Inspiratory flow limitation identified obstruction and breath cycling before, during, and after Cheyne Stokes breathing
Bibliographic record
Abstract
Introduction: We recently showed crescendo-decrescendo inspiratory flow limitation (IFL) with Cheyne-Stokes breathing (CSB) hyperpnoea. This suggests obstructive in addition to previously conjectured central pathogenesis. The association, if any, of CSB with respiration before and after CSB remains poorly described. Aim: We used a patented automated breath-by-breath algorithm to quantify IFL before, during, and after CSB. Methods: Diagnostic ambulatory sleep polygraphs (Remmers Sleep Recorder, Sagatech Electronics, Ltd., Calgary, Canada) where interpreting physicians identified CSB were further assessed by two biomedical engineers (VP and RSP). Where CSB was confirmed IFL and cyclic periodicity were assessed before, during, and after CSB. Results: From 66 774 ambulatory sleep polygraphs referred for diagnostic interpretation 30 studies were identified with potential CSB by interpreting clinicians, but only 19 studies by engineers. 9 of these 19 studies showed transitions from and to inspiratory flow limited breathing with CSB suggesting persistent obstruction. Attenuated but similarly timed IFL identified cycling was seen in breathing before and after CSB. Mean individual CSB cycle times remained highly consistent (range 34.4 to 64.4 s with individual coefficients of variance << 10%) in these 9 individuals. Conclusions: IFL with similarly timed respiratory cycling occurs before, during, and after CSB suggesting persistent obstruction. As a mechanistic model of treatment-emergent central apnoea CPAP may reduce IFL braking of cyclic hyperventilation so worsening CSB.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| 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) | 0.002 | 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".