{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T19:12:03Z","timestamp":1794424323293,"version":"4.9.1"},"reference-count":52,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100009708","name":"novo nordisk fonden","doi-asserted-by":"publisher","award":["NNF17OC0024718"],"award-info":[{"award-number":["NNF17OC0024718"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025321","name":"danish cardiovascular academy","doi-asserted-by":"publisher","award":["NNF20SA0067242"],"award-info":[{"award-number":["NNF20SA0067242"]}],"id":[{"id":"10.13039\/501100025321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    Obstructive sleep apnea (OSA) is associated with increased cerebrovascular disease, but acute intracranial dynamics during obstructive events remain uncertain. We hypothesized that negative intrathoracic pressure elevates intracranial pressure (ICP) by increasing central venous pressure (CVP) and impairing cerebral venous outflow. In an anesthetized porcine model, we measured ICP during simulated OSA with intermittent negative airway pressure (INAP) or positive end-expiratory pressure (PEEP) under controlled blood gas conditions. INAP consistently produced post-apneic ICP surges (+10\u2009mmHg) that were time-locked to CVP spikes with strong ICP\u2013CVP coupling during INAP (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u20090.74) and moderate pooled correlation across all epochs (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u20090.48). Pooled associations with arterial blood pressure (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u2009\u22120.02) and cerebral blood flow (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u20090.24) were negligible. The magnitude of responses was modulated by blood gases: hyperoxia attenuated ICP\/CVP changes, whereas hypercapnia augmented pressure surges and was associated with modest changes in global cerebral blood flow without proportionally increasing peak ICP. PEEP was accompanied by immediate increase in ICP and CVP, consistent with direct pressure transmission to the venous system. Collectively, these findings support a venous-mechanical contribution as a key driver of acute ICP elevation during obstructive events, with chemoregulatory effects modulating the response, and provide a hemodynamic context for OSA\u2019s established cerebrovascular risk associations.\n                  <\/jats:p>","DOI":"10.1177\/0271678x261431216","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:13:32Z","timestamp":1773915212000},"page":"2102-2114","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Central venous pressure elevations are associated with intracranial pressure spikes in a model of acute obstructive sleep apnea"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-0092","authenticated-orcid":false,"given":"Casper Schwartz","family":"Riedel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Centre of Neuroscience, Copenhagen University Hospital\u2014Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Neurophysiology, Danish Center for Sleep Medicine, Copenhagen University Hospital\u2014Rigshospitalet, Denmark"},{"name":"Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital\u2014Amager and Hvidovre, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7611-4130","authenticated-orcid":false,"given":"Benedikt Maximilian","family":"Linz","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0046-8731","authenticated-orcid":false,"given":"Kezia","family":"Jerltorp","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8598-7147","authenticated-orcid":false,"given":"Sarah Dalgas","family":"Nissen","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2259-5498","authenticated-orcid":false,"given":"Julie Norup","family":"Hertel","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Jespersen","sequence":"additional","affiliation":[{"name":"Cardiac Physiology Laboratory, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-5254","authenticated-orcid":false,"given":"Poul","family":"Jennum","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Danish Center for Sleep Medicine, Copenhagen University Hospital\u2014Rigshospitalet, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"},{"name":"Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.069"},{"key":"e_1_3_3_3_2","first-page":"100348","article-title":"Impact of pulmonary hypertension in patients undergoing atrial fibrillation ablation: a nationwide study","volume":"23","author":"Bandyopadhyay D","year":"2019","unstructured":"Bandyopadhyay D, Devanabanda AR, Hajra A, et al. Impact of pulmonary hypertension in patients undergoing atrial fibrillation ablation: a nationwide study. Int J Cardiol Heart Vasc 2019; 23: 100348.","journal-title":"Int J Cardiol Heart Vasc"},{"key":"e_1_3_3_4_2","first-page":"100424","article-title":"Nightly sleep apnea severity in patients with atrial fibrillation: potential applications of long-term sleep apnea monitoring","volume":"24","author":"Linz D","year":"2019","unstructured":"Linz D, Baumert M, Desteghe L, et al. Nightly sleep apnea severity in patients with atrial fibrillation: potential applications of long-term sleep apnea monitoring. 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