Evidence map›Paper›PMID 25061251›Full record

ArticleSleep2014

Obstructive sleep apnea in older adults is a distinctly different physiological phenotype.

Bradley A Edwards, Andrew Wellman, Scott A Sands, Robert L Owens, Danny J Eckert, David P White, Atul Malhotra

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 5 pooled it
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 5 syntheses or guidelines pooled it, 184 citations in OpenAlex.

  1. Pooled it
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  5. CPAP is associated with decreased risk of AF recurrence in patients with OSA, especially those younger and slimmer: a meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2020
    Pooled it
  6. Trial
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  11. Relationship of Fluid Accumulation in the Neck to Sleep Structure in Men during Daytime Sleep.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016
    Trial
  12. Article
  13. Article
  14. Article
  15. Challenges for predicting oxygen response in OSA.American journal of respiratory and critical care medicine · 2026
    Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Review

39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Bradley A EdwardsDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Andrew WellmanDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Scott A SandsDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Robert L OwensDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Danny J EckertDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA ; Neuroscience Research Australia (NeuRA) and the University of New South Wales, Randwick, Sydney, New South Wales, Australia.
David P WhiteDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Atul MalhotraDivision of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA ; Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, CA.
Brigham and Women's Hospital · USHarvard University · USUniversity of California System · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Wakefulness and Forebrain Activation by Orexin NeuronsP01HL095491 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI CHAMBERLIN, NANCY L · 2010 to 2019
$25.1M
SLEEP, AIRWAY PATENCY, AND THE PHARYNGEAL MUSCULATURER01HL048531 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI WHITE, DAVID P. · 1992 to 2009
$3.8M
Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
Mechanisms Underlying the Aging Predisposition to Obstructive Sleep ApneaR01HL090897 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MALHOTRA, ATUL · 2009 to 2012
$1.8M
Assessment of Upper Airway Mechanics Using Newer EMG TechniquesK24HL093218 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2009 to 2013
$857k
NCRR NIH HHS UL1 RR025758NCRR NIH HHS UL1 RR 025758-01NHLBI NIH HHS 5R01HL048531-16NHLBI NIH HHS K24 HL093218NHLBI NIH HHS K24 HL 093218-01A1NHLBI NIH HHS P01 HL 095491NHLBI NIH HHS P01 HL095491NHLBI NIH HHS R01 HL048531NHLBI NIH HHS R01 HL085188NHLBI NIH HHS R01 HL085188-02NHLBI NIH HHS R01 HL090897NHLBI NIH HHS R01 HL090897-01A2
6 · The paper itself

Abstract

STUDY

objectivesCurrent evidence suggests that the pathological mechanisms underlying obstructive sleep apnea (OSA) are altered with age. However, previous studies examining individual physiological traits known to contribute to OSA pathogenesis have been assessed in isolation, primarily in healthy individuals.

designWe assessed the four physiological traits responsible for OSA in a group of young and old patients with OSA.

settingSleep research laboratory.

participantsTen young (20-40 y) and old (60 y and older) patients with OSA matched by body mass index and sex. MEASUREMENTS AND

resultsPharyngeal anatomy/collapsibility, loop gain (LG), upper airway muscle responsiveness/gain (UAG) and the respiratory arousal threshold were determined using multiple 2- to 3-min decreases or drops in continuous positive airway pressure (CPAP). Passive pharyngeal anatomy/collapsibility was quantified as the ventilation at CPAP = 0 cmH2O immediately after the CPAP drop. LG was defined as the ratio of the ventilatory overshoot to the preceding reduction in ventilation. UAG was taken as the ratio of the increase in ventilation to the increase in ventilatory drive across the pressure drop. Arousal threshold was estimated as the ventilatory drive that caused arousal. Veupnea was quantified as the mean ventilation prior to the pressure drop. In comparison with younger patients with OSA, older patients had a more collapsible airway (ventilation at 0 cmH2O = 3.4 ± 0.9 versus 1.5 ± 0.7 L/min; P = 0.05) but lower Veupnea (8.2 ± 0.5 versus 6.1 ± 0.4 L/min; P < 0.01) and a lower LG (5.0 ± 0.7 versus 2.9 ± 0.5; P < 0.05). The remaining traits were similar between groups.

conclusionsOur data suggest that airway anatomy/collapsibility plays a relatively greater pathogenic role in older adults, whereas a sensitive ventilatory control system is a more prominent trait in younger adults with obstructive sleep apnea. CITATION: Edwards BA, Wellman A, Sands SA, Owens RL, Eckert DJ, White DP, Malhotra A. Obstructive sleep apnea in older adults is a distinctly different physiological phenotype.

Indexed as

PhenotypeAdultAgedAgingArousalBody Mass IndexContinuous Positive Airway PressureFemaleHumansMaleMiddle AgedPharynxPressureRespirationRespiratory SystemSleepagingloop gainlungobstructive sleep apneasleep disordered breathingupper airway collapsibility

Identifiers

PMID25061251
PMCPMC4098808
OpenAlexW2020103701

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.