0583 Improvement in Sleep Depth on CPAP Is Related to Odds-Ratio-Product (ORP) Type and Apnea-Hypopnea-Index at Baseline
Bibliographic record
Abstract
Abstract Introduction In split studies in academic sleep centers, CPAP improved NREM sleep depth, measured by the Odds-Ratio-Product (ORP, range 0 (deep sleep) to 2.5 (full-wakefulness), in only three (of 9) ORP types characterized by having < 10.2% of recording time with ORP< 0.5 (types 1,1, 1,2, and 1,3, with 1,3 additionally having excessive time (>12.5%) in full-wakefulness). Furthermore, ORPNREM did not improve on CPAP when AHI was < 30 hr-1 in any type except 1,3, where it improved marginally. In type 1,3, excessive time (>12.5%) in full wakefulness was only partially corrected with CPAP even at very high AHI, thereby suggesting an associated hyperarousal state. Here, we determined if the same applies during a full-night CPAP titration in a private practice setting. Methods We analyzed a cohort of 100 patients (Mage= 54.02±14.62) who underwent full-night diagnostic and full-night CPAP titration at a private sleep laboratory in Ontario, Canada. 77 patients had severe OSA (AHI 66.9hr-1, range 30-148 hr-1) and 23 had mild/moderate OSA (AHI 18.5, range 7.4-27.5 hr-1). In severe patients, there were 32 (41%) with little deep sleep and low/average full wakefulness (types 1,1 and 1,2), 39 (51%) with type 1,3, and 6 (8%) with other types. In the mild/moderate group 12 patients (52%) had type 1,3, and 11 (48%) shared the remaining 8 type. Results In severe patients ORPNREM decreased by 0.20±0.23, p< 0.0001 in types 1,1 and 1,2. In type 1,3, ORPNREM decreased by 0.26±0.29, p< 0.0001 (NS from 1,1 and 1,2) and time in full wakefulness and % awake also decreased by 6.82% and 9.80%, respectively (p’s< 0.01). In patients with AHI < 30 there was no significant change in ORPNREM or % wake with any type, including type 1,3, where %awake remained at 37.2% on CPAP. Conclusion Similar to earlier findings from split studies, in this cohort about half of the patients had type 1,3, consistent with associated hyperarousal, regardless of OSA severity. Those with the same three types had improved sleep depth on CPAP. While those with 1,3 showed a reduction of full wakefulness with CPAP (from 26.1% to 19.3%), it remained elevated suggesting persisting hyperarousal. Support (if any)
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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 | 0.001 |
| 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) | 0.004 | 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".