Loop gain predicts residual sleep apnoea among people using positive airway pressure.

Ventilatory control instability is a plausible cause of residual sleep apnoea.

通气控制不稳定性是残余性睡眠呼吸暂停的一个合理原因。

Elevated loop gain (LG), a measure of ventilatory instability, may be a risk factor, but this has not been rigorously tested.

升高的环路增益（LG），作为通气不稳定性的一种测量，可能是一个风险因素，但这一点尚未经过严格的测试。

Background

To assess whether high LG at baseline is associated with residual sleep apnoea on positive airway pressure therapy in two large, randomised control trials: Apnoea Positive Pressure Long-Term Efficacy Study (APPLES) and Randomised Intervention with CPAP in Coronary Artery Disease and OSA (RICCADSA).

评估基线时高LG是否与在两项大型随机对照试验中使用正压通气治疗后残余睡眠呼吸暂停有关：睡眠呼吸暂停正压长期疗效研究（APPLES）和冠状动脉疾病和OSA中使用CPAP的随机干预研究（RICCADSA）。

Methods

LG was estimated from baseline polysomnography using a validated method.

LG 是使用一种经过验证的方法从基线多导睡眠图中估计出来的。

Residual sleep apnoea was defined using polysomnography on positive airway pressure at 2 months (APPLES) or device downloads at 3 months (RICCADSA).

残余睡眠呼吸暂停是通过在正压通气下使用多导睡眠图在2个月时(APPLES)或通过设备下载在3个月时(RICCADSA)定义的。

Logistic regression estimated the odds of residual sleep apnoea with high LG (highest quartile), adjusting for confounders.

逻辑回归估计了高LG（最高四分位数）的残余睡眠呼吸暂停的几率，同时调整了混杂因素。

A sensitivity analysis was performed using linear regression, where both the exposure and outcome were defined continuously.

使用线性回归进行了敏感性分析，其中暴露和结果都被定义为连续变量。

measurements_and_main_results

In the unadjusted analysis, high LG was associated with threefold odds of residual sleep apnoea in both samples.

在未调整的分析中，高LG与两组样本中残余睡眠呼吸暂停的三倍风险相关。

After adjustment, elevated odds persisted in both APPLES (2.17 (1.24-3.78)) and RICCADSA (3.31 (1.33-8.24)).

调整后，APPLES组的增加风险持续存在（2.17 (1.24-3.78)），RICCADSA组也是如此（3.31 (1.33-8.24)）。

Associations remained after accounting for measures of central sleep apnoea.

在考虑了中央型睡眠呼吸暂停的测量后，这些关联仍然存在。

Linear regression confirmed the association of LG and residual Apnoea-Hypopnoea Index.

线性回归证实了轻度认知障碍与残余呼吸暂停低通气指数的关联。

Conclusions

High LG is a significant risk factor for residual sleep apnoea on positive airway pressure therapy.

高 LG 是正压通气治疗后残余睡眠呼吸暂停的一个显著风险因素。

Ventilatory control instability identified at baseline may warrant closer monitoring or the initiation of adjunctive therapies aimed at reducing LG and improving the therapeutic response.

在基线时识别出的通气控制不稳定性可能需要更密切的监测或启动辅助治疗，旨在降低 LG 并改善治疗反应。