{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:41:08Z","timestamp":1774014068683,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1112995"],"award-info":[{"award-number":["1112995"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002129","name":"Heart Foundation","doi-asserted-by":"publisher","award":["101167"],"award-info":[{"award-number":["101167"]}],"id":[{"id":"10.13039\/100002129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Frequent central apnoeas are sometimes observed in healthy children; however; the pathophysiology of an elevated central apnoea index (CAI) is poorly understood. A raised CAI may indicate underlying ventilatory control instability (i.e. elevated loop gain, LG) or a depressed ventilatory drive. This pilot study aimed to compare LG in otherwise healthy children with an elevated CAI to healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Polysomnographic recordings from children (age\u2009&gt; 6 months) without obstructive sleep apnoea and with a CAI\u2009&gt; 5 events\/h (<jats:italic>n<\/jats:italic> =\u200913) were compared with age and gender\u2010matched controls with a CAI\u2009&lt; 5 events\/h (<jats:italic>n<\/jats:italic> =\u200913). Spontaneous sighs were identified during non\u2010rapid eye movement (NREM) sleep, and breath\u2013breath measurements of ventilation were derived from the nasal pressure signal. A standard model of ventilatory control (gain, time constant and delay) was used to calculate LG by transforming ventilatory fluctuations seen in response to a sigh into a ventilatory\u2010drive signal that best matches observed ventilation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The high CAI group had an elevated LG (median\u2009= 0.36 (interquartile range, IQR\u2009= 0.35\u20130.53) vs 0.28 (0.23\u20130.36); <jats:italic>P<\/jats:italic> \u2264 0.01). There was no difference in either the time constant (<jats:italic>P<\/jats:italic> = 0.63) or delay (<jats:italic>P<\/jats:italic> = 0.29) between groups. Elevated LG observed in the high CAI group remained after accounting for degree of hypoxia (average oxygen saturation (SpO<jats:sub>2<\/jats:sub>) during each analysable window) experienced (0.40 (0.30\u20130.53) vs 0.25 (0.23\u20130.37); <jats:italic>P<\/jats:italic> = 0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An elevated CAI in otherwise healthy children is associated with a raised LG compared to matched controls with a low CAI, irrespective of level of hypoxia. This relative ventilatory instability helps explain the high CAI and may ultimately be able to help guide diagnosis and management in patients with high CAI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13606","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T00:44:42Z","timestamp":1559263482000},"page":"214-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Assessing ventilatory control stability in children with and without an elevated central apnoea index"],"prefix":"10.1111","volume":"25","author":[{"given":"Katherine","family":"Harman","sequence":"first","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne VIC Australia"},{"name":"Melbourne Children's Sleep Centre Monash Children's Hospital  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-0255","authenticated-orcid":false,"given":"Aidan J.","family":"Weichard","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margot J.","family":"Davey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne VIC Australia"},{"name":"Melbourne Children's Sleep Centre Monash Children's Hospital  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary S.C.","family":"Horne","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian M.","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne VIC Australia"},{"name":"Melbourne Children's Sleep Centre Monash Children's Hospital  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9383-1644","authenticated-orcid":false,"given":"Bradley A.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Sleep and Circadian Medicine Laboratory, Department of Physiology and School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne VIC Australia"},{"name":"School of Psychological Sciences and Turner Institute for Brain and Mental Health Monash University  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/146.5_Pt_1.1235"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2015.08.002"},{"key":"e_1_2_8_4_1","first-page":"1257","article-title":"Incidence and temporal characteristics of oscillatory breathing patterns in full term neonates","volume":"2","author":"Wilkinson MH","year":"1986","journal-title":"Conf. 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