Obstructive sleep apnea in incremental hemodialysis: Determinants, consequences, and impact on survival
Bibliographic record
Abstract
Sleep disorders are common in hemodialysis patients, although causes and consequences remain unclear. We sought to establish prevalence, determinants, and outcomes of sleep disturbances in patients receiving incremental dialysis. One hundred two unselected patients undergoing incremental high-flux hemodialysis or hemodiafiltration underwent limited overnight sleep study. Large subsets underwent echocardiography, interdialytic ambulatory blood pressure monitoring, and brain natriuretic peptide measurements. Patients were followed up to 44 months. Full sleep data were obtained in 91 patients. All had sleep disturbance as evidenced by an apnea-hypopnea index >5/min. We defined major obstructive sleep apnea (MOSA) as an apnea-hypopnea index ≥ 15, together with either significant oxygen desaturation or symptoms of daytime sleepiness. Forty patients met these criteria. Significant independent predictors of MOSA were age <65 years, male gender, has diabetes, and has a brain natriuretic peptide >2500 pg/mL. Mean ambulatory blood pressure and left ventricular mass index were significantly higher in these patients. In a model controlling for body mass index, high C-reactive protein, and the presence of cancer, MOSA was associated with a twofold increased risk of mortality, although this did not reach statistical significance. MOSA was common, and was associated with hypertension and high left ventricular mass index. Whether obstructive sleep apnea contributes to the high mortality remains to be firmly established.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".