scholarly journals Dynamic loop gain increases upon adopting the supine body position during sleep in patients with obstructive sleep apnoea

Respirology ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 1662-1669 ◽  
Author(s):  
Simon A. Joosten ◽  
Shane A. Landry ◽  
Scott A. Sands ◽  
Philip I. Terrill ◽  
Dwayne Mann ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Body Position ◽  
Sleep Apnoea ◽  
Loop Gain ◽  
Obstructive Sleep

scholarly journals Acetazolamide improves loop gain but not the other physiological traits causing obstructive sleep apnoea

2012 ◽  
Vol 590 (5) ◽  
pp. 1199-1211 ◽  
Author(s):  
Bradley A. Edwards ◽  
Scott A. Sands ◽  
Danny J. Eckert ◽  
David P. White ◽  
James P. Butler ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
The Other ◽  
Physiological Traits ◽  
Loop Gain ◽  
Obstructive Sleep

scholarly journals P019 Obstructive sleep apnoea endotypes in people with multiple sclerosis

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A27-A28
Author(s):  
S Carter ◽  
H Hensen ◽  
A Krishnan ◽  
A Chiang ◽  
J Carberry ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnoea ◽  
Group Analysis ◽  
Respiratory Control ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Loop Gain ◽  
Male Predominance ◽  
Arousal Threshold ◽  
Obstructive Sleep

Abstract Purpose Obstructive sleep apnoea (OSA) is common in people with multiple sclerosis (MS) despite a lack of typical risk factors for OSA in people with MS such as obesity and male predominance. Therefore, underlying factors other than sex and obesity may be particularly important in the pathogenesis of OSA in people with MS. Thus, the primary aim of this study was to determine the relative contributions of OSA endotypes in people with MS and compare this to matched controls with OSA only. Methods Eleven people with MS and OSA (MS-OSA group) (apnoea-hypopnoea index [AHI]>5events/h) and eleven controls matched for OSA severity, age and sex without MS (OSA group) were studied. Participants underwent a detailed overnight polysomnography with an epiglottic pressure catheter and genioglossus intramuscular electrodes to allow for quantification of pathophysiological contributors to OSA. This included the respiratory arousal threshold, genioglossus muscle responsiveness, respiratory loop gain and upper airway collapsibility. Results Measures of the four primary OSA endotypes were not different between the MS-OSA and OSA groups (e.g. NREM respiratory arousal threshold -27±15 vs. -23±8 cmH2O respectively, p=0.24). Within group analysis indicated higher loop gain in non-obese MS-OSA participants compared to obese MS-OSA participants (0.53±0.11 vs. 0.37±0.11, p=0.04). Conclusions Overall, OSA endotypes are similar between MS-OSA participants and matched OSA controls. However, within the MS-OSA group, non-obese participants have higher loop gain (unstable respiratory control) compared to obese participants. Thus, unstable respiratory control may play an important role in OSA pathogenesis in many people with MS.

scholarly journals Integrating loop gain into the understanding of obstructive sleep apnoea mechanisms

2018 ◽  
Vol 596 (17) ◽  
pp. 3819-3820 ◽  
Author(s):  
Luu V. Pham ◽  
Alan R. Schwartz ◽  
Vsevolod Y. Polotsky
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Loop Gain ◽  
Obstructive Sleep

scholarly journals Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy

2018 ◽  
Vol 52 (3) ◽  
pp. 1800674 ◽  
Author(s):  
Scott A. Sands ◽  
Bradley A. Edwards ◽  
Philip I. Terrill ◽  
James P. Butler ◽  
Robert L. Owens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnoea ◽  
Supplemental Oxygen ◽  
Sleep Apnoea ◽  
Loop Gain ◽  
Primary Analysis ◽  
Obstructive Sleep ◽  
Morning Blood Pressure ◽  
Randomised Controlled ◽  
Supplemental Oxygen Therapy

A possible precision-medicine approach to treating obstructive sleep apnoea (OSA) involves targeting ventilatory instability (elevated loop gain) using supplemental inspired oxygen in selected patients. Here we test whether elevated loop gain and three key endophenotypic traits (collapsibility, compensation and arousability), quantified using clinical polysomnography, can predict the effect of supplemental oxygen on OSA severity.36 patients (apnoea–hypopnoea index (AHI) >20 events·h−1) completed two overnight polysomnographic studies (single-blinded randomised-controlled crossover) on supplemental oxygen (40% inspired) versus sham (air). OSA traits were quantified from the air-night polysomnography. Responders were defined by a ≥50% reduction in AHI (supine non-rapid eye movement). Secondary outcomes included blood pressure and self-reported sleep quality.Nine of 36 patients (25%) responded to supplemental oxygen (ΔAHI=72±5%). Elevated loop gain was not a significant univariate predictor of responder/non-responder status (primary analysis). In post hoc analysis, a logistic regression model based on elevated loop gain and other traits (better collapsibility and compensation; cross-validated) had 83% accuracy (89% before cross-validation); predicted responders exhibited an improvement in OSA severity (ΔAHI 59±6% versus 12±7% in predicted non-responders, p=0.0001) plus lowered morning blood pressure and “better” self-reported sleep.Patients whose OSA responds to supplemental oxygen can be identified by measuring their endophenotypic traits using diagnostic polysomnography.

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