{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:02:47Z","timestamp":1790622167364,"version":"4.1.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>To predict the improvement in sleepiness following continuous positive airway pressure treatment for obstructive sleep apnea using baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Data from five polysomnography cohorts (HomePAP, BestAIR, ABC, STAGES, and MESA; total n\u2009=\u20092332) were analyzed. Associations between polysomnographic metrics and Epworth Sleepiness Scale were assessed using multivariable linear regression. Cross-validated Least Absolute Shrinkage and Selection Operator regression was used to select predictor variables. Prediction of Epworth Sleepiness Scale improvement was evaluated in continuous positive airway pressure\u2013treated participants (n\u2009=\u2009213) using linear regression models trained on 139 participants and tested in a holdout group (n\u2009=\u200974).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cross-sectional analysis revealed significant associations between baseline Epworth Sleepiness Scale and ventilatory burden (0.56 points\/standard deviation; 95% confidence interval 0.34 to 0.78), hypoxic burden (0.51; 0.28 to 0.74), the apnea\u2013hypopnea index (0.45; 0.23 to 0.68), time below 90% oxygen saturation (0.36; 0.15 to 0.57), and flow limitation severity (0.31; 0.10 to 0.53). Baseline Epworth Sleepiness Scale and baseline ventilatory burden were the most frequently selected predictors of Epworth Sleepiness Scale improvement. Using these two variables in a regression model, predicted and actual Epworth Sleepiness Scale improvement were correlated in the holdout group (adjusted R2\u2009=\u20090.313). The model classified continuous positive airway pressure responders (\u22652 points Epworth Sleepiness Scale improvement) more accurately than current clinical guidelines (78.1% [3.5% standard deviation] versus 68.4% [3.7%]). Substituting the apnea\u2013hypopnea index for ventilatory burden slightly reduced accuracy (77.3% [3.4%]). Charts were developed to assist in predicting Epworth Sleepiness Scale improvement from baseline metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Models incorporating baseline Epworth Sleepiness Scale and either ventilatory burden or apnea\u2013hypopnea index predict Epworth Sleepiness Scale improvement and may help identify patients with obstructive sleep apnea likely to benefit from continuous positive airway pressure. The ventilatory burden model demonstrated modestly better performance, while the apnea\u2013hypopnea index\u2013based model offers greater clinical applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Information<\/jats:title>\n                    <jats:p>This was a secondary analysis of retrospective data. Some of the data utilized originated from clinical trials and is registered with www.clinicaltrials.gov:<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag222","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:16:08Z","timestamp":1786965368000},"source":"Crossref","is-referenced-by-count":0,"title":["Machine learning prediction of the change in sleepiness following continuous positive airway pressure in obstructive sleep apnea: a multi-cohort analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8220-7368","authenticated-orcid":false,"given":"Eric","family":"Staykov","sequence":"first","affiliation":[{"name":"School of Electrical Engineering and Computer Science, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-1606","authenticated-orcid":false,"given":"Juha","family":"T\u00f6yr\u00e4s","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Computer Science, The University of Queensland , Brisbane ,","place":["Australia"]},{"name":"Department of Technical Physics, University of Eastern Finland , Kuopio ,","place":["Finland"]},{"name":"Science Service Center, Kuopio University Hospital , Kuopio ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2499-5415","authenticated-orcid":false,"given":"Dwayne L","family":"Mann","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Computer Science, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-821X","authenticated-orcid":false,"given":"Timo","family":"Lepp\u00e4nen","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Computer Science, The University of Queensland , Brisbane ,","place":["Australia"]},{"name":"Department of Technical Physics, University of Eastern Finland , Kuopio ,","place":["Finland"]},{"name":"Clinical Research Center, Kuopio University Hospital , Kuopio ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-2115","authenticated-orcid":false,"given":"Samu","family":"Kainulainen","sequence":"additional","affiliation":[{"name":"Department of Technical Physics, University of Eastern Finland , Kuopio ,","place":["Finland"]},{"name":"Clinical Research Center, Kuopio University Hospital , Kuopio ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-4753","authenticated-orcid":false,"given":"Ali","family":"Azarbarzin","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A","family":"Sands","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7649-0884","authenticated-orcid":false,"given":"Philip