2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T60b,Aboriginal and Torres Strait Islander peoples experience a higher burden of obstructive sleep apnoea (OSA) than non-Indigenous populations but face considerable barriers to diagnosis and management. In response to this unmet need, a regional/remote Aboriginal Community Controlled Health Organisation (ACCHO) in far western NSW developed a primary care-coordinated sleep service in 2016. This is a unique service model, providing primary care-coordinated, fully funded access to OSA diagnosis through at-home sleep studies, continuous positive airway pressure (CPAP) treatment, and access to sleep physician review in an ACCHO setting. This service model has facilitated improved access to diagnosis and management services and identified a significant unmet need in the community, with 100% (67/67) of people undertaking a sleep study diagnosed with OSA, and a prevalence of 52% for severe OSA in this referred cohort, higher than other published reports for Aboriginal and Torres Strait Islander populations. Despite the high prevalence of OSA in this population, significant symptom improvement and excellent disease control have been achieved in those who commenced CPAP through the service, reinforcing the need for ongoing and expanded service delivery within our region. With sufficient and sustainable funding, this innovative service model is one that could be considered in other under-serviced areas to improve access to OSA diagnosis and treatment, particularly among populations facing significant financial and geographical barriers.31:T61c,Aboriginal and Torres Strait Islander peoples experience a higher burden of obstructive sleep apnoea (OSA) than non-Indigenous populations but face considerable barriers to diagnosis and management. In response to this unmet need, a regional/remote Aboriginal Community Controlled Health Organisation (ACCHO) in far western NSW developed a primary care-coordinated sleep service in 2016. This is a unique service model, providing primary care-coordinated, fully funded access to OSA diagnosis through at-home sleep studies, continuous positive airway pressure (CPAP) treatment, and access to sleep physician review in an ACCHO setting. This service model has facilitated improved access to diagnosis and management services and identified a significant unmet need in the community, with 100% (67/67) of people undertaking a sleep study diagnosed with OSA, and a prevalence of 52% for severe OSA in this referred cohort, higher than other published reports for Aboriginal and Torres Strait Islander populations. Despite the high prevalence of OSA in this population, significant symptom improvement and excellent disease control have been achieved in those who commenced CPAP through the service, reinforcing the need for ongoing and expanded service delivery within our region. With sufficient and sustainable funding, this innovative service model is one that could be considered in other under-serviced areas to improve access to OSA diagnosis and treatment, particularly among populations facing significant financial and geographical barriers.32:T7f9,Obstructive sleep apnea (OSA) is associated with many health conditions, including dementia and early mortality. Prior epidemiological studies linking OSA with Parkinson disease (PD) are conflicting, and no studies have examined the influence of continuous positive airway pressure (CPAP), the criterion standard treatment for OSA, on PD risk. To examine the association between OSA with incident Parkinson disease among US veterans and risk modification by CPAP. This electronic health record (EHR)-based cohort study was conducted among US veterans from January 1, 1999, to December 30, 2022, with mean (SD) follow-up of 4.9 (1.8) years. Veterans with PD at the time of exposure or incomplete records were excluded. Data analysis was completed from September 2024 to September 2025. OSA was defined by its appropriate administrative code; CPAP usage was extracted from a semistructured medical interview field in the EHR. The primary outcome, cumulative incidence of PD, was calculated adjusting for competing risk of death after balancing for age, race, sex, and smoking status. A total of 13 737 081 US veterans were screened, and 11 310 411 veterans (1 109 543 female veterans [9.8%]) with mean (SD) age of 60.5 (14.7) years were included in analyses. Of included veterans, 1 552 505 (13.7%) had OSA. Veterans with OSA demonstrated 1.61 additional cases of PD (point estimate; 95% CI, 1.13-2.09) at 6 years from diagnosis per 1000 people compared to those without OSA. Results were confirmed when adjusting for body mass index, vascular comorbidities, psychiatric conditions, and relevant medications and were of greater magnitude in female veterans. Case numbers were significantly reduced when treated with CPAP early in the disease course. In this EHR-based cohort study, OSA appeared to be an independent risk factor for the later development of PD and could be modified by early treatment with CPAP. Effective screening measures and protocols for consistent adherence to CPAP may have large impacts on brain health.33:Tcce, Importance Obstructive sleep apnea (OSA) is associated with many health conditions, including dementia and early mortality. Prior epidemiological studies linking OSA with Parkinson disease (PD) are conflicting, and no studies have