{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:14:33Z","timestamp":1790835273465,"version":"4.1.0"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"3","funder":[{"name":"National Institute of Health","award":["P01HL094307"],"award-info":[{"award-number":["P01HL094307"]}]},{"name":"National Institute of Health","award":["P01HL095491"],"award-info":[{"award-number":["P01HL095491"]}]},{"name":"National Institute of Health","award":["R01HL102321"],"award-info":[{"award-number":["R01HL102321"]}]},{"name":"National Institute of Health","award":["R01HL128658"],"award-info":[{"award-number":["R01HL128658"]}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2018,7,29]]},"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>A possible precision-medicine approach to treating obstructive sleep apnoea (OSA) involves targeting ventilatory instability (elevated loop gain) using supplemental inspired oxygen in selected patients. Here we test whether elevated loop gain and three key endophenotypic traits (collapsibility, compensation and arousability), quantified using clinical polysomnography, can predict the effect of supplemental oxygen on OSA severity.<\/jats:p>\n                  <jats:p>\n                    36 patients (apnoea\u2013hypopnoea index (AHI) &gt;20\u2005events\u00b7h\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) completed two overnight polysomnographic studies (single-blinded randomised-controlled crossover) on supplemental oxygen (40% inspired)\n                    <jats:italic>versus<\/jats:italic>\n                    sham (air). OSA traits were quantified from the air-night polysomnography. Responders were defined by a \u226550% reduction in AHI (supine non-rapid eye movement). Secondary outcomes included blood pressure and self-reported sleep quality.\n                  <\/jats:p>\n                  <jats:p>\n                    Nine of 36\u00a0patients (25%) responded to supplemental oxygen (\u0394AHI=72\u00b15%). Elevated loop gain was not a significant univariate predictor of responder\/non-responder status (primary analysis). In\n                    <jats:italic>post hoc<\/jats:italic>\n                    analysis, a logistic regression model based on elevated loop gain and other traits (better collapsibility and compensation; cross-validated) had 83% accuracy (89% before cross-validation); predicted responders exhibited an improvement in OSA severity (\u0394AHI 59\u00b16%\n                    <jats:italic>versus<\/jats:italic>\n                    12\u00b17% in predicted non-responders, p=0.0001) plus lowered morning blood pressure and \u201cbetter\u201d self-reported sleep.\n                  <\/jats:p>\n                  <jats:p>Patients whose OSA responds to supplemental oxygen can be identified by measuring their endophenotypic traits using diagnostic polysomnography.<\/jats:p>","DOI":"10.1183\/13993003.00674-2018","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T10:55:11Z","timestamp":1535021711000},"page":"1800674","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":142,"title":["Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy"],"prefix":"10.1183","volume":"52","author":[{"given":"Scott A.","family":"Sands","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip I.","family":"Terrill","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":"Luigi","family":"Taranto-Montemurro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Azarbarzin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania","family":"Marques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren B.","family":"Hess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik T.","family":"Smales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila M.","family":"de Melo","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"}]}],"member":"81","published-online":{"date-parts":[[2018,8,23]]},"reference":[{"key":"2024102100342513000_52.3.1800674.1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1007\/s11325-013-0828-1","article-title":"Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA): a belief-based theoretical approach","volume":"17","author":"Skinner","year":"2013","journal-title":"Sleep Breath"},{"key":"2024102100342513000_52.3.1800674.2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s40463-016-0156-0","article-title":"Trends in CPAP adherence over twenty years of data collection: a flattened curve","volume":"45","author":"Rotenberg","year":"2016","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2024102100342513000_52.3.1800674.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.05.019"},{"key":"2024102100342513000_52.3.1800674.4","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.5665\/sleep.6226","article-title":"The combination of supplemental oxygen and a hypnotic markedly improves obstructive sleep apnea in patients with a mild to moderate upper airway collapsibility","volume":"39","author":"Edwards","year":"2016","journal-title":"Sleep"},{"key":"2024102100342513000_52.3.1800674.5","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1164\/rccm.201601-0099OC","article-title":"Upper-airway collapsibility and loop gain predict the response to oral appliance therapy in patients with obstructive sleep apnea","volume":"194","author":"Edwards","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102100342513000_52.3.1800674.6","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00064.2013"},{"key":"2024102100342513000_52.3.1800674.7","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1042\/CS20100588","article-title":"Eszopiclone increases the respiratory arousal threshold and lowers the apnoea\/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold","volume":"120","author":"Eckert","year":"2011","journal-title":"Clin Sci"},{"key":"2024102100342513000_52.3.1800674.8","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.90408.2008"},{"key":"2024102100342513000_52.3.1800674.9","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00747.2012"},{"key":"2024102100342513000_52.3.1800674.10","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201303-0448OC"},{"key":"2024102100342513000_52.3.1800674.11","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01214.2007"},{"key":"2024102100342513000_52.3.1800674.12","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00972.2010"},{"key":"2024102100342513000_52.3.1800674.