I","family":"Terrill","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Computer Science, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"8","key":"2026092814294538200_ref1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"3","key":"2026092814294538200_ref2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1067\/mhn.2002.122699","article-title":"Sleepy driving: accidents and injury","volume":"126","author":"Powell","year":"2002","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"6","key":"2026092814294538200_ref3","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"issue":"5","key":"2026092814294538200_ref4","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1001\/archinte.163.5.565","article-title":"Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: results of a meta-analysis","volume":"163","author":"Patel","year":"2003","journal-title":"Arch Intern Med"},{"issue":"2","key":"2026092814294538200_ref5","doi-asserted-by":"publisher","first-page":"301","DOI":"10.5664\/jcsm.7638","article-title":"Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment","volume":"15","author":"Patil","year":"2019","journal-title":"J Clin Sleep Med"},{"issue":"164","key":"2026092814294538200_ref6","doi-asserted-by":"publisher","first-page":"210230","DOI":"10.1183\/16000617.0230-2021","article-title":"Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view","volume":"31","author":"Craig","year":"2022","journal-title":"Eur Respir Rev"},{"issue":"4","key":"2026092814294538200_ref7","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1111\/jsr.12039","article-title":"Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure","volume":"22","author":"Gasa","year":"2013","journal-title":"J Sleep Res"},{"issue":"4","key":"2026092814294538200_ref8","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.jsmc.2019.08.001","article-title":"Sleep apnea, sleepiness, and driving risk","volume":"14","author":"Bonsignore","year":"2019","journal-title":"Sleep Med Clin"},{"key":"2026092814294538200_ref9","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.sleep.2018.06.012","article-title":"The relationships between improvements in daytime sleepiness, fatigue and depression and psychomotor vigilance task testing with CPAP use in patients with obstructive sleep apnea","volume":"49","author":"Bhat","year":"2018","journal-title":"Sleep Med"},{"issue":"3 Pt 1","key":"2026092814294538200_ref10","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1164\/ajrccm.161.3.9905053","article-title":"Predictors of improvements in daytime function outcomes with CPAP therapy","volume":"161","author":"Kingshott","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"2026092814294538200_ref11","doi-asserted-by":"publisher","first-page":"563","DOI":"10.5664\/jcsm.27351","article-title":"Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical\/polysomnographic measures in a community sample","volume":"4","author":"Buysse","year":"2008","journal-title":"J Clin Sleep Med"},{"issue":"2","key":"2026092814294538200_ref12","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s11325-019-01877-5","article-title":"Factors associated with improvements in subjective symptoms of obstructive sleep apnea syndrome after continuous positive airway pressure therapy","volume":"24","author":"Otsuka","year":"2020","journal-title":"Sleep Breath"},{"issue":"6","key":"2026092814294538200_ref13","doi-asserted-by":"publisher","first-page":"849","DOI":"10.5664\/jcsm.5884","article-title":"Predicting CPAP use and treatment outcomes using composite indices of sleep apnea severity","volume":"12","author":"Balakrishnan","year":"2016","journal-title":"J Clin Sleep Med"},{"issue":"7","key":"2026092814294538200_ref14","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1164\/rccm.202209-1808OC","article-title":"Sleep apnea physiological burdens and cardiovascular morbidity and mortality","volume":"208","author":"Labarca","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"issue":"11","key":"2026092814294538200_ref15","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1164\/rccm.202301-0109OC","article-title":"Ventilatory burden as a measure of obstructive sleep apnea severity is predictive of cardiovascular and all-cause mortality","volume":"208","author":"Parekh","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"2026092814294538200_ref16","doi-asserted-by":"publisher","first-page":"1802262","DOI":"10.1183\/13993003.02262-2018","article-title":"Quantifying the magnitude of pharyngeal obstruction during sleep using airflow shape","volume":"54","author":"Mann","year":"2019","journal-title":"Eur Respir J"},{"issue":"12","key":"2026092814294538200_ref17","doi-asserted-by":"publisher","first-page":"zsab170","DOI":"10.1093\/sleep\/zsab170","article-title":"Frequency of flow limitation using airflow shape","volume":"44","author":"Mann","year":"2021","journal-title":"Sleep"},{"issue":"14","key":"2026092814294538200_ref18","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1093\/eurheartj\/ehy624","article-title":"The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study","volume":"40","author":"Azarbarzin","year":"2019","journal-title":"Eur Heart J"},{"issue":"4","key":"2026092814294538200_ref19","doi-asserted-by":"publisher","first-page":"1901849","DOI":"10.1183\/13993003.01849-2019","article-title":"Severe