examined the influence of continuous positive airway pressure (CPAP), the criterion standard treatment for OSA, on PD risk. Objective To examine the association between OSA with incident Parkinson disease among US veterans and risk modification by CPAP. Design, Setting, and Participants This electronic health record (EHR)–based cohort study was conducted among US veterans from January 1, 1999, to December 30, 2022, with mean (SD) follow-up of 4.9 (1.8) years. Veterans with PD at the time of exposure or incomplete records were excluded. Data analysis was completed from September 2024 to September 2025. Exposure OSA was defined by its appropriate administrative code; CPAP usage was extracted from a semistructured medical interview field in the EHR. Main Outcomes and Measures The primary outcome, cumulative incidence of PD, was calculated adjusting for competing risk of death after balancing for age, race, sex, and smoking status. Results A total of 13 737 081 US veterans were screened, and 11 310 411 veterans (1 109 543 female veterans [9.8%]) with mean (SD) age of 60.5 (14.7) years were included in analyses. Of included veterans, 1 552 505 (13.7%) had OSA. Veterans with OSA demonstrated 1.61 additional cases of PD (point estimate; 95% CI, 1.13-2.09) at 6 years from diagnosis per 1000 people compared to those without OSA. Results were confirmed when adjusting for body mass index, vascular comorbidities, psychiatric conditions, and relevant medications and were of greater magnitude in female veterans. Case numbers were significantly reduced when treated with CPAP early in the disease course. Conclusions and Relevance In this EHR-based cohort study, OSA appeared to be an independent risk factor for the later development of PD and could be modified by early treatment with CPAP. Effective screening measures and protocols for consistent adherence to CPAP may have large impacts on brain health. 34:Tc5b,The purpose of this guideline is to establish clinical practice recommendations for the management of obstructive sleep apnea (OSA) in medically hospitalized adults. The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using Grading of Recommendations, Assessment, Development and Evaluation methodology. The task force provided a summary of the relevant literature and the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations. The following Good Practice Statement is based on expert consensus, and its implementation is necessary for the appropriate and effective management of hospitalized adults with sleep-disordered breathing: For medically hospitalized adults with an established diagnosis of sleep-disordered breathing and on active treatment, existing treatment should be continued rather than withheld, unless contraindicated. The following recommendations are intended as a guide for clinicians in managing medically hospitalized adults with OSA. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest…") is one that requires that the clinician use clinical knowledge and experience and strongly consider the patient's values and preferences to determine the best course of action. 1. For medically hospitalized adults at increased risk for OSA, the AASM suggests in-hospital screening for OSA as part of an evaluation and management pathway that incorporates diagnosis and treatment with positive airway pressure (PAP) rather than no in-hospital screening. (Conditional recommendation, low certainty of evidence) 2. For medically hospitalized adults with newly diagnosed OSA, or with a prior established diagnosis of moderate-to-severe OSA but not currently on treatment, the AASM suggests the use of inpatient treatment with PAP rather than no PAP. (Conditional recommendation, low certainty of evidence) 3. For medically hospitalized adults at increased risk for or with an established diagnosis of OSA, the AASM suggests that sleep medicine consultation be available as part of an evaluation and management pathway, rather than no sleep medicine consultation. (Conditional recommendation, very low certainty of evidence) 4. For medically hospitalized adults at increased risk for or with an established diagnosis of OSA, the AASM suggests a discharge management plan to ensure timely diagnosis and effective management of OSA, rather than no plan. (Conditional recommendation, very low certainty of evidence) Mehra R, Auckley DH, Johnson KG, et al. Evaluation and management of obstructive sleep apnea in adults hospitalized for medical care: an American Academy of Sleep Medicine clinical practice guideline. 35:T1047,This guideline establishes clinical practice recommendations for treatment of central sleep apnea (CSA) syndromes in adults. The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. The task force provided a summary of the relevant literature and the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations. The following good practice statement is based on expert consensus, and its implementation is necessary for the appropriate and effective management of patients with CSA. The optimal approach to CSA treatment should incorporate clinical features, comorbid conditions, and polysomnographic findings in an individualized manner. Specifically, clinicians must prioritize optimizing therapy for the conditions contributing to central apneas and improving patient-reported outcomes rather than solely focusing on eliminating disordered breathing events. Once therapy for CSA has been initiated, persistence of central respiratory events should prompt re-evaluation of the underlying risk factors and consideration of alternative treatment options. The following recommendations are intended as a guide for clinicians in choosing a specific treatment for adults with CSA. