{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:55:25Z","timestamp":1791201325984,"version":"4.2.0"},"reference-count":16,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: A recent study published by our group demonstrated that patient\u2013ventilator asynchrony (PVA) is independently associated with impaired gas exchange during long-term non-invasive ventilation (NIV). We aimed to determine whether the burden and phenotype of residual PVA vary according to disease category, NIV initiation context and follow-up timing, and whether the relationship between PVA and gas exchange differs according to follow-up timing. Methods: We performed a secondary analysis of 123 NIV-treated patients included in the primary study. PVA burden, upper-airway obstructive events and leaks were compared across disease categories and follow-up settings. Multivariable models for gas exchange outcomes were extended by introducing interaction terms between PVA burden and follow-up category. Patients underwent either long-term follow-up performed &gt;3 months after NIV initiation (n = 74), early acute follow-up, i.e., after stabilization following NIV initiation in acute respiratory failure (n = 30), or early planned follow-up, i.e., within 3 months after NIV initiation in stable chronic respiratory failure (CRF) (n = 19). Results: Overall, leaks, upper airway obstructions (UAOs) and PVA burden did not significantly differ across disease categories, and neither leaks nor UAO differed across follow-up categories. In contrast, patients undergoing early follow-up after acute NIV initiation exhibited a significantly greater burden of residual PVA than those initiated in stable CRF, predominantly because of ineffective efforts. Within the subgroup of patients undergoing early follow-up, total PVA burden was more than doubled after acute NIV initiation (4.5% versus 1.5% of recording time; 6.2 versus 2.5 events\u00b7h\u22121). The association between PVA burden and post-NIV PaCO2 did not differ according to follow-up timing. Conversely, in an exploratory analysis limited to 40 patients, the relationship between PVA burden and nocturnal TcPCO2 was significantly attenuated during early compared with long-term follow-up (interaction \u03b2 = \u22121.04, 95% CI \u22121.68 to \u22120.40; p = 0.003). However, this interaction was attenuated after adjustment for daytime PaCO2 (\u03b2 = \u22120.55, 95% CI \u22121.12 to 0.03; p = 0.076). Stratified analyses demonstrated significant associations between PVA burden and both post-NIV PaCO2 (\u03b2 = 0.38, p = 0.034) and nocturnal TcPCO2 (\u03b2 = 0.80, p &lt; 0.001) during routine long-term follow-up. Conclusions: Patients evaluated after acute NIV initiation exhibited the highest burden of residual PVA, predominantly ineffective efforts. However, PVA was independently associated with nocturnal hypercapnia primarily during established long-term NIV. These findings should be considered hypothesis-generating and require confirmation in larger prospectively monitored cohorts.<\/jats:p>","DOI":"10.3390\/jcm15197695","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:57:46Z","timestamp":1791197866000},"page":"7695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Residual Sleep-Related Respiratory Events During Early Versus Long-Term NIV Follow-Up: Burden and Relationship with Gas Exchange"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3793-7126","authenticated-orcid":false,"given":"Pierre","family":"Tank\u00e9r\u00e9","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France"},{"name":"Research on Healthcare Performance (RESHAPE), INSERM U1290, University Claude Bernard Lyon 1, 69373 Lyon, France"},{"name":"Hypoxie Physiopathologie (HP2), INSERM U1300, University Grenoble Alpes, 38058 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4659-5076","authenticated-orcid":false,"given":"Marjolaine","family":"Georges","sequence":"additional","affiliation":[{"name":"Institut Universitaire du Poumon, Centre de R\u00e9f\u00e9rence Constitutif des Maladies Pulmonaires Rares de l\u2019Adulte, Centre Hospitalo-Universitaire Dijon-Bourgogne, 21000 Dijon, France"},{"name":"Faculty of Medicine and Pharmacy, University Bourgogne Europe, 21000 Dijon, France"},{"name":"Centre des Sciences du Go\u00fbt et de l\u2019Alimentation, INRAE, UMR 6265 CNRS 1234, University Bourgogne Europe, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Ameline","family":"Vagner","sequence":"additional","affiliation":[{"name":"Institut Universitaire du Poumon, Centre de R\u00e9f\u00e9rence Constitutif des Maladies Pulmonaires Rares de l\u2019Adulte, Centre Hospitalo-Universitaire Dijon-Bourgogne, 21000 Dijon, 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