desaturations increase psychomotor vigilance task-based median reaction time and number of lapses in obstructive sleep apnoea patients","volume":"55","author":"Kainulainen","year":"2020","journal-title":"Eur Respir J"},{"issue":"4","key":"2026092814294538200_ref20","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/j.chest.2023.11.031","article-title":"Increased flow limitation during sleep is associated with increased psychomotor vigilance task lapses in individuals with suspected OSA","volume":"165","author":"Staykov","year":"2024","journal-title":"Chest"},{"issue":"8","key":"2026092814294538200_ref21","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202308-710OC","article-title":"Flow limitation is associated with excessive daytime sleepiness in individuals without moderate or severe obstructive sleep apnea","volume":"21","author":"Mann","year":"2024","journal-title":"Ann Am Thorac Soc"},{"issue":"6","key":"2026092814294538200_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsae077","article-title":"Increased flow limitation during sleep is associated with decreased psychomotor vigilance task performance in individuals with suspected obstructive sleep apnea: a multi-cohort study","volume":"47","author":"Staykov","year":"2024","journal-title":"Sleep"},{"issue":"4","key":"2026092814294538200_ref23","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1136\/thoraxjnl-2018-211959","article-title":"Minimum important difference of the Epworth Sleepiness Scale in obstructive sleep apnoea: estimation from three randomised controlled trials","volume":"74","author":"Crook","year":"2019","journal-title":"Thorax"},{"issue":"7","key":"2026092814294538200_ref24","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1164\/rccm.201704-0672LE","article-title":"The Epworth sleepiness scale: minimum clinically important difference in obstructive sleep apnea","volume":"197","author":"Patel","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"2026092814294538200_ref25","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1093\/jamia\/ocy064","article-title":"The National Sleep Research Resource: towards a sleep data commons","volume":"25","author":"Zhang","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2026092814294538200_ref26","doi-asserted-by":"publisher","first-page":"757","DOI":"10.5665\/sleep.1870","article-title":"A multisite randomized trial of portable sleep studies and positive airway pressure autotitration versus laboratory-based polysomnography for the diagnosis and treatment of obstructive sleep apnea: the HomePAP study","volume":"35","author":"Rosen","year":"2012","journal-title":"Sleep"},{"issue":"2","key":"2026092814294538200_ref27","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.chest.2016.03.019","article-title":"Motivational enhancement for increasing adherence to CPAP: a randomized controlled trial","volume":"150","author":"Bakker","year":"2016","journal-title":"Chest"},{"issue":"8","key":"2026092814294538200_ref28","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1164\/rccm.201708-1637LE","article-title":"Gastric banding surgery versus continuous positive airway pressure for obstructive sleep apnea: a randomized controlled trial","volume":"197","author":"Bakker","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2026092814294538200_ref29","volume-title":"Prepared by Brown Evidence-based Practice Center (Providence, RI) for the Agency for Healthcare Research and Quality (Rockville, MD, USA)","author":"Balk","year":"2022"},{"key":"2026092814294538200_ref30","unstructured":"EricStaykov\/Filter-Scored-Respiratory-Desaturation-Events: Initial Release [computer program]. Version v1.0.1: Zenodo; 2026: 10.5281\/zenodo.20838010."},{"key":"2026092814294538200_ref31","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 3","author":"Troester","year":"2023"},{"issue":"1","key":"2026092814294538200_ref32","doi-asserted-by":"publisher","first-page":"121","DOI":"10.5664\/jcsm.6404","article-title":"Effect of manual editing of total recording time: implications for home sleep apnea testing","volume":"13","author":"Zhao","year":"2017","journal-title":"J Clin Sleep Med"},{"key":"2026092814294538200_ref33","volume-title":"StatPearls","author":"Sankari","year":"2026"},{"issue":"7","key":"2026092814294538200_ref34","doi-asserted-by":"publisher","first-page":"737","DOI":"10.5664\/jcsm.27032","article-title":"Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients.","volume":"3","author":"Collop","year":"2007","journal-title":"J Clin Sleep Med"},{"key":"2026092814294538200_ref35","volume-title":"Randomized Trial of Bariatric Surgery for Treatment of Sleep Apnea\u2014Manual of Procedures","author":"ABC Cohort Investigator Group","year":"2010"},{"issue":"1","key":"2026092814294538200_ref36","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1109\/TBME.2022.3187945","article-title":"A flexible deep learning architecture for temporal sleep stage classification using accelerometry and photoplethysmography","volume":"70","author":"Olsen","year":"2023","journal-title":"IEEE Trans Biomed Eng"},{"key":"2026092814294538200_ref37","author":"STAGES Cohort Investigator