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend …") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest …") is one that clinicians should offer to most patients if clinically appropriate. Some recommendations include remarks that provide additional context to guide clinicians with the implementation of this recommendation. 1. The AASM suggests using continuous positive airway pressure over no continuous positive airway pressure in adults with CSA due to the following etiologies: primary CSA, CSA due to heart failure, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, low certainty of evidence). 2. The AASM suggests using bilevel positive airway pressure 3. The AASM suggests against the use of bilevel positive airway pressure 4. The AASM suggests using adaptive servo-ventilation over no adaptive servo-ventilation in adults with CSA due to the following etiologies: primary CSA, CSA due to heart failure, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, low certainty of evidence). 5. The AASM suggests using low-flow oxygen over no low-flow oxygen in adults with CSA due to heart failure. (Conditional recommendation, low certainty of evidence). 6. The AASM suggests using low-flow oxygen over no low-flow oxygen in adults with CSA due to high altitude. (Conditional recommendation, very low certainty of evidence). 7. The AASM suggests using oral acetazolamide over no acetazolamide in adults with CSA due to the following etiologies: primary CSA, CSA due to heart failure, CSA due to medication or substance use, treatment-emergent CSA, and CSA due to a medical condition or disorder. (Conditional recommendation, low certainty of evidence). 8. The AASM suggests using oral acetazolamide over no acetazolamide in adults with CSA due to high altitude. (Conditional recommendation, very low certainty of evidence). 9. The AASM suggests using transvenous phrenic nerve stimulation over no transvenous phrenic nerve stimulation in adults with CSA due to the following etiologies: primary CSA and CSA due to heart failure. (Conditional recommendation, very low certainty of evidence). Badr MS, Khayat RN, Allam JS, et al. Treatment of central sleep apnea in adults: an American Academy of Sleep Medicine clinical practice guideline. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Positive Airway Pressure: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Positive Airway Pressure (modality). Clinician-written summaries and actionable practice insights. 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The guideline relies heavily on expert consensus rather than high-quality RCT data.","practice_takeaway":"Screen every pregnant patient for OSA using a validated tool; if at risk, diagnose with HST or PSG and treat with APAP when AHI thresholds or symptom criteria are met. Plan postpartum OSA reassessment for appropriate patients."}},{"doi":"10.1080/02770903.2025.2596655","pmid":"41321048","title":"The effect of continuous positive airway pressure therapy in patients with expiratory large airway collapse with and without asthma","journal_title":"Journal of Asthma","journal_issn":"0277-0903","published_at":"2025-12-01T00:00:00.000Z","url":"https://doi.org/10.1080/02770903.2025.2596655","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-07","doi":"10.1080/02770903.2025.2596655","days":"7","issn":"0277-0903","rank":"5","field":"Clinical Medicine","score":"1","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1080/02770903.2025.2596655","title":"The effect of continuous positive airway pressure therapy in patients with expiratory large airway collapse with and without asthma.","journal":"The Journal of asthma : official journal of the Association for the Care of Asthma","methods":"","results":"Thirty-nine patients were adherent to CPAP. Adherence was not related to demographics, clinical characteristics or CPAP settings (all ","abstract":"Expiratory large airway collapse (ELAC) is characterized by abnormal (>50%) narrowing of the large airways. It is a potential reason for poor asthma control and increased rate of asthma exacerbations. Continuous positive airway pressure (CPAP) is a potential treatment for ELAC. However, data on adherence to CPAP and its clinical impact in ELAC are limited.\nSixty-five patients with ELAC [age 61 (55-70) years, 56 females] who were set up on CPAP between December 2014 and May 2022 were included in this retrospective observational cohort study. Etiologies for ELAC included asthma (\nThirty-nine patients were adherent to CPAP. Adherence was not related to demographics, clinical characteristics or CPAP settings (all \nCPAP is well tolerated in patients with ELAC, and many report improvement in their respiratory and sleep-related symptoms. There is an additional benefit in patients with concomitant asthma in terms of steroid reduction that needs to be investigated in future studies.","keywords":["Asthma","continuous positive airway pressure","exacerbation","excessive dynamic airway collapse","expiratory large airway