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00062914"},{"key":"2024102100342513000_52.3.1800674.14","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1164\/rccm.201707-1435OC","article-title":"Phenotyping pharyngeal pathophysiology using polysomnography in patients with obstructive sleep apnea","volume":"197","author":"Sands","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102100342513000_52.3.1800674.15","doi-asserted-by":"crossref","first-page":"zsx183","DOI":"10.1093\/sleep\/zsx183","article-title":"Quantifying the arousal threshold using polysomnography in obstructive sleep apnea","volume":"41","author":"Sands","year":"2018","journal-title":"Sleep"},{"key":"2024102100342513000_52.3.1800674.16","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2014.277210"},{"key":"2024102100342513000_52.3.1800674.17","first-page":"604","article-title":"Delivered oxygen concentrations using low-flow and high-flow nasal cannulas","volume":"50","author":"Wettstein","year":"2005","journal-title":"Respir Care"},{"key":"2024102100342513000_52.3.1800674.18","unstructured":"Rechtschaffen A , Kales A . A Manual of Standardized Terminology, Techniques and Scoring Systems for Sleep Stages of Human Subjects. Los Angeles, CA, UCLA Brain Information Service\u2044Brain Research Institute, 1968."},{"key":"2024102100342513000_52.3.1800674.19","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1152\/jappl.1982.53.3.644","article-title":"Factors inducing periodic breathing in humans: a general model","volume":"53","author":"Khoo","year":"1982","journal-title":"J Appl Physiol"},{"key":"2024102100342513000_52.3.1800674.20","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"2024102100342513000_52.3.1800674.21","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/tri.12895","article-title":"Five myths about variable selection","volume":"30","author":"Heinze","year":"2017","journal-title":"Transpl Int"},{"key":"2024102100342513000_52.3.1800674.22","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1152\/jappl.1992.72.1.116","article-title":"Effects of inhaled oxygen (up to 40%) on periodic breathing and apnea in preterm infants","volume":"72","author":"Weintraub","year":"1992","journal-title":"J Appl Physiol"},{"key":"2024102100342513000_52.3.1800674.23","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1093\/sleep\/22.8.1101","article-title":"Effects of nasal O2 on sleep-related disordered breathing in ambulatory patients with stable heart failure","volume":"22","author":"Javaheri","year":"1999","journal-title":"Sleep"},{"key":"2024102100342513000_52.3.1800674.24","doi-asserted-by":"crossref","unstructured":"Wang D , Wong KK , Rowsell L , et\u00a0al. Predicting response to oxygen therapy in obstructive sleep apnoea patients using a 10-minute daytime test. Eur Respir J 2018; 51: 1701587.","DOI":"10.1183\/13993003.01587-2017"},{"key":"2024102100342513000_52.3.1800674.25","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2011.223925"},{"key":"2024102100342513000_52.3.1800674.26","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/32.10.1355"},{"key":"2024102100342513000_52.3.1800674.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306766"},{"key":"2024102100342513000_52.3.1800674.28","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000217128.41284.78"},{"key":"2024102100342513000_52.3.1800674.29","first-page":"958","article-title":"The effects of oxygen in patients with sleep apnea","volume":"130","author":"Smith","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"2024102100342513000_52.3.1800674.30","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1164\/arrd.1986.134.5.925","article-title":"The effect of chronic nocturnal oxygen administration upon sleep apnea","volume":"134","author":"Gold","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"2024102100342513000_52.3.1800674.31","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/sleep\/29.4.564","article-title":"Effect of continuous positive airway pressure versus supplemental oxygen on sleep quality in obstructive sleep apnea: a placebo-CPAP-controlled study","volume":"29","author":"Loredo","year":"2006","journal-title":"Sleep"},{"key":"2024102100342513000_52.3.1800674.32","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01503.2012"},{"key":"2024102100342513000_52.3.1800674.33","doi-asserted-by":"publisher","DOI":"10.1038\/nm.4173"},{"key":"2024102100342513000_52.3.1800674.34","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.5664\/jcsm.6716","article-title":"Physiology-based modeling may predict surgical treatment outcome for obstructive sleep apnea","volume":"13","author":"Li","year":"2017","journal-title":"J Clin Sleep Med"},{"key":"2024102100342513000_52.3.1800674.35","doi-asserted-by":"crossref","first-page":"zsx094","DOI":"10.1093\/sleep\/zsx094","article-title":"Loop gain predicts the response to upper airway surgery in patients with obstructive sleep apnea","volume":"40","author":"Joosten","year":"2017","journal-title":"Sleep"},{"key":"2024102100342513000_52.3.1800674.36","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200810-1658OC"},{"issue":"Suppl. 1","key":"2024102100342513000_52.3.1800674.37","first-page":"5","article-title":"Phenotyping using polysomnography to select obstructive sleep apnoea patients for mandible advancement device therapy","volume":"26","author":"Bamagoos","year":"2017","journal-title":"J Sleep Res"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.00674-2018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T01:59:19Z","timestamp":1740362359000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.00674-2018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,23]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,9,27]]},"published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1183\/13993003.00674-2018"],"URL":"https:\/\/doi.org\/10.1183\/13993003.00674-2018","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.733862079.793561220","asserted-by":"object"}]},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,23]]}}}