{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T05:19:24Z","timestamp":1770441564473,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Obstructive sleep apnea (OSA) patients may develop central respiratory events under continuous positive airway pressure (CPAP), referred to as complex sleep apnea (CompSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to assess prevalence and predictive factors of complex apnea and to evaluate treatment response to CPAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Within a retrospective cohort study, we assessed clinical data of OSA patients, attending the sleep lab during a 15\u2010months period. Included participants underwent two consecutive polysomnographies; baseline diagnosis and treatment trial. Complex apnea patients, defined by a central apnea index\u2009\u2265\u20095 per hour during pressure auto\u2010titration, were compared to remainders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 263 included patients, the prevalence of complex apnea was 9.1%. The mean apnea hypopnea index only dropped from 52.7 to 39.9 per hour in CompSA patients, while it improved from 40.9 to 7.3 in patients without CompSA. Although a decreased sleep\u2010fragmentation under CPAP was observable in both groups, the enhancement of Non\u2010REM sleep was superior in patients without CompSA. The CompSA patients showed higher median apnea\u2010hypopnea, mixed apnea and central apnea indices at baseline and displayed higher rates of comorbid heart failure and obstructive pulmonary disease, but no higher severity of associated daytime fatigue and sleepiness symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite evidenced partial improvement of obstructive events, nocturnal hypoxemia and sleep fragmentation, the occurrence of complex apnea presented here as a clear therapeutic failure of auto\u2010titrating CPAP and was associated with heart failure, COPD and higher central and mixed apnea indices at baseline.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.12325","type":"journal-article","created":{"date-parts":[[2015,6,15]],"date-time":"2015-06-15T08:54:48Z","timestamp":1434358488000},"page":"200-209","source":"Crossref","is-referenced-by-count":11,"title":["Complex sleep apnea at auto\u2010titrating CPAP initiation: prevalence, significance and predictive factors"],"prefix":"10.1111","volume":"11","author":[{"given":"Daniel","family":"Neu","sequence":"first","affiliation":[{"name":"Sleep Laboratory and Unit for Chronobiology U78 Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (U.L.B.) Brussels Belgium"},{"name":"UNI Neuroscience Institute, ULB312 Faculty of Medicine, and Faculty of Motor Sciences, Universit\u00e9 Libre de Bruxelles (U.L.B.) Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adamou Dodo","family":"Balkissou","sequence":"additional","affiliation":[{"name":"Sleep Laboratory and Unit for Chronobiology U78 Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (U.L.B.) Brussels Belgium"},{"name":"Department of Pneumology Brugmann University Hospital U.L.B. Brussels Belgium"},{"name":"Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Mairesse","sequence":"additional","affiliation":[{"name":"Sleep Laboratory and Unit for Chronobiology U78 Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (U.L.B.) Brussels Belgium"},{"name":"Department of Experimental and Applied Psychology (EXTO) Vrije Universiteit Brussel (V.U.B.) Brussels Belgium"},{"name":"Department LIFE Royal Military Academy Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Walter","family":"Pefura\u2010Yone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Noseda","sequence":"additional","affiliation":[{"name":"Department of Pneumology Brugmann University Hospital U.L.B. 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