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sense_dimmed_sleep/s41598023340024_57_0.txt
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sense_dimmed_sleep/s41598023340024_271_0.txt
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sense_dimmed_sleep/s12931022021413_443_3.txt
jEtNi44OC0xNi42Mi00LjQxLTQuNC0xMC4zOS02Ljg4LTE2LjYyLTYuODh6bTAgNDEuMjVjLTkuOCAwLTE3Ljc1LTcuOTUtMTcuNzUtMTcuNzVzNy45NS0xNy43NSAxNy43NS0xNy43NSAxNy43NSA3Ljk1IDE3Ljc1IDE3Ljc1Y
sense_dimmed_sleep/therelationshipbetwe_132_0.txt
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sense_dimmed_sleep/s12931022021413_281_1.txt
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MuMi45OC4yLjM4IDAgLjY1LS4wOC44My0uMjNzLjI3LS4zNS4yNy0uNmMwLS4xNC0uMDUtLjI2LS4xMy0uMzctLjA4LS4xLS4yLS4yLS4zNC0uMjgtLjE0LS4wOS0uMjktLjE2LS40Ny0uMjNsLS41My0u
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sense_dimmed_sleep/s41598023340024_13_0.txt
# Respiratory arousal threshold among patients with isolated sleep apnea and with comorbid insomnia (COMISA)
sense_dimmed_sleep/s41598023340024_244_1.txt
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sense_dimmed_sleep/s41598023340024_282_0.txt
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sense_dimmed_sleep/s12931022021413_68_0.txt
An Alice 4, 5, or 6 Sleep Diagnostic System (Respironics Inc., Pittsburgh, PA, USA) was used for nocturnal monitoring for full-night laboratory PSG. During the laboratory-based PSG, electroencephalogram, electrooculogram, electrocardiogram, and electromyogram recordings were obtained. Nasal airflow was measured using a...
sense_dimmed_sleep/s41598023340024_219_0.txt
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sense_dimmed_sleep/s12931022021413_395_1.txt
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sense_dimmed_sleep/s41598023340024_42_0.txt
\(2014\)."). A low AT has been implicated in the pathogenesis of OSA and may affect one-third of moderate to severe OSA patients [ 4 ](/articles/s41598-023-34002-4#ref-CR4 "El-Solh, A. A., Lawson, Y. & Wilding, G. E. Impact of low arousal threshold on treatment of obstructive sleep apnea in patients with post-traumati...
sense_dimmed_sleep/s41598023340024_109_0.txt
\(1996\)."). For instance, the difference in AHI among participants with a low and high AT in a previous study (17 and 48 events/h, respectively) [ 17 ](/articles/s41598-023-34002-4#ref-CR17 "Zinchuk, A. et al. Prevalence, associated clinical features, and impact on continuous positive airway pressure use of a low res...
sense_dimmed_sleep/s12931022021413_302_0.txt
23. O’Driscoll DM, Landry SA, Pham J, Young A, Sands SA, Hamilton GS, et al. The physiological phenotype of obstructive sleep apnea differs between Caucasian and Chinese patients. Sleep. 2019. [ https://doi.org/10.1093/sleep/zsz186 ](https://doi.org/10.1093/sleep/zsz186).
