ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2016
Residual Events during Use of CPAP: Prevalence, Predictors, and Detection Accuracy.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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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.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Accuracy of residual respiratory event detection by CPAPs: a meta-analysis.Sleep & breathing = Schlaf & Atmung · 2023Pooled it
- Trial
- Treatment of obstructive sleep apnea in high risk pregnancy: a multicenter randomized controlled trial.Respiratory research · 2023Trial
- Optimizing CPAP Adherence in Obstructive Sleep Apnea: A Narrative Review of Practical Strategies for Everyday Clinical Care.Healthcare (Basel, Switzerland) · 2026Review
- Residual Apnoea-Hypopnoea Index Measurement from Positive Airway Pressure Devices versus Home Polygraphy: A Method Comparison Study Using Real-World Data.Respiration; international review of thoracic diseases · 2026Article
- Comparison of under-mattress sensor and CPAP data for home monitoring in obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2026Article
- Unraveling sleep apnea dynamics: quantifying loop gain using dynamical modeling of ventilatory control.Sleep · 2026Article
- Obstructive sleep apnea-associated hypertensive disorders in pregnancy: a literature review and clinical management strategies.Reproductive biology and endocrinology : RB&E · 2025Review
- Auto-adjusting positive airway pressure: the fine line between engineering and medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
- The combination of physiology and machine learning for prediction of CPAP pressure and residual AHI in OSA.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Inspiratory positive pressure modulation to minimize respiratory control instability.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Morphological Prediction of Continuous Positive Airway Pressure-associated Acute Respiratory Instability.Annals of the American Thoracic Society · 2025Article
- Novel physiologic predictors of positive airway pressure effectiveness (NICEPAP) study: rationale, design and methods.Sleep & breathing = Schlaf & Atmung · 2024Observational
- Continuous positive airway pressure treatment of obstructive sleep apnea and hypertensive complications in high-risk pregnancy.Sleep & breathing = Schlaf & Atmung · 2023Article
- 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
- Electronic health record-derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Review
- Interpreting CPAP device respiratory indices in children.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Use of the WatchPAT to detect occult residual sleep-disordered breathing in patients on CPAP for obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- DISE-PAP: a method for troubleshooting residual AHI elevation despite positive pressure therapy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesTo assess the frequency, severity, and determinants of residual respiratory events during continuous positive airway therapy (CPAP) for obstructive sleep apnea (OSA) as determined by device output.
methodsSubjects were consecutive OSA patients at an American Academy of Sleep Medicine accredited multidisciplinary sleep center. Inclusion criteria included CPAP use for a minimum of 3 months, and a minimum nightly use of 4 hours. Compliance metrics and waveform data from 217 subjects were analyzed retrospectively. Events were scored manually when there was a clear reduction of amplitude (≥ 30%) or flow-limitation with 2-3 larger recovery breaths. Automatically detected versus manually scored events were subjected to statistical analyses included Bland-Altman plots, correlation coefficients, and logistic regression exploring predictors of residual events.
resultsThe mean patient age was 54.7 ± 14.2 years; 63% were males. All patients had a primary diagnosis of obstructive sleep apnea, 26% defined as complex sleep apnea. Residual flow measurement based apnea-hypopnea index (AHIFLOW) > 5, 10, and 15/h was seen in 32.3%, 9.7%, and 1.8% vs. 60.8%, 23%, and 7.8% of subjects based on automated vs. manual scoring of waveform data. Automatically detected versus manually scored average AHIFLOW was 4.4 ± 3.8 vs. 7.3 ± 5.1 per hour. In a logistic regression analysis, the only predictors for a manual AHIFLOW > 5/h were the absolute central apnea index (CAI), (odds ratio [OR]: 1.5, p: 0.01, CI: 1.1-2.0), or using a CAI threshold of 5/h of sleep (OR: 5.0, p: < 0.001, CI: 2.2-13.8). For AHIFLOW > 10/h, the OR was 1.14, p: 0.03 (CI: 1.1-1.3) per every CAI unit of 1/hour.
conclusionsResidual respiratory events are common during CPAP treatment, may be missed by automated device detection and predicted by a high central apnea index on the baseline diagnostic study. Direct visualization of flow data is generally available and improves detection.
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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.