{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:06:53Z","timestamp":1793383613067,"version":"4.5.0"},"reference-count":38,"publisher":"European Respiratory Society (ERS)","issue":"2","content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2014,8,14]]},"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas\/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response\/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain.<\/jats:p><jats:p>Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide.<\/jats:p><jats:p>Our method quantified loop gain from baseline polysomnography (correlation<jats:italic>versus<\/jats:italic>CPAP-estimated loop gain: n=28; r=0.63, p&lt;0.001), detected the known reduction in loop gain with oxygen (n=11; mean\u00b1<jats:sc>sem<\/jats:sc>change in loop gain (\u0394LG) \u22120.23\u00b10.08, p=0.02) and acetazolamide (n=11; \u0394LG \u22120.20\u00b10.06, p=0.005), and predicted the OSA response to loop gain-lowering therapy.<\/jats:p><jats:p>We validated a means to quantify the ventilatory control contribution to OSA pathogenesis using clinical polysomnography, enabling identification of likely responders to therapies targeting ventilatory control.<\/jats:p>","DOI":"10.1183\/09031936.00062914","type":"journal-article","created":{"date-parts":[[2014,10,17]],"date-time":"2014-10-17T10:08:52Z","timestamp":1413540532000},"page":"408-418","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":275,"title":["Quantifying the ventilatory control contribution to sleep apnoea using polysomnography"],"prefix":"10.1183","volume":"45","author":[{"given":"Philip I.","family":"Terrill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamim","family":"Nemati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Butler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Owens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny J.","family":"Eckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wellman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Sands","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2014,10,16]]},"reference":[{"key":"2024102023051135000_45.2.408.1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-119MG"},{"key":"2024102023051135000_45.2.408.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.05.019"},{"key":"2024102023051135000_45.2.408.3","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00064.2013"},{"key":"2024102023051135000_45.2.408.4","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2011.223925"},{"key":"2024102023051135000_45.2.408.5","doi-asserted-by":"publisher","DOI":"10.1042\/CS20100588"},{"key":"2024102023051135000_45.2.408.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5664\/jcsm.28036","article-title":"Predictors of response to a nasal expiratory resistor device and its potential mechanisms of action for treatment of obstructive sleep apnea","volume":"7","author":"Patel","year":"2011","journal-title":"J Clin Sleep Med"},{"key":"2024102023051135000_45.2.408.7","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-202610"},{"key":"2024102023051135000_45.2.408.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308659"},{"key":"2024102023051135000_45.2.408.9","unstructured":"National Centeron Sleep Disorders Research. 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