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Volume 15 No. 06
Earn CME
Accepted Papers

Case Reports

The Respiratory Signature: A Novel Concept to Leverage Continuous Positive Airway Pressure Therapy as an Early Warning System for Exacerbations of Common Diseases such as Heart Failure

Christopher N. Schmickl, MD, PhD1,2; Eric Heckman, MD2; Robert L. Owens, MD1; Robert J. Thomas, MD2
1University of California San Diego, San Diego, California; 2Beth Israel Deaconess Medical Center, Boston, Massachusetts

Each night millions of patients use continuous positive airway pressure (CPAP) to treat obstructive sleep apnea (OSA). To facilitate monitoring of treatment success, modern CPAP machines routinely record and analyze the respiratory signal in near real-time and submit some of these data to the manufacturer's centralized cloud server. Some of the conditions frequently associated with OSA such as heart failure or chronic obstructive pulmonary disease result in characteristic changes of the respiratory signal (“signatures”), especially during exacerbations. Thus, this infrastructure could be leveraged to detect changes in patients' health status facilitating early interventions. To illustrate this concept, we present and discuss the case of a patient with OSA who showed abrupt changes in his breathing pattern (increase in periodic breathing and machine-detected obstructive apneas) from 10 days prior until 8 days after a hospitalization for acute heart failure exacerbation.


Schmickl CN, Heckman E, Owens RL, Thomas RJ. The respiratory signature: a novel concept to leverage continuous positive airway pressure therapy as an early warning system for exacerbations of common diseases such as heart failure. J Clin Sleep Med. 2019;15(6):923–927.

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