269954.","journal-title":"Assessment"},{"key":"50_CR26","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th edition) American Psychiatric Association; 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"6","key":"50_CR27","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","volume":"88","author":"JB Saunders","year":"1993","unstructured":"Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791\u2013804. https:\/\/doi.org\/10.1111\/j.1360-0443.1993.tb02093.x.","journal-title":"Addiction"},{"issue":"11","key":"50_CR28","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1111\/joor.12686","volume":"45","author":"KVM Taveira","year":"2018","unstructured":"Taveira KVM, Kuntze MM, Berretta F, et al. Association between obstructive sleep apnea and alcohol, caffeine and tobacco: a meta-analysis. J Oral Rehabil. 2018;45(11):890\u2013902. https:\/\/doi.org\/10.1111\/joor.12686.","journal-title":"J Oral Rehabil"},{"issue":"1","key":"50_CR29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3922\/j.psns.2009.1.12","volume":"2","author":"C de Meneses-Gaya","year":"2009","unstructured":"de Meneses-Gaya C, Zuardi AW, Loureiro SR, Crippa JAS. Alcohol use disorders identification test (AUDIT): an updated systematic review of psychometric properties. Psychol Neurosci. 2009;2(1):83\u201397. https:\/\/doi.org\/10.3922\/j.psns.2009.1.12.","journal-title":"Psychol Neurosci"},{"issue":"2","key":"50_CR30","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","volume":"28","author":"DJ Buysse","year":"1989","unstructured":"Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 28(2):193\u2013213. https:\/\/doi.org\/10.1016\/0165-1781(89)90047-4","journal-title":"Psychiatry Res."},{"issue":"8","key":"50_CR31","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.5664\/jcsm.6050","volume":"12","author":"JR Dietch","year":"2016","unstructured":"Dietch JR, Taylor DJ, Sethi K, Kelly K, Bramoweth AD, Roane BM. Psychometric evaluation of the PSQI in U.S. college students. J Clin Sleep Med. 2016;12(8):1121\u20139. https:\/\/doi.org\/10.5664\/jcsm.6050.","journal-title":"J Clin Sleep Med"},{"issue":"6","key":"50_CR32","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","volume":"14","author":"MW Johns","year":"1991","unstructured":"Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540\u20135. https:\/\/doi.org\/10.1093\/sleep\/14.6.540.","journal-title":"Sleep"},{"issue":"1","key":"50_CR33","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-019-1098-9","volume":"17","author":"MD Manzar","year":"2019","unstructured":"Manzar MD, Salahuddin M, Alamri M, et al. Psychometric properties of the Epworth sleepiness scale in Ethiopian university students. Health Qual Life Outcomes. 2019;17(1):30. https:\/\/doi.org\/10.1186\/s12955-019-1098-9.","journal-title":"Health Qual Life Outcomes"},{"key":"50_CR34","doi-asserted-by":"crossref","unstructured":"Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney, NSW: Psychology Foundation of Australia; 1996.","DOI":"10.1037\/t01004-000"},{"issue":"1","key":"50_CR35","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-018-0216-5","volume":"6","author":"R Guest","year":"2018","unstructured":"Guest R, Tran Y, Gopinath B, Cameron ID, Craig A. Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation. BMC Psychol. 2018;6(1):4. https:\/\/doi.org\/10.1186\/s40359-018-0216-5.","journal-title":"BMC Psychol"},{"key":"50_CR36","unstructured":"Thorpy M. In: Lawrence K, editor. International classification of sleep disorders. Diagnostic and coding manual. Allen Press Inc; 1990."},{"issue":"4","key":"50_CR37","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/s1389-9457(00)00065-4","volume":"2","author":"CH Bastien","year":"2001","unstructured":"Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001;2(4):297\u2013307. https:\/\/doi.org\/10.1016\/s1389-9457(00)00065-4.","journal-title":"Sleep Med"},{"issue":"5","key":"50_CR38","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/s0022-3956(01)00028-0","volume":"35","author":"MK Shear","year":"2001","unstructured":"Shear MK, Rucci P, Williams J, et al. Reliability and validity of the panic disorder severity scale: replication and extension. J Psychiatr Res. 2001;35(5):293\u20136. https:\/\/doi.org\/10.1016\/s0022-3956(01)00028-0.","journal-title":"J Psychiatr Res"},{"key":"50_CR39","doi-asserted-by":"publisher","DOI":"10.2196\/39206","volume":"7","author":"LA Rutter","year":"2023","unstructured":"Rutter LA, Howard J, Lakhan P, Valdez D, Bollen J, Lorenzo-Luaces L. I haven\u2019t been diagnosed, but I should be\"-insight into self-diagnoses of common mental health disorders: cross-sectional study. JMIR Form Res. 2023;7:e39206. https:\/\/doi.org\/10.2196\/39206.","journal-title":"JMIR Form Res"},{"issue":"5","key":"50_CR40","doi-asserted-by":"publisher","first-page":"407","DOI":"10.3109\/00048674.2010.543654","volume":"45","author":"KL Mills","year":"2011","unstructured":"Mills KL, McFarlane AC, Slade T, et al. Assessing the prevalence of trauma exposure in epidemiological surveys. Aust N Z J Psychiatry. 