{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:20:57Z","timestamp":1790799657520,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL117037"],"award-info":[{"award-number":["R01 HL117037"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Sleep\u2010disordered breathing is highly prevalent in individuals with high\u2010level spinal cord injury. In addition, chest mechanics are known to be altered, leading to paradoxical breathing. Here we investigated the interaction between paradoxical breathing and sleep quality in these patients, and its association with measurements of respiratory function, hypercapnic ventilatory response and peak exercise ventilation. Home\u2010based polysomnography was performed in 13 patients with spinal cord injury (C4 to T4) untreated for sleep\u2010disordered breathing. We defined paradoxical breathing as counterphase between thoracic and abdominal movements during slow\u2010wave and rapid eye movement sleep. Sleep quality, pulmonary function, hypercapnic ventilatory responses and peak exercise ventilation were compared between those with and without paradoxical breathing. Half of individuals presented with nocturnal paradoxical breathing. Despite similar age, body mass index, injury level, time since injury, and respiratory function, those with paradoxical breathing had higher apnea\u2013hypopnea index (13\u2009\u00b1\u20098 versus 5\u2009\u00b1\u20093 events per hr) and average sleep heart rate (67\u2009\u00b1\u200912 versus 54\u2009\u00b1\u20094\u2009bpm; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Moreover, paradoxical breathing was associated with lower hypercapnic ventilatory response (slope: 0.35\u2009\u00b1\u20090.17 versus 0.96\u2009\u00b1\u20090.38) and lower peak exercise ventilation (33\u2009\u00b1\u20094 versus 48\u2009\u00b1\u200912\u2009L\u2005min<jats:sup>\u22121<\/jats:sup>; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Nocturnal respiratory muscle desynchronization could play a role in the pathophysiology of sleep apnea, and could relate to low ventilatory responses to both hypercapnia and exercise in high\u2010level spinal cord injury. Polysomnography may be an important diagnostic tool for these patients for whom therapeutic approaches should be considered to treat this abnormality.<\/jats:p>","DOI":"10.1111\/jsr.14171","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T07:28:20Z","timestamp":1707982100000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Paradoxical breathing during sleep is associated with increased sleep apnea and reduced ventilatory capacities in high\u2010level spinal cord injury"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-8603","authenticated-orcid":false,"given":"Isabelle","family":"Vivodtzev","sequence":"first","affiliation":[{"name":"Neuroscience Paris Seine NPS, CNRS UMR8246, INSERM U1130, UM119, Institut de Biologie Paris Seine IBPS Sorbonne Universit\u00e9 Sciences, Campus UPMC  Paris France"},{"name":"Sorbonne Universit\u00e9 Inserm, UMR_S1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Rong","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9 Inserm, UMR_S1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Ely","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston Massachusetts USA"},{"name":"Cardiovascular Research Laboratory Schoen Adams Research Institute at Spaulding Rehabilitation  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Patout","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9 Inserm, UMR_S1158 Neurophysiologie Respiratoire Exp\u00e9rimentale et Clinique  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Andrew","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston Massachusetts USA"},{"name":"Cardiovascular Research Laboratory Schoen Adams Research Institute at Spaulding Rehabilitation  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2018.10.2.191"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.033"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2172"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30057-8"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0205-2022"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419889371"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1980.122.4.591"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.099044"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1985.132.1.53"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2023.101738"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-020-00595-0"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0199-2022"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9256"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-198605000-00016"},{"issue":"7","key":"e_1_2_11_16_1","first-page":"35","article-title":"Prevalence and correlates of alpha\u2010delta sleep in major depressive disorders","volume":"8","author":"Jaimchariyatam N.","year":"2011","journal-title":"Innovations in Clinical Neuroscience"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.3.725"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-197507000-00008"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000880"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.1967.16.1.20"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201907-1312OC"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2022.111208"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5485.465"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212729"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S197375"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.10.002"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.04.002"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1963.18"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.03.020"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.10.044"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-198207000-00011"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12588"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.14171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T04:55:49Z","timestamp":1729140949000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.14171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/jsr.14171"],"URL":"https:\/\/doi.org\/10.1111\/jsr.14171","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,14]]},"assertion":[{"value":"2023-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14171"}}