Evidence map›Paper›PMID 30794310›Full record

Trial reportSleep2019

Is there a threshold that triggers cortical arousals in obstructive sleep apnea.

Yanru Li, Jeremy Orr, Rachel Jen, Scott A Sands, Pamela DeYoung, Erik Smales, Bradley Edwards, Robert L Owens, Atul Malhotra

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Sleep, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02264353 (The Impact of Arousal Threshold in Obstructive Sleep Apnea), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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.

NCT02264353 phase4completednot on this map

The Impact of Arousal Threshold in Obstructive Sleep Apnea: Donepezil's Effects on the Arousal Threshold and on the Apnea Hypopnea Index

TypeinterventionalSponsorUniversity of California, San DiegoRan2014 to 2015Enrolled44ConditionsObstructive Sleep ApneaArmsDonepezil, placebo
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023
    Review
  4. Article
  5. Review
  6. Article
  7. Contribution of the Retrotrapezoid Nucleus and Carotid Bodies to Hypercapnia- and Hypoxia-induced Arousal from Sleep.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2019
    Article
  8. New organisation for follow-up and assessment of treatment efficacy in sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yanru LiDepartment of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education of China), Beijing, China.
Jeremy OrrPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.
Rachel JenPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.
Scott A SandsDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Pamela DeYoungPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.
Erik SmalesPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.
Bradley EdwardsDepartment of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education of China), Beijing, China.
Robert L OwensPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.
Atul MalhotraPulmonary, Critical Care and Sleep Division, University of California at San Diego, San Diego, CA.

Funding

Neural Plasticity During Acclimatization to HypoxiaR01HL081823 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI POWELL, FRANK L. · 2005 to 2019
$4.5M
Determination of the site of pharyngeal collapse in Obstructive Sleep Apnea patients from snoring soundsR01HL128658 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI WELLMAN, DAVID ANDREW · 2016 to 2025
$4.3M
Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
Imaging Blood Flow, Ventilation, and Density InteractionsR01HL119201 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI HOPKINS, SUSAN R · 2016 to 2019
$2.5M
Training in the Next Generation in Respiratory ScienceT32HL134632 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL, POWELL, FRANK L. · 2017 to 2021
$2.1M
Assessment of Upper Airway Mechanics Using Newer Electromyographic TechniquesK24HL132105 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2016 to 2020
$611k
MR Imaging of Upper Airway Dynamics in Obstructive Sleep ApneaR21HL121794 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DARQUENNE, CHANTAL · 2014 to 2015
$423k
The Contribution of Ventilatory Instability to Sleep Disordered Breathing in Pulmonary HypertensionF32HL131306 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ORR, JEREMY ELLIOT · 2016 to 2017
$139k
NHLBI NIH HHS F32 HL131306NHLBI NIH HHS K24 HL132105NHLBI NIH HHS R01 HL081823NHLBI NIH HHS R01 HL085188NHLBI NIH HHS R01 HL119201NHLBI NIH HHS R01 HL128658NHLBI NIH HHS R21 HL121794NHLBI NIH HHS T32 HL134632
6 · The paper itself

Abstract

STUDY

objectivesTo determine whether there is a consistent epiglottic pressure value that predicts respiratory arousal from sleep.

methodsThirty-one patients with obstructive sleep apnea underwent overnight polysomnography while instrumented with an epiglottic catheter to measure airway pressures. Nadir epiglottic pressures during respiration events (obstructive apneas/hypopneas) terminated with or without arousals were compared. The events were selected by two methods, (1) 20 events with/without arousals were randomly selected, and (2) Events were sampled in pairs (one terminated with arousal and one without arousal) to minimize the effect of sleep duration/stage on the measurement.

resultsA total of 1,317 respiratory events were analyzed. There was substantial variability in nadir epiglottic pressure within an individual and among different individuals. The average pressure of 20 randomly selected events with arousals was (-21.2 ± 11.2, ranged -6.68 to -63.34 cm H2O). The nadir epiglottic pressure during respiratory events in NREM stage 2 sleep terminated with arousals was more negative compared with those terminated without arousals using both sampling methods (-23.5 vs. -18.5 cm H2O, p = 0.007 and -20.3 vs. -16.3 cm H2O, p < 0.001).

conclusionsThere were very different levels of epiglottic pressures that preceded arousals within and among individuals. However, cortical arousals are associated with a level of more negative epiglottic pressure compared to events terminated without arousal, findings which support the concept of a respiratory arousal threshold. CLINICAL

trial registrationThe study used existing data to study methodology (from clinical trial "The Impact of Arousal Threshold in Obstructive Sleep Apnea" https://clinicaltrials.gov/show/NCT02264353) and it is not a clinical trial.

Indexed as

AdultArousalEpiglottisFemaleHumansMaleMiddle AgedPolysomnographyRespirationSleep Apnea, ObstructiveSleep Stagesarousalepiglottic pressureobstructive sleep apnearespiratory arousal threshold

Identifiers

PMID30794310
PMCPMC6559175

What OpenQuestion holds

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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.