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Comment by Mark Lavercombe: In this pilot study, the authors attempted to identify an upper threshold of continuous positive airways pressure (CPAP) therapy at which the patient remains comfortable and expiratory effort measured by diaphragm and transversus abdominus electromyography (EMG) is not increased. After determining that 10 cmH₂O appeared most appropriate, twenty five patients for whom a manually titrated CPAP pressure requirement of less than 10 cmH2O then had two nights of CPAP in random order: one at their titrated pressure and one at a fixed 10 cmH2O. Across a range of polysomnographic metrics, no significant difference was seen between titrated pressure and 10 cmH2O. This interesting work will require further study in other cohorts, given the relatively low body mass index in the volunteer participants.