{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T22:25:26Z","timestamp":1786659926005,"version":"build-2736575974"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People\u2019s Republic of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970869"],"award-info":[{"award-number":["81970869"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171125"],"award-info":[{"award-number":["82171125"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81700896"],"award-info":[{"award-number":["81700896"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371131"],"award-info":[{"award-number":["82371131"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hospital Level Scientific Research Fund Program of Shanghai Sixth People\u2019s Hospital","award":["ynts202404"],"award-info":[{"award-number":["ynts202404"]}]},{"name":"the Shanghai Municipal Commission of Science and Technology","award":["18DZ2260200"],"award-info":[{"award-number":["18DZ2260200"]}]},{"name":"Shanghai Science and Technology Innovation Program of Science and Technology Commission","award":["20Y11902100"],"award-info":[{"award-number":["20Y11902100"]}]},{"name":"Shanghai Shen-Kang Hospital Management Center Project","award":["SHDC2020CR2044B"],"award-info":[{"award-number":["SHDC2020CR2044B"]}]},{"name":"Shanghai Shen-Kang Hospital Management Center Project","award":["SHDC2020CR3056B"],"award-info":[{"award-number":["SHDC2020CR3056B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Multilevel upper airway surgery is effective for some patients with obstructive sleep apnea (OSA), but predicting the response to surgery remains a challenge. The underlying endotypes of OSA include upper airway collapsibility, muscle compensation, loop gain, and the arousal threshold. This study aimed to explore the effect of surgery on polysomnography (PSG)-derived OSA endotypes and establish a surgical response prediction model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Our study included 54 Chinese patients with OSA who underwent multilevel upper airway surgery. Participants underwent PSG before and after surgery with a median follow-up time of 6.5 months. Using AHIBaseline\/AHIpost-surgery \u2265 2 and AHIpost-surgery\u2005&amp;lt; 10 events\/h as criteria, participants were classified as surgery responders and non-responders. The surgical success rate was 26%. These endotypic traits were derived from a standard PSG data by validated methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The surgery altered both anatomical and non-anatomical endotypic traits, including increased Vpassive (baseline vs post-surgery: 51.5 [18.7\u201384.2] vs 86.8 [67.4\u201393.7] %Veupnea, p\u2005&amp;lt;\u2005.001), decreased loop gain (baseline vs post-surgery: 0.7 [0.7\u20130.8] vs 0.6 [0.5\u20130.6]; p\u2005&amp;lt;\u2005.001), and a higher arousal threshold (baseline vs post-surgery: 202.9 [183.7\u2013222.0] vs 160.7 [143.9\u2013177.4] %Veupnea; p\u2005&amp;lt;\u2005.001). However, it did not significantly affect muscle compensation. Fully adjusted logistic regression analyses indicated that a favorable response to surgery was independently associated with a lower LG (OR [CI 95%], 0.1 [0.0\u20130.5], p\u2005=\u2005.032). In patients with improved muscle compensation or a more collapsible airway (lower Vpassive), a lower loop gain was more strongly indicative of success. However, when muscle compensation was lower or collapsibility was less severe (higher Vpassive), a lower loop gain was less predictive of success.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrated that multilevel upper airway surgery altered both anatomical and non-anatomical endotypes in Chinese patients with OSA. An endotype based regression model may meaningfully predict surgical success.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsaf012","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T15:32:44Z","timestamp":1737127964000},"source":"Crossref","is-referenced-by-count":8,"title":["Polysomnographic endotypes of successful multilevel upper airway surgery for obstructive sleep apnea"],"prefix":"10.1093","volume":"48","author":[{"given":"Xiaoting","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]},{"name":"Shanghai Key Laboratory of Sleep Disordered Breathing , Shanghai,","place":["China"]},{"name":"Otolaryngology Institute of Shanghai Jiao Tong University , 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