sense_dimmed_sleep/s12931022021413_443_36.txt
NjF2OS44OGgtMS4zM2wtLjExLS43NGgtLjA2Yy0uMjUuMjUtLjU0LjQ2LS44OC42NC0uMzMuMTgtLjY5LjI3LTEuMDYuMjctLjg3IDAtMS41Ni0uMzItMi4wNy0uOTVzLS43Ni0xLjUxLS43Ni0yLjY1em0xLjY
sense_dimmed_sleep/s12931022021413_414_0.txt
9. Hongliang Yi
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sense_dimmed_sleep/s41598023340024_219_1.txt
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sense_dimmed_sleep/s41598023340024_246_3.txt
jEtNi44OC0xNi42Mi00LjQxLTQuNC0xMC4zOS02Ljg4LTE2LjYyLTYuODh6bTAgNDEuMjVjLTkuOCAwLTE3Ljc1LTcuOTUtMTcuNzUtMTcuNzVzNy45NS0xNy43NSAxNy43NS0xNy43NSAxNy43NSA3Ljk1IDE3Ljc1IDE3Ljc1Y
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zMy0xLjI2LS4zMy0yLjAyem04LjQtNS4zM2gxLjYxdjIuNTRsLS4wNSAxLjMzYy4yOS0uMjcuNjEtLjUxLjk2LS43MnMuNzYtLjMxIDEuMjQtLjMxYy43MyAwIDEuMjcuMjMgMS42MS43MS4zMy40Ny41
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sense_dimmed_sleep/s41598023340024_246_13.txt
4IDEuMjMuMjQuMzYuMTYuNjUuMzguODkuNjdzLjQyLjYzLjU0IDEuMDNjLjEyLjQxLjE4Ljg0LjE4IDEuMzIgMCAuMzItLjAyLjU3LS4wNy43NmgtNC4zNmMuMDcuNjIuMjkgMS4xLjY1IDEuNDQuMz
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Prevalence, characteristics, and respiratory arousal threshold of positional obstructive sleep apnea in China: a large scale study from Shanghai Sleep Health Study cohort
sense_dimmed_sleep/therelationshipbetwe_92_0.txt
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sense_dimmed_sleep/s12931022021413_22_0.txt
### Purpose
sense_dimmed_sleep/s41598023340024_136_0.txt
1. Chung, K. F. Insomnia subtypes and their relationships to daytime sleepiness in patients with obstructive sleep apnea. _Respiration_ **72** (5), 460–465. [ https://doi.org/10.1159/000087668 ](https://doi.org/10.1159/000087668) (2005).
sense_dimmed_sleep/s12931022021413_193_0.txt
APOC:
sense_dimmed_sleep/nonobesepatientswith_40_0.txt
First Name
sense_dimmed_sleep/s41598023340024_285_0.txt
### Publishing policies
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sense_dimmed_sleep/nonobesepatientswith_2_7.txt
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sense_dimmed_sleep/s41598023340024_264_2.txt
%3D1785,476,692,699%26kwrd%3DDiseases,Psychiatric+disorders,Respiratory+tract+diseases)
sense_dimmed_sleep/s12931022021413_40_1.txt
ients with positional obstructive sleep apnea. Sleep Breath. 2021.
sense_dimmed_sleep/s12931022021413_147_0.txt
."), [ 46 ](/articles/10.1186/s12931-022-02141-3#ref-CR46 "Gleeson K, Zwillich CW, White DP. The influence of increasing ventilatory effort on arousal from sleep. Am Rev Respir Dis. 1990;142\(2\):295–300. https://doi.org/10.1164/ajrccm/142.2.295
sense_dimmed_sleep/nonobesepatientswith_29_0.txt
_Neurology_. 2020;94(15 suppl):2740.
sense_dimmed_sleep/s41598023340024_158_0.txt
12. Sweetman, A. _et al._ Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA). _Sleep Med. Rev._ **60**, 101519. [ https://doi.org/10.1016/j.smrv.2021.101519 ](https://doi.org/10.1016/j.smrv.2021.101519) (2021).
sense_dimmed_sleep/s41598023340024_35_0.txt
## Introduction
sense_dimmed_sleep/s12931022021413_430_0.txt
The authors declare that they have no competing interests.
sense_dimmed_sleep/s41598023340024_246_26.txt
MS42NSAwYzAgLjY5LjE0IDEuMjQuNDMgMS42Ni4yOC40MS42OC42MiAxLjE4LjYyLjUxIDAgLjktLjIxIDEuMTktLjYyLjI5LS40Mi40NC0uOTcuNDQtMS42NiAwLS43LS4xNS0xLjI2LS40NC0xLjY3LS4yOS0uNDItLjY4LS42
sense_dimmed_sleep/s12931022021413_346_0.txt
45. Schorr F, Kayamori F, Hirata RP, Danzi-Soares NJ, Gebrim EM, Moriya HT, et al. Different craniofacial characteristics predict upper airway collapsibility in Japanese-Brazilian and white men. Chest. 2016;149(3):737–46. [ https://doi.org/10.1378/chest.15-0638 ](https://doi.org/10.1378/chest.15-0638).
sense_dimmed_sleep/s12931022021413_120_2.txt
-3#Tab1) ) and APOC (Table [ 2 ](/articles/10.1186/s12931-022-02141-3#Tab2) ) criteria (all _P_ < 0.001). The APOC III group had a significantly higher percentage of supine sleep than the APOC I and APOC II groups (Table [ 2 ](/articles/10.1186/s12931-022-02141-3#Tab2) ).