2011;45(5):407\u201315. https:\/\/doi.org\/10.3109\/00048674.2010.543654.","journal-title":"Aust N Z J Psychiatry"},{"issue":"1","key":"50_CR41","doi-asserted-by":"publisher","DOI":"10.1080\/20008066.2024.2434314","volume":"15","author":"MT Schenker","year":"2024","unstructured":"Schenker MT, Cherian D, Felmingham KL, Jordan AS. The relationship between sleep disturbances and post-traumatic stress disorder symptomatology in university students. Eur J Psychotraumatol. 2024;15(1):2434314. https:\/\/doi.org\/10.1080\/20008066.2024.2434314.","journal-title":"Eur J Psychotraumatol"},{"key":"50_CR42","unstructured":"American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications (version 2.6). Darien, IL: American Academy of Sleep Medicine; 2023."},{"issue":"3","key":"50_CR43","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1113\/jphysiol.2004.064238","volume":"558","author":"AS Jordan","year":"2004","unstructured":"Jordan AS, McEvoy RD, Edwards JK, et al. The influence of gender and upper airway resistance on the ventilatory response to arousal in obstructive sleep apnoea in humans. J Physiol. 2004;558(3):993\u20131004. https:\/\/doi.org\/10.1113\/jphysiol.2004.064238.","journal-title":"J Physiol"},{"key":"50_CR44","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1152\/japplphysiol.00608.2012","volume":"113","author":"JM Cori","year":"2012","unstructured":"Cori JM, Nicholas CL, Baptista S, et al. Inspiratory resistive loading increases the ventilatory response to arousal but does not reduce genioglossus muscle activity on the return to sleep. J Appl Physiol. 2012;113:909\u201316 https:\/\/doi.org\/10.1152\/japplphysiol.00608.2012.","journal-title":"J Appl Physiol"},{"key":"50_CR45","doi-asserted-by":"publisher","unstructured":"Cori JM, Thornton T, O'Donoghue FJ, et al. Arousal-induced Hypocapnia does not reduce genioglossus activity in obstructive sleep apnea. Sleep. 2017;40(6). https:\/\/doi.org\/10.1093\/sleep\/zsx057","DOI":"10.1093\/sleep\/zsx057"},{"issue":"12","key":"50_CR46","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1164\/rccm.200302-150OC","volume":"168","author":"AS Jordan","year":"2003","unstructured":"Jordan AS, Eckert DJ, Catcheside PG, McEvoy RD. Ventilatory response to brief arousal from non-rapid eye movement sleep is greater in men than in women. Am J Respir Crit Care Med. 2003;168(12):1512\u20139. https:\/\/doi.org\/10.1164\/rccm.200302-150OC.","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"50_CR47","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1164\/rccm.202107-1761OC","volume":"205","author":"B Lechat","year":"2022","unstructured":"Lechat B, Naik G, Reynolds A, et al. Multinight prevalence, variability, and diagnostic misclassification of obstructive sleep apnea. Am J Respir Crit Care Med. 2022;205(5):563\u20139. https:\/\/doi.org\/10.1164\/rccm.202107-1761OC.","journal-title":"Am J Respir Crit Care Med"},{"key":"50_CR48","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2019.08.004","volume":"48","author":"Y Zhang","year":"2019","unstructured":"Zhang Y, Ren R, Sanford LD, et al. Sleep in posttraumatic stress disorder: a systematic review and meta-analysis of polysomnographic findings. Sleep Med Rev. 2019;48:101210. https:\/\/doi.org\/10.1016\/j.smrv.2019.08.004.","journal-title":"Sleep Med Rev"},{"issue":"2","key":"50_CR49","doi-asserted-by":"publisher","first-page":"281","DOI":"10.5665\/sleep.2390","volume":"36","author":"BA Edwards","year":"2013","unstructured":"Edwards BA, Connolly JG, Campana LM, et al. Acetazolamide attenuates the ventilatory response to arousal in patients with obstructive sleep apnea. Sleep. 