ArticleThe Journal of physiology2018
Breath-holding as a means to estimate the loop gain contribution to obstructive sleep apnoea.
Article in The Journal of physiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed.
- Quantification of ventilatory control in sleep apnea: from physiological insight to computable loop gain.Sleep · 2026Review
- Differential Cardiac and Peripheral Vascular Low-Frequency Oscillation Responses to Voluntary Breath-Hold.Life (Basel, Switzerland) · 2026Article
- TMD and Bruxism as Expressions of Central Regulatory State: The Functional Occlusion Regulated Model (FORM).Journal of clinical medicine · 2026Review
- Dysfunctional breathing in patients with moderate and severe obstructive sleep apnea: a cross sectional study.Sleep & breathing = Schlaf & Atmung · 2026Article
- OSA Endotyping as Targets for Treatment. How Far Have We Come?Respirology (Carlton, Vic.) · 2026Review
- The upper airway in obstructive sleep apnoea: state of the art.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Sex differences in loop gain measured via superimposed end-expiratory breath holds and inspired steady-state hypoxia.Experimental physiology · 2026Article
- Unraveling sleep apnea dynamics: quantifying loop gain using dynamical modeling of ventilatory control.Sleep · 2026Article
- Rebreathing during CPAP therapy and its implications in obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Review
- 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
- Increased loop gain and upper airway collapsibility among smoking patients with obstructive sleep apnoea.ERJ open research · 2025Article
- Morphological Prediction of Continuous Positive Airway Pressure-associated Acute Respiratory Instability.Annals of the American Thoracic Society · 2025Article
- Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review.Sleep science (Sao Paulo, Brazil) · 2024Review
- Effect of comprehensive rehabilitation on apnea hypopnea index in patients with obstructive sleep apnea: a protocol for randomized controlled trial.Sleep & breathing = Schlaf & Atmung · 2024Article
- Article
- Wavelet Analysis of Respiratory Muscle sEMG Signals during the Physiological Breakpoint of Static Dry End-Expiratory Breath-Holding in Naive Apneists: A Pilot Study.Sensors (Basel, Switzerland) · 2023Article
- Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome.Signal transduction and targeted therapy · 2023Review
- Obstructive sleep apnea phenotypes eligible for pharmacological treatment.Frontiers in sleep · 2023Review
- Sleep apnea endotypes: from the physiological laboratory to scalable polysomnographic measures.Frontiers in sleep · 2023Article
- The role of neuromuscular function in sleep apnea pathogenesis and management: A consensus of experts.Frontiers in sleep · 2023Review
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8 authors.
Funding
Abstract
key pointsA hypersensitive ventilatory control system or elevated "loop gain" during sleep is a primary phenotypic trait causing obstructive sleep apnoea (OSA). Despite the multitude of methods available to assess the anatomical contributions to OSA during wakefulness in the clinical setting (e.g. neck circumference, pharyngometry, Mallampati score), it is currently not possible to recognize elevated loop gain in patients in this context. Loop gain during sleep can now be recognized using simplified testing during wakefulness, specifically in the form of a reduced maximal breath-hold duration, or a larger ventilatory response to voluntary 20-second breath-holds. We consider that easy breath-holding manoeuvres will enable daytime recognition of a high loop gain in OSA for more personalized intervention. ABSTRACT: Increased "loop gain" of the ventilatory control system promotes obstructive sleep apnoea (OSA) in some patients and offers an avenue for more personalized treatment, yet diagnostic tools for directly measuring loop gain in the clinical setting are lacking. Here we test the hypothesis that elevated loop gain during sleep can be recognized using voluntary breath-hold manoeuvres during wakefulness. Twenty individuals (10 OSA, 10 controls) participated in a single overnight study with voluntary breath-holding manoeuvres performed during wakefulness. We assessed (1) maximal breath-hold duration, and (2) the ventilatory response to 20 s breath-holds. For comparison, gold standard loop gain values were obtained during non-rapid eye movement (non-REM) sleep using the ventilatory response to 20 s pulses of hypoxic-hypercapnic gas (6% CO
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