Group"},{"key":"2026092814294538200_ref38","volume-title":"MESA PSG Sleep Reading Center Manual of Operations and Scoring Rules","author":"MESA Cohort Investigator Group","year":"2014"},{"issue":"6","key":"2026092814294538200_ref39","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4732","article-title":"Racial\/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"38","author":"Chen","year":"2015","journal-title":"Sleep"},{"issue":"6","key":"2026092814294538200_ref40","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/S0194-5998(98)70277-3","article-title":"Obstructive sleep apnea treatment outcomes pilot study","volume":"118","author":"Piccirillo","year":"1998","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2026092814294538200_ref41","doi-asserted-by":"publisher","DOI":"10.1109\/EMBC40787.2023.10340215","article-title":"Nasal pressure derived airflow limitation and ventilation measurements are resilient to reduced signal quality","volume":"2023","author":"Staykov","year":"2023","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"2026092814294538200_ref42","doi-asserted-by":"publisher","author":"PUPbeta git [computer program]","year":"2022","DOI":"10.13140\/RG.2.2.31282.89283"},{"issue":"9","key":"2026092814294538200_ref43","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac129","article-title":"Within-night repeatability and long-term consistency of sleep apnea endotypes: the Multi-Ethnic Study of Atherosclerosis and Osteoporotic Fractures in Men Study","volume":"45","author":"Alex","year":"2022","journal-title":"Sleep"},{"issue":"6","key":"2026092814294538200_ref44","doi-asserted-by":"publisher","first-page":"e70032","DOI":"10.1111\/jsr.70032","article-title":"Sleep apnea specific hypoxic burden in children with Down syndrome and typically developing children","volume":"34","author":"Walter","year":"2025","journal-title":"J Sleep Res"},{"issue":"2","key":"2026092814294538200_ref45","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1177\/0194599812464468","article-title":"Composite severity indices reflect sleep apnea disease burden more comprehensively than the apnea\u2013hypopnea index","volume":"148","author":"Balakrishnan","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"2026092814294538200_ref46","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1111\/j.2517-6161.1964.tb00553.x","article-title":"An analysis of transformations","volume":"26","author":"Box","year":"1964","journal-title":"J R Stat Soc B Methodol"},{"key":"2026092814294538200_ref47","volume-title":"geoR: Analysis of Geostatistical Data","author":"Ribeiro","year":"2022"},{"key":"2026092814294538200_ref48","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team R","year":"2022"},{"key":"2026092814294538200_ref49","first-page":"1","article-title":"Cost-sensitive classifier selection using the ROC Convex Hull method","author":"Bettinger","year":"2003","journal-title":"SAS Institute"},{"issue":"4","key":"2026092814294538200_ref50","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.5664\/jcsm.9792","article-title":"Dose\u2013response relationship between positive airway pressure therapy and excessive daytime sleepiness: the HomePAP study","volume":"18","author":"Pascoe","year":"2022","journal-title":"J Clin Sleep Med"},{"key":"2026092814294538200_ref51","author":"American Academy of Sleep Medicine. International Classification of Sleep Disorders","year":"2014","edition":"3"},{"issue":"2","key":"2026092814294538200_ref52","doi-asserted-by":"publisher","first-page":"335","DOI":"10.5664\/jcsm.7640","article-title":"Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline","volume":"15","author":"Patil","year":"2019","journal-title":"J Clin Sleep Med"},{"issue":"5","key":"2026092814294538200_ref53","doi-asserted-by":"publisher","first-page":"1700348","DOI":"10.1183\/13993003.00348-2017","article-title":"Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6\u00a0months of continuous positive airway pressure therapy","volume":"50","author":"Budhiraja","year":"2017","journal-title":"Eur Respir J"},{"issue":"12","key":"2026092814294538200_ref54","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1152\/japplphysiol.01008.2015","article-title":"Hypercapnia is more important than hypoxia in the neuro-outcomes of sleep-disordered breathing","volume":"120","author":"Wang","year":"2016","journal-title":"J Appl Physiol"},{"issue":"3","key":"2026092814294538200_ref55","doi-asserted-by":"publisher","first-page":"271","DOI":"10.5664\/jcsm.2500","article-title":"Obstructive sleep apnea and oxygen therapy: a systematic review of the literature and meta-analysis","volume":"9","author":"Mehta","year":"2013","journal-title":"J Clin Sleep Med"},{"issue":"5","key":"2026092814294538200_ref56","doi-asserted-by":"publisher","first-page":"517","DOI":"10.5664\/jcsm.3700","article-title":"Hypercapnia is a key correlate of EEG activation and daytime sleepiness in hypercapnic sleep disordered breathing patients","volume":"10","author":"Wang","year":"2014","journal-title":"J Clin Sleep Med"},{"issue":"2","key":"2026092814294538200_ref57","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/j.chest.2020.02.036","article-title":"Update on persistent excessive daytime sleepiness in