{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T20:38:28Z","timestamp":1793479108068,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2004,12,1]],"date-time":"2004-12-01T00:00:00Z","timestamp":1101859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ventilatory instability may play an important role in the pathogenesis of obstructive sleep apnea. We hypothesized that the influence of ventilatory instability in this disorder would vary depending on the underlying collapsibility of the upper airway. To test this hypothesis, we correlated loop gain with apnea\u2013hypopnea index during supine, nonrapid eye movement sleep in three groups of patients with obstructive sleep apnea based on pharyngeal closing pressure: negative pressure group (pharyngeal closing pressure less than \u20131 cm H2O), atmospheric pressure group (between \u20131 and +1 cm H2O), and positive pressure group (greater than +1 cm H2O). Loop gain was measured by sequentially increasing proportional assist ventilation until periodic breathing developed, which occurred in 24 of 25 subjects. Mean loop gain for all three groups was 0.37 \u00b1 0.11. A significant correlation was found between loop gain and apnea\u2013hypopnea index in the atmospheric group only (r = 0.88, p = 0.0016). We conclude that loop gain has a substantial impact on apnea severity in certain patients with sleep apnea, particularly those with a pharyngeal closing pressure near atmospheric.<\/jats:p>","DOI":"10.1164\/rccm.200404-510oc","type":"journal-article","created":{"date-parts":[[2004,8,18]],"date-time":"2004-08-18T20:25:18Z","timestamp":1092860718000},"page":"1225-1232","source":"Crossref","is-referenced-by-count":266,"title":["Ventilatory Control and Airway Anatomy in Obstructive Sleep Apnea"],"prefix":"10.1093","volume":"170","author":[{"given":"Andrew","family":"Wellman","sequence":"first","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Fogel","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliot S.","family":"Katz","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Schory","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill K.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"White","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,12,1]]},"reference":[{"key":"2026032606333889000_BIB1","first-page":"1300","volume-title":"Am Rev Respir Dis","year":"1991"},{"key":"2026032606333889000_BIB2","first-page":"1319","volume-title":"J Appl Physiol","year":"1997"},{"key":"2026032606333889000_BIB3","first-page":"33","volume-title":"Clin Chest Med","year":"1998"},{"key":"2026032606333889000_BIB4","first-page":"1207","volume-title":"Lancet","year":"2002"},{"key":"2026032606333889000_BIB5","first-page":"717","volume-title":"Am Rev Respir Dis","year":"1989"},{"key":"2026032606333889000_BIB6","first-page":"355","volume-title":"Am Rev Respir Dis","year":"1984"},{"key":"2026032606333889000_BIB7","first-page":"149","volume-title":"Am J Respir Crit Care Med","year":"1999"},{"key":"2026032606333889000_BIB8","first-page":"1142","volume-title":"Am J Respir Crit Care Med","year":"1998"},{"key":"2026032606333889000_BIB9","first-page":"1181","volume-title":"Am J Respir Crit Care Med","year":"2001"},{"key":"2026032606333889000_BIB10","first-page":"206","volume-title":"IEEE Trans Biomed Eng","year":"2002"},{"key":"2026032606333889000_BIB11","first-page":"42","volume-title":"Am Rev Respir Dis","year":"1986"},{"key":"2026032606333889000_BIB12","first-page":"311","volume-title":"Respir Physiol","year":"1982"},{"key":"2026032606333889000_BIB13","first-page":"1438","volume-title":"J Appl Physiol","year":"1986"},{"key":"2026032606333889000_BIB14","first-page":"2201","volume-title":"J Appl Physiol","year":"1987"},{"key":"2026032606333889000_BIB15","first-page":"899","volume-title":"Am Rev Respir Dis","year":"1987"},{"key":"2026032606333889000_BIB16","first-page":"406","volume-title":"Am Rev Respir Dis","year":"1991"},{"key":"2026032606333889000_BIB17","first-page":"1682","volume-title":"J Appl Physiol","year":"1994"},{"key":"2026032606333889000_BIB18","first-page":"1806","volume-title":"J Appl Physiol","year":"1995"},{"key":"2026032606333889000_BIB19","first-page":"33","volume-title":"Respir Physiol","year":"1997"},{"key":"2026032606333889000_BIB20","first-page":"A791","volume-title":"Am J Respir Crit Care Med","year":"2003"},{"key":"2026032606333889000_BIB21","first-page":"667","volume-title":"Sleep","year":"1999"},{"key":"2026032606333889000_BIB22","first-page":"1031","volume-title":"Chest","year":"2000"},{"key":"2026032606333889000_BIB23","first-page":"A600","volume-title":"Am J Respir Crit Care Med","year":"2003"},{"key":"2026032606333889000_BIB24","first-page":"S164","volume-title":"Sleep","year":"1996"},{"key":"2026032606333889000_BIB25","first-page":"1929","volume-title":"J Appl Physiol","year":"1998"},{"key":"2026032606333889000_BIB26","first-page":"114","volume-title":"Am Rev Respir Dis","year":"1992"},{"key":"2026032606333889000_BIB27"},{"key":"2026032606333889000_BIB28"},{"key":"2026032606333889000_BIB29","first-page":"945","volume-title":"Am J Respir Crit Care Med","year":"2002"},{"key":"2026032606333889000_BIB30","first-page":"167","volume-title":"Am Rev Respir Dis","year":"1982"},{"key":"2026032606333889000_BIB31","first-page":"973","volume-title":"J Appl Physiol","year":"1989"},{"key":"2026032606333889000_BIB32","first-page":"548","volume-title":"J Appl Physiol","year":"1991"},{"key":"2026032606333889000_BIB33","first-page":"515","volume-title":"Am J Respir Crit Care Med","year":"1997"},{"key":"2026032606333889000_BIB34","first-page":"118","volume-title":"Exp Neurol","year":"1985"},{"key":"2026032606333889000_BIB35","first-page":"197","volume-title":"J Appl Physiol","year":"1984"},{"key":"2026032606333889000_BIB36","first-page":"801","volume-title":"J Appl Physiol","year":"1980"},{"key":"2026032606333889000_BIB37","first-page":"397","volume-title":"J Appl Physiol","year":"1984"},{"key":"2026032606333889000_BIB38","first-page":"2720","volume-title":"J Appl Physiol","year":"1994"},{"key":"2026032606333889000_BIB39","first-page":"1597","volume-title":"J Appl Physiol","year":"1993"},{"key":"2026032606333889000_BIB40","first-page":"530","volume-title":"J Appl Physiol","year":"1982"},{"key":"2026032606333889000_BIB41","first-page":"1052","volume-title":"J Appl Physiol","year":"1981"},{"key":"2026032606333889000_BIB42","first-page":"215","volume-title":"Am Rev Respir Dis","year":"1981"},{"key":"2026032606333889000_BIB43","first-page":"15","volume-title":"Respir Physiol","year":"1991"},{"key":"2026032606333889000_BIB44","first-page":"912","volume-title":"J Appl Physiol","year":"1986"},{"key":"2026032606333889000_BIB45","first-page":"759","volume-title":"J Appl Physiol","year":"1989"},{"key":"2026032606333889000_BIB46","first-page":"713","volume-title":"Am J Respir Crit Care Med","year":"1998"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/170\/11\/1225\/67491805\/ajrccm_170_11_1225.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/170\/11\/1225\/67491805\/ajrccm_170_11_1225.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:33:44Z","timestamp":1774521224000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/170\/11\/1225\/8538872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12,1]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2004,12,1]]},"published-print":{"date-parts":[[2004,12,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.200404-510oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,12]]},"published":{"date-parts":[[2004,12,1]]}}}