sense_dimmed_sleep/s41598023340024_77_0.txt
## Results
sense_dimmed_sleep/s12931022021413_54_1.txt
https://doi.org/10.1164/rccm.202101-0055OC
sense_dimmed_sleep/s12931022021413_316_1.txt
.
sense_dimmed_sleep/s12931022021413_104_0.txt
**Fig. 3**
sense_dimmed_sleep/nonobesepatientswith_31_0.txt
5\. Bixler EO, Vgontzas AN, Lin HM, et al. Prevalence of sleep-disordered breathing in women: effects of gender. _Am J Respir Crit Care Med_. 2001;163(3 Pt 1):608-613. [ doi: 10.1164/ajrccm.163.3.9911064 ](about:blank)
sense_dimmed_sleep/s41598023340024_133_0.txt
## Data availability
sense_dimmed_sleep/s12931022021413_291_1.txt
scholar.google.com/scholar_lookup?&title=Positional%20vs%20nonpositional%20obstructive%20sleep%20apnea%20patients%3A%20anthropomorphic%2C%20nocturnal%20polysomnographic%2C%20and%20multiple%20sleep%20latency%20test%20data&journal=Chest&doi=10.1378%2Fchest.112.3.629&volume=112&issue=3&pages=629-
sense_dimmed_sleep/s41598023340024_246_34.txt
M5LjQ2LS45OC40Ni0xLjc3IDAtLjY5LS4xMi0xLjIyLS4zNS0xLjYxLS4yMy0uMzgtLjYxLS41Ny0xLjEzLS41Ny0uNDkgMC0uOTkuMjYtMS41Mi43N3ptNS44Ny0xLjY5YzAtLjU2LjA4LTEuMDYuMjUtMS41
sense_dimmed_sleep/s12931022021413_114_0.txt
**Fig. 5**
sense_dimmed_sleep/s41598023340024_45_0.txt
\(2021\).") and is associated with insomnia severity as measured by the Insomnia Severity Index (ISI) [ 6 ](/articles/s41598-023-34002-4#ref-CR6 "Puzino, K. et al. Arousability as a trait predisposition to insomnia: Multidimensional structure and clinical utility of the Spanish and English versions of the arousal pred...
sense_dimmed_sleep/therelationshipbetwe_6_0.txt
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sense_dimmed_sleep/s12931022021413_299_1.txt
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sense_dimmed_sleep/s12931022021413_123_1.txt
, 1.357–1.809) were significantly associated with the development of low ArTH. In a model adjusted for more potential confounders, si-POSA (adjusted OR, 3.542; 95% CI, 2.862–4.384; P < 0.001) was still significantly associated with the development of low ArTH, although significance disappeared for sp- POSA. With regard...
sense_dimmed_sleep/s41598023340024_279_0.txt
Scientific Reports ( _Sci Rep_ ) ISSN 2045-2322 (online)
sense_dimmed_sleep/s12931022021413_127_2.txt
(15 ≤ AHI < 30/h) and 30 ≤ AHI < 55/h were more likely to be associated with POSA according to the CC (adjusted OR, 4.174; 95% CI, 3.238–5.380; adjusted OR, 4.818; 95% CI, 3.826–6.066; and adjusted OR, 3.643; 95% CI, 2.977–4.457, respectively). Similar results were found for APOC (adjusted OR, 3.400; 95%
sense_dimmed_sleep/s41598023340024_51_0.txt
\(2013\)."). The arousal threshold has not been studied according to the different insomnia subtypes.
sense_dimmed_sleep/therelationshipbetwe_26_0.txt
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sense_dimmed_sleep/s12931022021413_443_33.txt
UtMS4xLjI1LS4zIDAtLjYtLjA3LS45LS4ycy0uNTktLjMxLS44Ny0uNTZ6bTAtMi4zYy4yNi4yMi41LjM3LjczLjQ1LjI0LjA5LjQ2LjEzLjY2LjEzLjQ2IDAgLjg0LS4yIDEuMTUtLjYuMzEtLj
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_lookup?&title=The%20effect%20of%20body%20position%20on%20physiological%20factors%20that%20contribute%20to%20obstructive%20sleep%20apnea&journal=Sleep&doi=10.5665%2Fsleep.4992&volume=38&issue=9&pages=1469-1478&publication_year=2015&author=Joosten%2CSA&author=Edwards%2CBA&author=Wellman%2
sense_dimmed_sleep/s12931022021413_35_0.txt
.") ]. Obstructive sleep apnea (OSA) is a common sleep disorder with serious adverse health consequences [ 3 , 4 , [ 5 ](/articles/10.1186/s12931-022-02141-3#ref-CR5 "Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020;323\(14\):1389–400. https://doi.org/10.1001/jama.202...