collapse","tracheobronchomalacia"],"pubmed_id":"41321048","conclusions":"","publication_date":"2025-12-01T00:00:00"},"crossref":{"DOI":"10.1080/02770903.2025.2596655","URL":"https://doi.org/10.1080/02770903.2025.2596655","ISSN":["0277-0903","1532-4303"],"link":[{"URL":"https://www.tandfonline.com/doi/pdf/10.1080/02770903.2025.2596655","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1-6","type":"journal-article","issue":null,"score":1,"title":["The effect of continuous positive airway pressure therapy in patients with expiratory large airway collapse with and without asthma"],"author":[{"given":"Andras","family":"Bikov","sequence":"first","affiliation":[{"name":"Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust"},{"name":"Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester"}]},{"given":"M Zahid","family":"Hassan","sequence":"additional","affiliation":[{"name":"Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust"}]},{"given":"Saba","family":"Bokhari","sequence":"additional","affiliation":[{"name":"Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust"}]},{"given":"Stephen J","family":"Fowler","sequence":"additional","affiliation":[{"name":"Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust"},{"name":"Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester"}]}],"funder":[{"id":[{"id":"10.13039/100014653","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100014653","name":"NIHR Manchester Biomedical Research Centre","doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2025,12,9]]},"member":"301","prefix":"10.1080","source":"Crossref","volume":null,"created":{"date-time":"2025-12-01T07:25:51Z","timestamp":1764573951000,"date-parts":[[2025,12,1]]},"indexed":{"date-time":"2025-12-09T14:17:43Z","timestamp":1765289863338,"date-parts":[[2025,12,9]]},"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.tandfonline.com/doi/full/10.1080/02770903.2025.2596655"}},"subtitle":[],"assertion":[{"name":"peerreview_statement","label":"Peer Review Statement","order":1,"value":"The publishing and review policy for this title is described in its Aims & Scope."},{"URL":"http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ijas20","name":"aims_and_scope_url","label":"Aim & Scope","order":2,"value":"http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ijas20"},{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-09-25"},{"name":"revised","group":{"name":"publication_history","label":"Publication History"},"label":"Revised","order":1,"value":"2025-11-15"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2025-11-25"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2025-12-09"}],"deposited":{"date-time":"2025-12-09T14:15:10Z","timestamp":1765289710000,"date-parts":[[2025,12,9]]},"issn-type":[{"type":"print","value":"0277-0903"},{"type":"electronic","value":"1532-4303"}],"published":{"date-parts":[[2025,12,9]]},"publisher":"Informa UK Limited","reference":[{"DOI":"10.1378/chest.127.3.984","key":"e_1_3_3_2_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_3_3_1","year":"2007","issue":"6","author":"Murgu SD","volume":"52","first-page":"752","unstructured":"Murgu SD, Cherrison LJ, Colt HG. 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The program reports symptom improvement and excellent disease control in those who started CPAP, without quantitative measures provided.","what_studied":"A primary care–coordinated, fully funded sleep service within an Aboriginal Community Controlled Health Organisation in far western NSW (started in 2016) offering at‑home sleep studies, CPAP treatment, and on‑site sleep physician review for obstructive sleep apnoea. Outcomes from the referred cohort undergoing sleep studies were described.","limitations":"Single‑site service description with no comparator and a referred cohort, which may inflate apparent prevalence and severity. 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veterans (1,552,505 with OSA), OSA was associated with 1.61 additional PD cases per 1000 people at 6 years (95% CI, 1.13-2.09) versus no OSA; estimates were robust to adjustment for BMI, vascular and psychiatric comorbidities, and medications, were larger in women, and PD case numbers were significantly reduced with early CPAP use.","limitations":"OSA was identified by administrative codes and CPAP by a semistructured interview field, which may misclassify exposure and treatment; timing of “early” CPAP was not precisely defined; findings come from a veteran cohort, which may limit generalizability and leave residual confounding.","practice_takeaway":"In this large veteran cohort, OSA was linked to a small absolute increase in 6-year PD incidence, and early CPAP use was associated with fewer PD cases. 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The good practice statement relies on expert consensus.","practice_takeaway":"For adults with CSA, individualize therapy by treating contributing conditions and prioritizing patient-reported outcomes; consider CPAP or ASV across etiologies, oxygen or acetazolamide for heart failure– or high-altitude–related CSA, and phrenic nerve stimulation for primary or heart failure–related CSA, with shared decision-making given low certainty."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Positive Airway Pressure"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Positive Airway Pressure"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Positive Airway Pressure"}}}]]

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