ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2013
Air leak during CPAP titration as a risk factor for central apnea.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
- Trial
- Treatment-emergent central sleep apnea resolves with lower inspiratory pressure.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- The prevalence and polysomnographic characteristics of treatment-emergent central sleep apnea with obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2024Article
- Periodic breathing in patients with stable obstructive sleep apnea on long-term continuous positive airway pressure treatment: a retrospective study using CPAP remote monitoring data.Sleep & breathing = Schlaf & Atmung · 2022Article
- A longitudinal study of the accuracy of positive airway pressure therapy machine-detected apnea-hypopnea events.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Noninvasive Ventilation by Helmet vs Face Mask in COVID-19 Pneumonia: Emerging Evidence and Need of the Hour.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Review
- Positive Airway Pressure Therapy Adherence with Mask Resupply: A Propensity-Matched Analysis.Journal of clinical medicine · 2021Article
- Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP-treated patient.Respirology case reports · 2020Article
- Persistent High Residual AHI After CPAP Use.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
- Emergent central sleep apnea during CPAP therapy-clinical implications.Journal of thoracic disease · 2017Article
- Article
- A Randomized Crossover Trial of a Pressure Relief Technology (SensAwake™) in Continuous Positive Airway Pressure to Treat Obstructive Sleep Apnea.Sleep disorders · 2017Article
- Residual Events during Use of CPAP: Prevalence, Predictors, and Detection Accuracy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016Article
- Unmasking a Role for Noninvasive Ventilation in Early Acute Respiratory Distress Syndrome.JAMA · 2016Article
- Pathophysiology of central sleep apneas.Sleep & breathing = Schlaf & Atmung · 2016Review
- Clinical predictors of central sleep apnea evoked by positive airway pressure titration.Nature and science of sleep · 2016Article
- Article
- Complex sleep apnea syndrome.Sleep disorders · 2014Review
- The complexities of complex sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2013Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesEmergence of central sleep apnea has been described in the setting of continuous positive airway pressure (CPAP) initiation. The underlying mechanism is unclear; however, we postulate that air leak washing out anatomical dead space is a contributing factor.
designData were obtained from 310 patients with obstructive sleep apnea (OSA) who underwent either split-night or full-night CPAP titration during January to July of 2009. The majority (n = 245) underwent titration with a nasal mask. Average total leak and maximum total leak were measured at therapeutic CPAP level. Unintentional leak was calculated by subtracting manufacturer-defined intentional leak from maximum leak.
resultsSUBJECTS WERE DIVIDED INTO TWO GROUPS: central apnea index (CAI) during titration < 5/hour and ≥ 5/hour. The groups were similar in terms of gender, age, BMI, and AHI. The CAI < 5 group had a median average leak of 45.5 L/min (IQR 20.8 L/min) versus 51.0 L/min (IQR 21.0 L/min) with CAI ≥ 5 (p = 0.056). Maximum leak was 59.5 L/min (IQR 27.0 L/min) with CAI < 5 and 75.0 L/min (IQR 27.8 L/min) with CAI ≥ 5 (p = 0.003). In the subset of subjects titrated using a nasal mask, median average leak was 42.0 L/min (IQR 17.0) in the CAI < 5 group and 50.0 L/min (IQR 16.8) in the CAI ≥ 5 group (p = 0.001). In the CAI < 5 group, median maximum leak was 57.0 L/min (IQR 23.0) versus 74.5 L/min (IQR 24.3) in the CAI ≥ 5 group (p < 0.001).
conclusionsLeak during CPAP titration is associated with the development of acute central apnea; these data may have mechanistic and therapeutic implications for complex apnea. COMMENTARY: A commentary on this article appears in this issue on page 1193.
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