Observational studyJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2018
Prevalence, Associated Clinical Features, and Impact on Continuous Positive Airway Pressure Use of a Low Respiratory Arousal Threshold Among Male United States Veterans With Obstructive Sleep Apnea.
Observational study in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 50 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.
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.
Novel physIologiC prEdictors of Positive Airway Pressure Effectiveness: NICEPAP Study Prospective Cohort
Effects of Eszopiclone and Lemborexant in People With Obstructive Sleep Apnoea (OSA) With a Low Arousal Threshold Who Have Difficulty Maintaining or Falling Asleep (ELOSA): A Double-blind, Placebo-controlled, Randomised, Trial.
Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.
- Acetazolamide for OSA and Central Sleep Apnea: A Comprehensive Systematic Review and Meta-Analysis.Chest · 2020Pooled it
- The Effects of Daridorexant on Patients With Comorbid Insomnia Disorder and Untreated Mild Obstructive Sleep Apnoea: A Post Hoc Subgroup Analysis of a Phase 3, Randomised Clinical Trial.Journal of sleep research · 2026Trial
- Combination Drug Therapy with Acetazolamide, Eszopiclone ± Venlafaxine for Obstructive Sleep Apnea (RESCUE-Combo): A Randomized, Double-Blind, Placebo-controlled Clinical Trial.Annals of the American Thoracic Society · 2025Trial
- Daily Exposure to Mild Intermittent Hypoxia Reduces Blood Pressure in Male Patients with Obstructive Sleep Apnea and Hypertension.American journal of respiratory and critical care medicine · 2022Trial
- Physiological Traits and Adherence to Sleep Apnea Therapy in Individuals with Coronary Artery Disease.American journal of respiratory and critical care medicine · 2021Trial
- The Arousal Threshold as a Drug Target to Improve Continuous Positive Airway Pressure Adherence: Secondary Analysis of a Randomized Trial.American journal of respiratory and critical care medicine · 2020Trial
- Trial
- "Phenotyping obstructive sleep apnea: a pathway to precision medicine".Sleep & breathing = Schlaf & Atmung · 2026Review
- Review
- Comparative Study on CPAP Compliance: PAP-NAP Followed by CPAP Trial vs. CPAP Trial Alone.Sleep science (Sao Paulo, Brazil) · 2025Article
- Research Priorities for Translating Endophenotyping of Adult Obstructive Sleep Apnea to the Clinic: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Role of arousal in diagnosing sleep apnea in atrial fibrillation patients.Sleep & breathing = Schlaf & Atmung · 2025Article
- Is Obstructive Sleep Apnea in People Without Obesity a Unique Disease?Archivos de bronconeumologia · 2025Article
- Respiratory Arousal Threshold in Patients with Epilepsy and Obstructive Sleep Apnea.Nature and science of sleep · 2025Article
- The Arousal Threshold: The "Weakest Link" in Obstructive Sleep Apnea Pathogenesis?American journal of respiratory and critical care medicine · 2024Article
- Low arousal threshold is associated with altered functional connectivity of the ascending reticular activating system in patients with obstructive sleep apnea.Scientific reports · 2024Article
- The Present and Future of the Clinical Use of Physiological Traits for the Treatment of Patients with OSA: A Narrative Review.Journal of clinical medicine · 2024Review
- Continuous positive airway pressure and adherence in patients with different endotypes of obstructive sleep apnea.Journal of sleep research · 2024Article
- The Association of High Arousal Threshold with Hypertension and Diabetes in Obstructive Sleep Apnea.Nature and science of sleep · 2024Article
- Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
STUDY
objectivesDetermine the prevalence of, and clinical features associated with, a low respiratory arousal threshold (ArTH) among patients with obstructive sleep apnea (OSA), and to assess whether a low ArTH is associated with reduced long-term CPAP use.
methodsCross-sectional and longitudinal analyses were performed in an observational study conducted among 940 male Veterans with OSA. Data for clinical characteristics, polysomnography characteristics, and long-term (5 ± 2 years) CPAP use were obtained from clinical records. Logistic regression was used to assess the associations between low ArTH and clinical features, including regular CPAP use.
resultsA low ArTH was observed in 38% of participants overall, and was more common among nonobese (body mass index < 30 kg/m
conclusionsLow ArTH is a common trait among Veterans with OSA and is more frequent among those who are older and nonobese and those taking antidepressants, but is less frequent among patients taking antihypertensive medications. A marked reduction of long-term CPAP use in nonobese patients with low ArTH highlights the importance of understanding a patient's physiologic phenotype for OSA management, and suggests potential targets to improve CPAP adherence. COMMENTARY: A commentary on this article appears in this issue on page 713.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.