ArticleSleep2018
Quantifying the Arousal Threshold Using Polysomnography in Obstructive Sleep Apnea.
Article in Sleep, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07577661 (Combination Upper-Airway Electrical and Pharmacological Stimulation for Obstructive Sleep Apnea), which is not on this map. Cited by 114 papers, 2 of them syntheses that pooled 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.
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.
Combination Upper-Airway Electrical and Pharmacological Stimulation for Obstructive Sleep Apnea: A Randomized-Controlled Trial.
Who cites it
114 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of norepinephrine reuptake inhibitors combined with antimuscarinic agents vs monotherapy for OSA: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Pooled it
- Association of alternative polysomnographic features with patient outcomes in obstructive sleep apnea: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Pooled it
- Quetiapine modestly improves sleep and breathing but impairs next-day performance in people with obstructive sleep apnea and difficulty maintaining sleep: a randomized controlled trial.Annals of the American Thoracic Society · 2026Trial
- Effect of viloxazine and trazodone in obstructive sleep apnoea: a randomised, placebo-controlled, cross-over study.Thorax · 2025Trial
- Cognitive behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Trial
- The effect of M-current activation on controller gain and obstructive sleep apnoea severity: a randomised controlled trial using flupirtine.The Journal of physiology · 2025Trial
- Arousal threshold modifies the effect of CPAP on executive function among individuals with obstructive sleep apnoea.The European respiratory journal · 2025Trial
- 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
- Atomoxetine and fesoterodine combination improves obstructive sleep apnoea severity in patients with milder upper airway collapsibility.Respirology (Carlton, Vic.) · 2022Trial
- A single dose of noradrenergic/serotonergic reuptake inhibitors combined with an antimuscarinic does not improve obstructive sleep apnoea severity.Physiological reports · 2022Trial
- Trial
- Mandibular Advancement Device Treatment Efficacy Is Associated with Polysomnographic Endotypes.Annals of the American Thoracic Society · 2021Trial
- Trial
- Polysomnographic Endotyping to Select Patients with Obstructive Sleep Apnea for Oral Appliances.Annals of the American Thoracic Society · 2019Trial
- Identifying obstructive sleep apnoea patients responsive to supplemental oxygen therapy.The European respiratory journal · 2018Trial
- Real-world generalizability of sleep apnea-related polysomnographic metrics and their associations with clinical comorbidities.Annals of the American Thoracic Society · 2026Article
- Differential associations of arousals and respiratory events on oxygen desaturation and resaturation parameters in sleep.Sleep & breathing = Schlaf & Atmung · 2026Article
- Event duration, endotypes and hypoxic burden in obstructive sleep apnoea.ERJ open research · 2026Article
- Predicting optimal CPAP pressure in obstructive sleep apnea among Chinese patients using respiratory endotype derived from polysomnography.Scientific reports · 2026Article
- Orforglipron for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity or overweight: Study design and baseline characteristics of ATTAIN-OSA, a phase 3 trial.Contemporary clinical trials communications · 2026Article
54 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
Study Objectives: Precision medicine for obstructive sleep apnea (OSA) requires noninvasive estimates of each patient's pathophysiological "traits." Here, we provide the first automated technique to quantify the respiratory arousal threshold-defined as the level of ventilatory drive triggering arousal from sleep-using diagnostic polysomnographic signals in patients with OSA. Methods: Ventilatory drive preceding clinically scored arousals was estimated from polysomnographic studies by fitting a respiratory control model (Terrill et al.) to the pattern of ventilation during spontaneous respiratory events. Conceptually, the magnitude of the airflow signal immediately after arousal onset reveals information on the underlying ventilatory drive that triggered the arousal. Polysomnographic arousal threshold measures were compared with gold standard values taken from esophageal pressure and intraoesophageal diaphragm electromyography recorded simultaneously (N = 29). Comparisons were also made to arousal threshold measures using continuous positive airway pressure (CPAP) dial-downs (N = 28). The validity of using (linearized) nasal pressure rather than pneumotachograph ventilation was also assessed (N = 11). Results: Polysomnographic arousal threshold values were correlated with those measured using esophageal pressure and diaphragm EMG (R = 0.79, p < .0001; R = 0.73, p = .0001), as well as CPAP manipulation (R = 0.73, p < .0001). Arousal threshold estimates were similar using nasal pressure and pneumotachograph ventilation (R = 0.96, p < .0001). Conclusions: The arousal threshold in patients with OSA can be estimated using polysomnographic signals and may enable more personalized therapeutic interventions for patients with a low arousal threshold.
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What Socratic 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 Socratic graph.