Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea

American Journal of Respiratory and Critical Care Medicine, Journal Year: 2021, Volume and Issue: 205(5), P. 563 - 569

Published: Dec. 14, 2021

Rationale: Recent studies suggest that obstructive sleep apnea (OSA) severity can vary markedly from night to night, which may have important implications for diagnosis and management. Objectives: This study aimed assess OSA prevalence multinight in-home recordings the impact of night-to-night variability in on diagnostic classification a large, global, nonrandomly selected community sample consumer database people purchased novel, validated, under-mattress analyzer. Methods: A total 67,278 individuals aged between 18 90 years underwent nightly monitoring over an average approximately 170 nights per participant July 2020 March 2021. was defined as mean apnea–hypopnea index (AHI) more than 15 events/h. Outcomes were global likelihood misclassification single night's AHI value. Measurements Main Results: More 11.6 million data collected analyzed. 22.6% (95% confidence interval, 20.9–24.3%). The misdiagnosis with based ranged 20% 50%. Misdiagnosis error rates decreased increased (e.g., 1-night F1-score = 0.77 vs. 0.94 14 nights) remained stable after monitoring. Conclusions: Multinight using noninvasive sensor technology indicates moderate severe 20%, diagnosed single-night be misclassified. These findings highlight need consider variation

Language: Английский

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Comorbid insomnia and sleep apnoea is associated with all-cause mortality

European Respiratory Journal, Journal Year: 2021, Volume and Issue: 60(1), P. 2101958 - 2101958

Published: Dec. 2, 2021

Background Increased mortality has been reported in people with insomnia and those obstructive sleep apnoea (OSA). However, these conditions commonly co-occur the combined effect of comorbid (COMISA) on risk is unknown. This study used Sleep Heart Health Study (SHHS) data to assess associations between COMISA all-cause risk. Methods Insomnia was defined as difficulties falling asleep, maintaining and/or early morning awakenings from ≥16 times per month, daytime impairments. OSA an apnoea–hypopnoea index ≥15 events·h −1 . if both were present. Multivariable adjusted Cox proportional hazards models determine association (n=1210) over 15 years follow-up. Results 5236 participants included. 2708 (52%) did not have insomnia/OSA (reference group), 170 (3%) had insomnia-alone, 2221 (42%) OSA-alone 137 COMISA. a higher prevalence hypertension (OR 2.00, 95% CI 1.39–2.90) cardiovascular disease (CVD) 1.70, 1.11–2.61) compared reference group. Insomnia-alone associated but CVD Compared group, 47% (hazard ratio 1.47, 1.06–2.07) increased mortality. The consistent across multiple definitions insomnia. Conclusions rates at baseline, no insomnia/OSA.

Language: Английский

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High night-to-night variability in sleep apnea severity is associated with uncontrolled hypertension

npj Digital Medicine, Journal Year: 2023, Volume and Issue: 6(1)

Published: March 30, 2023

Obstructive sleep apnea (OSA) severity can vary markedly from night-to-night. However, the impact of night-to-night variability in OSA on key cardiovascular outcomes such as hypertension is unknown. Thus, primary aim this study to determine effects likelihood. This uses in-home monitoring 15,526 adults with ~180 nights per participant an under-mattress sensor device, plus ~30 repeat blood pressure measures. defined mean estimated apnea-hypopnoea index (AHI) over ~6-month recording period for each participant. Night-to-night determined standard deviation AHI across nights. Uncontrolled systolic ≥140 mmHg and/or diastolic ≥90 mmHg. Regression analyses are performed adjusted age, sex, and body mass index. A total 12,287 participants (12% female) included analyses. Participants highest quartile within category, have a 50-70% increase uncontrolled likelihood versus lowest quartile, independent severity. demonstrates that high predictor hypertension, These findings important implications identification which patients most at risk harm.

Language: Английский

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Single-Night Diagnosis of Sleep Apnea Contributes to Inconsistent Cardiovascular Outcome Findings

CHEST Journal, Journal Year: 2023, Volume and Issue: 164(1), P. 231 - 240

Published: Jan. 28, 2023

Language: Английский

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All-Cause Mortality in People with Co-Occurring Insomnia Symptoms and Sleep Apnea: Analysis of the Wisconsin Sleep Cohort

Nature and Science of Sleep, Journal Year: 2022, Volume and Issue: Volume 14, P. 1817 - 1828

Published: Oct. 1, 2022

Insomnia symptoms and sleep apnea frequently co-occur are associated with worse sleep, daytime function, mental health quality of life, compared to either insomnia or obstructive (OSA) alone. This study aimed investigate the association co-morbid (COMISA) all-cause mortality.Wisconsin Sleep Cohort data were analysed assess potential associations between COMISA mortality. Nocturnal defined as difficulties initiating maintaining and/or early morning awakenings "often" "almost always", regular sedative-hypnotic medicine use. OSA was an apnea-hypopnea index ≥5/hr sleep. Participants classified having neither nor OSA, alone, symptoms. Associations four groups mortality over 20 years follow-up examined via multivariable adjusted Cox regression models.Among 1115 adult participants (mean ± SD age 55 8 years, 53% males), 19.1% had After controlling for sociodemographic behavioral factors, increased risk no (HR [95% CI]; 1.71 [1.00-2.93]). alone (0.91 [0.53, 1.57]) (1.04 [0.55, 1.97]) not risk.Co-morbid is risk. Future research should mechanisms underpinning effectiveness different treatment approaches reduce this common condition.

