{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:35:28Z","timestamp":1767792928556,"version":"3.49.0"},"reference-count":31,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Faculty of Medicine and Health Executive Dean Stipend Scholarship","award":["Scholarship. No grant number"],"award-info":[{"award-number":["Scholarship. No grant number"]}]},{"name":"Berg Family Trust","award":["No grant number. Administered through Sydney Unive"],"award-info":[{"award-number":["No grant number. Administered through Sydney Unive"]}]},{"DOI":"10.13039\/100001465","name":"American Thoracic Society","doi-asserted-by":"publisher","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}],"id":[{"id":"10.13039\/100001465","id-type":"DOI","asserted-by":"publisher"}]},{"name":"John Notaras","award":["No grant number. Administered through Sydney Unive"],"award-info":[{"award-number":["No grant number. Administered through Sydney Unive"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Introduction<\/jats:title>\n Subjective sleep disturbance is common in chronic obstructive pulmonary disease (COPD) and is related to hyperinflation when supine and tidal expiratory flow limitation (EFL). We hypothesised that abnormalities in supine lung mechanics disturb sleep and impair gas exchange in COPD. We aimed to assess relationships between supine lung derecruitment, EFL and hyperinflation, and polysomnographic measures of sleep disturbance and gas exchange in COPD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this prospective, observational study, supine oscillometry was performed in stable COPD patients to assess lung derecruitment (reactance at 5\u2009Hz (Xrs\n 5<\/jats:sub>\n ) z-score) and EFL (difference between mean inspiratory and expiratory reactance (\u2206Xrs\n 5<\/jats:sub>\n )). Hyperinflation was assessed by supine inspiratory capacity (IC\n supine<\/jats:sub>\n ) z-score. In-laboratory polysomnography was used to assess sleep disturbance, measured by Apnoea-Hypopnoea Index (AHI), Oxygen Desaturation Index (ODI) and AHI during rapid eye movement sleep (AHI REM). Monitoring of transcutaneous carbon dioxide (TcCO\n 2<\/jats:sub>\n ), and measurements of partial pressure of arterial carbon dioxide (PaCO\n 2<\/jats:sub>\n ) and HCO\n 3<\/jats:sub>\n \u2212<\/jats:sup>\n were performed in a subgroup.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 28 COPD patients were enrolled (13 female, mean age (SD) 67.5 (8.71) years and mean forced expiratory volume in 1second (FEV1) z-scores (SD) \u22122.61 (1.06)). Worse Xrs\n 5(supine)<\/jats:sub>\n correlated with greater respiratory arousals (AHI r\n s<\/jats:sub>\n =0.47, p=0.01; ODI r\n s<\/jats:sub>\n =\u22120.58, p=0.001), as did greater \u2206Xrs\n 5(supine)<\/jats:sub>\n (AHI REM r\n s<\/jats:sub>\n =0.53, p=0.005). Xrs\n 5(supine)<\/jats:sub>\n correlated with peripheral oxygen saturation nadir (r\n s<\/jats:sub>\n =0.43, p=0.02). IC\n supine<\/jats:sub>\n correlated negatively with hypoventilation (PaCO\n 2<\/jats:sub>\n r\n s<\/jats:sub>\n =\u22120.77, p=0.001; HCO\n 3<\/jats:sub>\n \u2212<\/jats:sup>\n r\n s<\/jats:sub>\n =\u22120.78, p=0.001, n=15), as did Xrs\n 5(supine)<\/jats:sub>\n (rise in TcCO\n 2<\/jats:sub>\n r\n s<\/jats:sub>\n =\u22120.65, p=0.009).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Lung derecruitment, EFL and supine hyperinflation likely contribute to sleep disturbance and sleep-related gas exchange impairment in COPD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003513","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T06:25:29Z","timestamp":1762410329000},"page":"e003513","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Supine hyperinflation and expiratory flow limitation are associated with respiratory arousals and nocturnal hypoventilation in COPD"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3646-0952","authenticated-orcid":false,"given":"Meera","family":"Srinivasan","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"},{"name":"Department of Respiratory and Sleep Medicine, The Canberra Hospital, Canberra, ACT, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Touma","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-6359","authenticated-orcid":false,"given":"Kaj E C","family":"Blokland","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina O","family":"Tonga","sequence":"additional","affiliation":[{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"},{"name":"Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"},{"name":"School of Life Sciences, University of Technology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2559-3706","authenticated-orcid":false,"given":"Andrew S L","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7920-4924","authenticated-orcid":false,"given":"Peter A","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory G","family":"King","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"},{"name":"Airways Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"2026010701514249000_12.1.e003513.1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.2147\/COPD.S48570","article-title":"Impact of night-time symptoms in COPD: a real-world study in five European countries","volume":"8","author":"Price","year":"2013","journal-title":"Int J Chron Obstruct Pulmon 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