ReviewSleep2023
Central sleep apnea: pathophysiologic classification.
Review in Sleep, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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.
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.
Who cites it
45 citing papers in PubMed, 82 citations in OpenAlex.
- Classifying hypopneas as obstructive or central can enhance transvenous phrenic nerve stimulation therapy patient selection and outcomes.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Trial
- Quantification of ventilatory control in sleep apnea: from physiological insight to computable loop gain.Sleep · 2026Review
- The Intersection of Cardiology and Sleep Medicine: Impact of Sleep-Disordered Breathing on Heart Failure Outcomes.Journal of clinical medicine · 2026Review
- Obstructive Sleep Apnea and Cardiovascular Disease: Mechanisms, Diagnostics, and Emerging Therapeutic Approaches.Biomedicines · 2026Review
- GABAergic Inhibition from the Nucleus Tractus Solitarius to Ventrolateral Medulla Phox2b Neurons Modulates Central Respiratory Chemoreflex and Ventilatory Homeostasis.Neuroscience bulletin · 2026Article
- Progress in understanding the mechanism of sleep apnea in patients with PTSD.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Impact of Bariatric Surgery on Hypoglossal Nerve Stimulation Outcomes.The Laryngoscope · 2026Article
- Hyperbaric Oxygen Therapy and Its Physio-Mechanical Effects on Sleep Breathing Disorder: A Systematic Review.Pulmonary therapy · 2026Review
- Sex differences in loop gain measured via superimposed end-expiratory breath holds and inspired steady-state hypoxia.Experimental physiology · 2026Article
- Long-term impacts of COVID-19 on systemic inflammation and control of breathing reflexes: an observational cohort study.Respiratory research · 2026Observational
- ERS Congress 2025: highlights from the Sleep Disordered Breathing Assembly.ERJ open research · 2026Article
- Prevalence and Clinical Implications of Sleep Apnea in Hypertrophic Cardiomyopathy.JAMA cardiology · 2025Article
- Genetic associations between serotonin receptor 1F (The European respiratory journal · 2025Article
- Spinal stenosis as a rare cause of central sleep apnea: a case report.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Interdisciplinary Perspectives on Dentistry and Sleep Medicine: A Narrative Review of Sleep Apnea and Oral Health.Journal of clinical medicine · 2025Review
- An Atypical Presentation of Central Sleep Apnea in the Context of Bariatric Surgery: A Case Report.Cureus · 2025Article
- Unraveling potential reporting bias in Mendelian randomization studies.Human genetics · 2025Article
- Nocturnal hypoxemia is associated with poor pulmonary hemodynamics in patients with chronic thromboembolic pulmonary disease.Respiratory research · 2025Article
- 3-minute central apneas: enhanced expiratory rebreathing space to the rescue.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Rapid Eye Movement (REM)-Predominant Central Sleep Apnea With Alpha-Delta Sleep Pattern: A Case Report.Cureus · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
Central sleep apnea is not a single disorder; it can present as an isolated disorder or as a part of other clinical syndromes. In some conditions, such as heart failure, central apneic events are due to transient inhibition of ventilatory motor output during sleep, owing to the overlapping influences of sleep and hypocapnia. Specifically, the sleep state is associated with removal of wakefulness drive to breathe; thus, rendering ventilatory motor output dependent on the metabolic ventilatory control system, principally PaCO2. Accordingly, central apnea occurs when PaCO2 is reduced below the "apneic threshold". Our understanding of the pathophysiology of central sleep apnea has evolved appreciably over the past decade; accordingly, in disorders such as heart failure, central apnea is viewed as a form of breathing instability, manifesting as recurrent cycles of apnea/hypopnea, alternating with hyperpnea. In other words, ventilatory control operates as a negative-feedback closed-loop system to maintain homeostasis of blood gas tensions within a relatively narrow physiologic range, principally PaCO2. Therefore, many authors have adopted the engineering concept of "loop gain" (LG) as a measure of ventilatory instability and susceptibility to central apnea. Increased LG promotes breathing instabilities in a number of medical disorders. In some other conditions, such as with use of opioids, central apnea occurs due to inhibition of rhythm generation within the brainstem. This review will address the pathogenesis, pathophysiologic classification, and the multitude of clinical conditions that are associated with central apnea, and highlight areas of uncertainty.
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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.