OSA","volume":"158","author":"Javaheri","year":"2020","journal-title":"Chest"},{"issue":"8","key":"2026092814294538200_ref58","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1513\/AnnalsATS.202206-482OC","article-title":"Relationship between self-reported sleepiness and positive airway pressure treatment adherence in obstructive sleep apnea","volume":"20","author":"Cistulli","year":"2023","journal-title":"Ann Am Thorac Soc"},{"key":"2026092814294538200_ref59","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.690008","article-title":"Excessive daytime sleepiness in obstructive sleep apnea patients treated with continuous positive airway pressure: data from the European Sleep Apnea Database","volume":"12","author":"Bonsignore","year":"2021","journal-title":"Front Neurol"},{"issue":"2","key":"2026092814294538200_ref60","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1164\/ajrccm.163.2.9808132","article-title":"Classification of sleep-disordered breathing","volume":"163","author":"Hosselet","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"issue":"7","key":"2026092814294538200_ref61","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab010","article-title":"Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea","volume":"44","author":"Parekh","year":"2021","journal-title":"Sleep"},{"issue":"5","key":"2026092814294538200_ref62","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1183\/09031936.98.11051121","article-title":"Influence of correction of flow limitation on continuous positive airway pressure efficiency in sleep apnoea\/hypopnoea syndrome","volume":"11","author":"Meurice","year":"1998","journal-title":"Eur Respir J"},{"issue":"3","key":"2026092814294538200_ref63","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.jsmc.2016.05.005","article-title":"Residual daytime sleepiness in obstructive sleep apnea after continuous positive airway pressure optimization: causes and management","volume":"11","author":"Chapman","year":"2016","journal-title":"Sleep Med Clin"},{"issue":"17","key":"2026092814294538200_ref64","doi-asserted-by":"publisher","first-page":"9248","DOI":"10.3390\/ijerph18179248","article-title":"Comorbid insomnia and obstructive sleep apnea (COMISA): current concepts of patient management","volume":"18","author":"Ragnoli","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"2026092814294538200_ref65","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1038\/s41698-024-00553-6","article-title":"All models are wrong and yours are useless: making clinical prediction models impactful for patients","volume":"8","author":"Markowetz","year":"2024","journal-title":"NPJ Precis Oncol"},{"issue":"2","key":"2026092814294538200_ref66","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhad513","article-title":"The Epworth sleepiness scale may have more advantages than the multiple sleep latency test in assessing sleepiness in patients with obstructive sleep apnea","volume":"34","author":"Sun","year":"2024","journal-title":"Cereb Cortex"},{"issue":"1","key":"2026092814294538200_ref67","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1378\/chest.14-0500","article-title":"Intermittent hypoxemia and OSA: implications for comorbidities","volume":"147","author":"Dewan","year":"2015","journal-title":"Chest"},{"issue":"10","key":"2026092814294538200_ref68","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1136\/thoraxjnl-2012-201622","article-title":"The effect of continuous positive airway pressure usage on sleepiness in obstructive sleep apnoea: real effects or expectation of benefit?","volume":"67","author":"Crawford","year":"2012","journal-title":"Thorax"},{"key":"2026092814294538200_ref69","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1303778","article-title":"Evaluation of daytime sleepiness and insomnia symptoms in OSA patients with a characterization of symptom-defined phenotypes and their involvement in depression comorbidity\u2014a cross-sectional clinical study","volume":"15","author":"Gabryelska","year":"2024","journal-title":"Front Psych"},{"issue":"7","key":"2026092814294538200_ref70","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1111\/resp.13090","article-title":"Connecting insomnia, sleep apnoea and depression","volume":"22","author":"Grandner","year":"2017","journal-title":"Respirology"},{"issue":"21","key":"2026092814294538200_ref71","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.1093\/eurheartj\/ehab151","article-title":"Sleep arousal burden is associated with long-term all-cause and cardiovascular mortality in 8001 community-dwelling older men and women","volume":"42","author":"Shahrbabaki","year":"2021","journal-title":"Eur Heart J"}],"container-title":["SLEEP"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsag222\/70725434\/zsag222.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsag222\/70725434\/zsag222.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:30:00Z","timestamp":1790620200000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article\/doi\/10.1093\/sleep\/zsag222\/8767251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":71,"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsag222","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"article-number":"zsag222"}}