David P. White
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View article: Rebreathing during CPAP therapy and its implications in obstructive sleep apnea
Rebreathing during CPAP therapy and its implications in obstructive sleep apnea Open
Noah WH, White DP, Hete B, Messineo L. Rebreathing during CPAP therapy and its implications in obstructive sleep apnea. J Clin Sleep Med. 2025;21(10):1759-1771.
View article: The combination of pimavanserin and atomoxetine reduces obstructive sleep apnea severity: a randomized crossover trial
The combination of pimavanserin and atomoxetine reduces obstructive sleep apnea severity: a randomized crossover trial Open
Background Obstructive sleep apnea (OSA) pharmacological interventions like the noradrenergic muscle stimulant atomoxetine have wake-promoting properties. Pimavanserin, a promising serotonin 2 A receptor antagonist, may help counteract ato…
View article: Kairos positive airway pressure (KPAP) equals continuous PAP in effectiveness, and offers superior comfort for obstructive sleep apnea treatment
Kairos positive airway pressure (KPAP) equals continuous PAP in effectiveness, and offers superior comfort for obstructive sleep apnea treatment Open
KPAP is as effective as CPAP in reducing respiratory events, but is more comfortable and potentially better tolerated.
View article: Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments
Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments Open
Despite the commonly-accepted paradigm that patients with obstructive sleep apnea (OSA) also invariably have obesity, OSA prevalence extends beyond obesity. This necessitates a reevaluation of screening strategies, biomarkers of increased …
View article: 0866 Prevalence of Obesity in Obstructive Sleep Apnea Within a Large Community-based Cohort of Middle-aged/Older Adults
0866 Prevalence of Obesity in Obstructive Sleep Apnea Within a Large Community-based Cohort of Middle-aged/Older Adults Open
Introduction Obesity is a well-known risk factor for obstructive sleep apnea (OSA), gaining interest due to the global rise in obesity and novel obesity drugs. The rationale behind this lies in the role of obesity in the pathophysiology of…
View article: Physiological Determinants of Snore Loudness
Physiological Determinants of Snore Loudness Open
Rationale: The physiological factors modulating the severity of snoring have not been adequately described. Airway collapse or obstruction is generally the leading determinant of snore sound generation; however, we suspect that ventilatory…
View article: Sleep Apnea Physiological Burdens and Cardiovascular Morbidity and Mortality
Sleep Apnea Physiological Burdens and Cardiovascular Morbidity and Mortality Open
Rationale: Obstructive sleep apnea is characterized by frequent reductions in ventilation, leading to oxygen desaturations and/or arousals. Objectives: In this study, association of hypoxic burden with incident cardiovascular disease (CVD)…
View article: Drive versus Pressure Contributions to Genioglossus Activity in Obstructive Sleep Apnea
Drive versus Pressure Contributions to Genioglossus Activity in Obstructive Sleep Apnea Open
Rationale: Loss of pharyngeal dilator muscle activity is a key determinant of respiratory events in obstructive sleep apnea (OSA). After the withdrawal of wakefulness stimuli to the genioglossus at sleep onset, mechanoreceptor negative pre…
View article: 0830 Novel OSA-driven metric predicts incident dementia in sleep apnea in two different community-based cohort studies
0830 Novel OSA-driven metric predicts incident dementia in sleep apnea in two different community-based cohort studies Open
Introduction Obstructive sleep apnea (OSA) is associated with intermittent hypoxemia and sleep fragmentation. In OSA, sleep fragmentation is often measured by the number of electroencephalographic arousals per hour of sleep without conside…
View article: Development of a combination of noradrenergic and antimuscarinic drugs for the treatment of obstructive sleep apnea: Challenges and progress
Development of a combination of noradrenergic and antimuscarinic drugs for the treatment of obstructive sleep apnea: Challenges and progress Open
Obstructive sleep apnea (OSA) is a disorder characterized by repetitive collapse of the upper airway during sleep, leading to intermittent hypoxia and sleep fragmentation. The combination of noradrenergic and antimuscarinic drugs has emerg…
View article: Pathophysiology Underlying Demographic and Obesity Determinants of Sleep Apnea Severity
Pathophysiology Underlying Demographic and Obesity Determinants of Sleep Apnea Severity Open
Rationale: Sleep apnea is the manifestation of key endotypic traits, including greater pharyngeal collapsibility, reduced dilator muscle compensation, and elevated chemoreflex loop gain. Objectives: We investigated how endotypic traits var…
View article: Patients with Epiglottic Collapse Are Less Adherent to Autotitrating Positive Airway Pressure Therapy for Obstructive Sleep Apnea
Patients with Epiglottic Collapse Are Less Adherent to Autotitrating Positive Airway Pressure Therapy for Obstructive Sleep Apnea Open