sense_dimmed_sleep/s41598023340024_38_0.txt
\(2005\)."). The comorbidity of insomnia and sleep apnea (COMISA) is associated to poorer health outcomes [ 2 ](/articles/s41598-023-34002-4#ref-CR2 "Sweetman, A., Lack, L. & Bastien, C. Co-morbid insomnia and sleep apnea \(COMISA\): Prevalence, consequences, methodological considerations, and recent randomized contro...
sense_dimmed_sleep/s12931022021413_205_0.txt
CPAP:
sense_dimmed_sleep/s12931022021413_467_1.txt
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### Corresponding authors
sense_dimmed_sleep/s41598023340024_36_0.txt
Obstructive sleep apnea and insomnia are highly prevalent sleep disorders that are associated with impaired daytime functioning and reduced quality of life [ 1 ](/articles/s41598-023-34002-4#ref-CR1 "Chung, K. F. Insomnia subtypes and their relationships to daytime sleepiness in patients with obstructive sleep apnea. R...
sense_dimmed_sleep/s41598023340024_76_0.txt
All methods were carried out in accordance with relevant guidelines and regulations and all protocols were approved by Comissão de Ética e Pesquisa (CEP) from FMUSP.
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sense_dimmed_sleep/s12931022021413_271_1.txt
Scholar ](http://scholar.google.com/scholar_lookup?&title=Positional%20OSA%20part%201%3A%20towards%20a%20clinical%20classification%20system%20for%20position- dependent%20obstructive%20sleep%20apnoea&journal=Sleep%20Breath&doi=10.1007%2Fs11325-014-1022-9&volume=19&issue=2&pages=473-480&publication_
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* Accepted : 22 April 2023
sense_dimmed_sleep/s12931022021413_368_0.txt
56. Messineo L, Eckert DJ, Lim R, Chiang A, Azarbarzin A, Carter SG, et al. Zolpidem increases sleep efficiency and the respiratory arousal threshold without changing sleep apnoea severity and pharyngeal muscle activity. J Physiol. 2020;598(20):4681–92. [ https://doi.org/10.1113/jp280173 ](https://doi.org/10.1113/jp280...
sense_dimmed_sleep/s12931022021413_443_9.txt
Yy0uMzguNDMtLjguNzYtMS4yOC45OS0uNDcuMjItMSAuMzQtMS41OC4zNC0uNTkgMC0xLjEzLS4xLTEuNjQtLjMxLS41LS4yLS45NC0uNTEtMS4zMS0uOTEtLjM4LS40LS42Ny0uOS0uODgtMS40OC0uMjItLjU5LS4
sense_dimmed_sleep/s41598023340024_197_2.txt
)
sense_dimmed_sleep/s12931022021413_175_0.txt
.") ]. As the major determinants of OSA severity in Chinese patients are anatomical, rather than non-anatomical, the ArTH may have been slightly overestimated for a given level of OSA severity which is similar in non-ethnic Chinese population. Our indirect estimations of ArTH should be verified via invasive measurement...
sense_dimmed_sleep/therelationshipbetwe_70_0.txt
o Try lycra sheets (“Skweezrs”), using a weighted blanket (7-10% of child’s body weight)
sense_dimmed_sleep/s41598023340024_70_0.txt
https://doi.org/10.1164/rccm.201404-0718OC
sense_dimmed_sleep/s41598023340024_290_0.txt
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sense_dimmed_sleep/s41598023340024_246_22.txt
jZoLTEuNjF2LTUuNmgtLjkydi0xLjJsLjkyLS4wN3YtLjcyYzAtLjM1LjA0LS42OC4xMy0uOTguMDgtLjMxLjIxLS41Ny40LS43OXMuNDItLjM5LjcxLS41MWMuMjgtLjEyLjYzLS4xOCAxLjA0LS4xOC4yNCAwIC40