2013;36(2):281\u20135. https:\/\/doi.org\/10.5665\/sleep.2390.","journal-title":"Sleep"},{"issue":"2","key":"50_CR50","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1513\/AnnalsATS.202407-736OC","volume":"22","author":"CN Schmickl","year":"2025","unstructured":"Schmickl CN, Orr JE, Alex RM, et al. Combination drug therapy with acetazolamide, Eszopiclone +\/\u2212 venlafaxine for obstructive sleep apnea (RESCUE-combo): a randomized, double-blind, placebo-controlled clinical trial. Ann Am Thorac Soc. 2025;22(2):263\u201373. https:\/\/doi.org\/10.1513\/AnnalsATS.202407-736OC.","journal-title":"Ann Am Thorac Soc"},{"key":"50_CR51","doi-asserted-by":"publisher","unstructured":"Edwards BA, Sands SA, Eckert DJ, et al. Acetazolamide improves loop gain but not the other physiological traits causing obstructive sleep apnoea. J Physiol. 2012; https:\/\/doi.org\/10.1113\/jphysiol.2011.223925.","DOI":"10.1113\/jphysiol.2011.223925"},{"key":"50_CR52","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.neuropharm.2012.11.031","volume":"67","author":"MT Yang","year":"2013","unstructured":"Yang MT, Chien WL, Lu DH, Liou HC, Fu WM. Acetazolamide impairs fear memory consolidation in rodents. Neuropharmacology. 2013;67:412\u20138. https:\/\/doi.org\/10.1016\/j.neuropharm.2012.11.031.","journal-title":"Neuropharmacology"},{"key":"50_CR53","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.neubiorev.2016.07.014","volume":"69","author":"DV Zuj","year":"2016","unstructured":"Zuj DV, Palmer MA, Lommen MJ, Felmingham KL. The centrality of fear extinction in linking risk factors to PTSD: a narrative review. Neurosci Biobehav Rev. 2016;69:15\u201335. https:\/\/doi.org\/10.1016\/j.neubiorev.2016.07.014.","journal-title":"Neurosci Biobehav Rev"},{"key":"50_CR54","doi-asserted-by":"publisher","unstructured":"Sweetman A, Lack L, McEvoy RD, et al Cognitive behavioural therapy for insomnia reduces sleep apnoea severity: a randomised controlled trial. ERJ Open Res. 2020;6(2). https:\/\/doi.org\/10.1183\/23120541.00161-2020.","DOI":"10.1183\/23120541.00161-2020"},{"issue":"6","key":"50_CR55","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.5664\/jcsm.11636","volume":"21","author":"EJ Brooker","year":"2025","unstructured":"Brooker EJ, Landry SA, Genta PR, Abdelmessih GT, Edwards BA, Drummond SPA. Cognitive behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea. J Clin Sleep Med. 2025;21(6):1041\u201351. https:\/\/doi.org\/10.5664\/jcsm.11636.","journal-title":"J Clin Sleep Med"},{"issue":"1","key":"50_CR56","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.tins.2020.09.010","volume":"44","author":"HY Weng","year":"2021","unstructured":"Weng HY, Feldman JL, Leggio L, Napadow V, Park J, Price CJ. Interventions and manipulations of interoception. Trends Neurosci. 2021;44(1):52\u201362. https:\/\/doi.org\/10.1016\/j.tins.2020.09.010.","journal-title":"Trends Neurosci"},{"issue":"5","key":"50_CR57","doi-asserted-by":"publisher","first-page":"597","DOI":"10.5664\/jcsm.2172","volume":"8","author":"RB Berry","year":"2012","unstructured":"Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of sleep medicine. J Clin Sleep Med. 2012;8(5):597\u2013619. https:\/\/doi.org\/10.5664\/jcsm.2172.","journal-title":"J Clin Sleep Med"},{"issue":"9","key":"50_CR58","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1164\/rccm.201707-1435OC","volume":"197","author":"SA Sands","year":"2018","unstructured":"Sands SA, Edwards BA, Terrill PI, et al. Phenotyping pharyngeal pathophysiology using polysomnography in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 2018;197(9):1187\u201397. https:\/\/doi.org\/10.1164\/rccm.201707-1435OC.","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Journal of Clinical Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44470-026-00050-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44470-026-00050-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44470-026-00050-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:59:54Z","timestamp":1781650794000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44470-026-00050-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":58,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["50"],"URL":"https:\/\/doi.org\/10.1007\/s44470-026-00050-6","relation":{},"ISSN":["1550-9389","1550-9397"],"issn-type":[{"value":"1550-9389","type":"print"},{"value":"1550-9397","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"assertion":[{"value":"30 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the University of Melbourne Human Research Ethics Committee (#23625) and performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Participants gave written informed consent to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Participants gave consent for group data to be published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"73"}}