Rationale: The anatomic orientation of the epiglottis is such that it points in the opposite direction to inspiratory flow, thereby potentially making positive airway pressure (PAP) treatment challenging in patients with epiglottic collaps…
View article: Effect of Pimavanserin on the Respiratory Arousal Threshold from Sleep: A Randomized Trial
Effect of Pimavanserin on the Respiratory Arousal Threshold from Sleep: A Randomized Trial Open
Rationale: A low respiratory arousal threshold is a key endotype responsible for obstructive sleep apnea (OSA) pathogenesis. Pimavanserin is an antiserotoninergic capable of suppressing CO2-mediated arousals without affecting the respirato…
View article: Within-night repeatability and long-term consistency of sleep apnea endotypes: the Multi-Ethnic Study of Atherosclerosis and Osteoporotic Fractures in Men Study
Within-night repeatability and long-term consistency of sleep apnea endotypes: the Multi-Ethnic Study of Atherosclerosis and Osteoporotic Fractures in Men Study Open
Study Objectives Obstructive sleep apnea (OSA) is characterized by multiple “endotypic traits,” including pharyngeal collapsibility, muscle compensation, loop gain, and arousal threshold. Here, we examined (1) within-night repeatability, (…
View article: Head rotation improves airway obstruction, especially in patients with less severe obstructive sleep apnea without oropharyngeal collapse
Head rotation improves airway obstruction, especially in patients with less severe obstructive sleep apnea without oropharyngeal collapse Open
Purpose Head rotation is thought to have an effect on obstructive sleep apnea (OSA) severity. However, keeping the head rotated fully during sleep is difficult to maintain, and the effect of head rotation is not the same in all OSA patient…
View article: Cardiovascular Benefit of Continuous Positive Airway Pressure in Adults with Coronary Artery Disease and Obstructive Sleep Apnea without Excessive Sleepiness
Cardiovascular Benefit of Continuous Positive Airway Pressure in Adults with Coronary Artery Disease and Obstructive Sleep Apnea without Excessive Sleepiness Open
Rationale: Randomized controlled trials of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) have not demonstrated protection against adverse cardiovascular outcomes. Recently, observational studies …
View article: Clinical polysomnographic methods for estimating pharyngeal collapsibility in obstructive sleep apnea
Clinical polysomnographic methods for estimating pharyngeal collapsibility in obstructive sleep apnea Open
Study Objectives Obstructive sleep apnea has major health consequences but is challenging to treat. For many therapies, efficacy is determined by the severity of underlying pharyngeal collapsibility, yet there is no accepted clinical means…
View article: Neural ventilatory drive decline as a predominant mechanism of obstructive sleep apnoea events
Neural ventilatory drive decline as a predominant mechanism of obstructive sleep apnoea events Open
Background In the classic model of obstructive sleep apnoea (OSA), respiratory events occur with sleep-related dilator muscle hypotonia, precipitating increased neural ventilatory ‘drive’. By contrast, a drive-dependent model has been prop…
View article: Metrics of sleep apnea severity: beyond the apnea-hypopnea index
Metrics of sleep apnea severity: beyond the apnea-hypopnea index Open
Obstructive sleep apnea (OSA) is thought to affect almost 1 billion people worldwide. OSA has well established cardiovascular and neurocognitive sequelae, although the optimal metric to assess its severity and/or potential response to ther…
View article: Automated Apnea–Hypopnea Index from Oximetry and Spectral Analysis of Cardiopulmonary Coupling
Automated Apnea–Hypopnea Index from Oximetry and Spectral Analysis of Cardiopulmonary Coupling Open
Rationale: The increased prevalence of obstructive sleep apnea (OSA) coincides with a severe shortage of sleep physicians. There is a need for widescale home-sleep-testing devices with accurate automated scoring to accelerate access to tre…
View article: The Sleep Apnea–Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality
The Sleep Apnea–Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality Open
Rationale: Randomized controlled trials have been unable to detect a cardiovascular benefit of continuous positive airway pressure in unselected patients with obstructive sleep apnea (OSA). We hypothesize that deleterious cardiovascular ou…
View article: A Novel Model to Estimate Key Obstructive Sleep Apnea Endotypes from Standard Polysomnography and Clinical Data and Their Contribution to Obstructive Sleep Apnea Severity
A Novel Model to Estimate Key Obstructive Sleep Apnea Endotypes from Standard Polysomnography and Clinical Data and Their Contribution to Obstructive Sleep Apnea Severity Open
Rationale: There are at least four key pathophysiological endotypes that contribute to obstructive sleep apnea (OSA) pathophysiology. These include 1) upper-airway collapsibility (Pcrit); 2) arousal threshold; 3) loop gain; and 4) pharynge…