Language: Английский

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Multi-night measurement for diagnosis and simplified monitoring of obstructive sleep apnoea

Sleep Medicine Reviews, Journal Year: 2023, Volume and Issue: 72, P. 101843 - 101843

Published: Sept. 1, 2023

Substantial night-to-night variability in obstructive sleep apnoea (OSA) severity has raised misdiagnosis and misdirected treatment concerns with the current prevailing single-night diagnostic approach. In-home, multi-night monitoring technology may provide a feasible complimentary pathway to improve both speed accuracy of OSA diagnosis monitor efficacy. This review describes latest evidence on severity, its impact misclassification. Emerging for potential influence important health risk outcomes associated is considered. also characterises emerging applications wearable non-wearable technologies that an alternative, or complimentary, approach traditional pathways. The required translate these devices into clinical care discussed. Appropriately sized randomised controlled trials are needed determine most appropriate effective diagnosis, as well optimal number nights accurate management. Potential risks versus benefits, patient perspectives, cost-effectiveness novel approaches should be carefully considered future trials.

Language: Английский

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A novel EEG marker predicts perceived sleepiness and poor sleep quality

SLEEP, Journal Year: 2022, Volume and Issue: 45(5)

Published: March 4, 2022

To determine if a novel EEG-derived continuous index of sleep depth/alertness, the odds ratio product (ORP), predicts self-reported daytime sleepiness and poor quality in two large population-based cohorts.ORP values which range from 0 (deep sleep) to 2.5 (fully alert) were calculated 3s intervals during awake periods (ORPwake) NREM (ORPNREM) determined home studies HypnoLaus (N = 2162: 1106 females, 1056 males) men androgen inflammation lifestyle environment stress (MAILES) cohorts 754 males). Logistic regression was used examine associations between ORPwake, ORPNREM, traditional polysomnography measures (as comparators) with excessive (Epworth scale >10) (Pittsburgh >5) insomnia symptoms.High ORPwake associated ~30% increase both (odds ratio, OR, 95% CI) 1.28 (1.09, 1.51), MAILES 1.36 (1.10, 1.68). High also ~28% decrease dataset. ORPNREM but not MAILES. No consistent across detected using markers.ORP, metric, measured wake independent cohorts. Consistent symptomatology perceived absence sleepiness, may provide valuable objective mechanistic insight into physiological hyperarousal.

Language: Английский

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Strengths, weaknesses, opportunities and threats of using AI-enabled technology in sleep medicine: a commentary

Journal of Clinical Sleep Medicine, Journal Year: 2024, Volume and Issue: 20(7), P. 1183 - 1191

Published: March 27, 2024

Over the past few years, artificial intelligence (AI) has emerged as a powerful tool used to efficiently automate several tasks across multiple domains. Sleep medicine is perfectly positioned leverage this due wealth of physiological signals obtained through sleep studies or tracking devices and abundance accessible clinical data electronic medical records. However, caution must be applied when utilizing AI, intrinsic challenges associated with novel technology. The Artificial Intelligence in Medicine Committee American Academy reviews advancements AI within field. In article, committee members provide commentary on scope technology medicine. identifies 3 pivotal areas that can benefit from technologies: care, lifestyle management, population health management. This article provides detailed analysis strengths, weaknesses, opportunities, threats using AI-enabled technologies each area. Finally, broadly barriers offers possible solutions.

Language: Английский

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Representations of temporal sleep dynamics: Review and synthesis of the literature

Sleep Medicine Reviews, Journal Year: 2022, Volume and Issue: 63, P. 101611 - 101611

Published: Feb. 17, 2022

Sleep is characterized by an intricate variation of brain activity over time. Measuring these temporal sleep dynamics relevant for elucidating healthy and pathological mechanisms. The rapidly increasing possibilities obtaining processing registrations have led to abundance data, which can be challenging analyze interpret. This review provides a structured overview approaches represent dynamics, categorized based on the way source data compressed. For each category representations, we describe advantages disadvantages. Standard human-defined 30-s stages standardization interpretability. Alternative representations are less standardized but offer higher resolution (in case microstructural events such as spindles), or reflect non-categorical information (for example spectral power analysis). Machine-learned additional possibilities: automated useful handling large quantities while alternative obtained from clustering data-driven features could aid finding new patterns possible clinical interpretations. While newly developed may insights, they difficult interpret in context. Therefore, there should always balance between developing sophisticated analysis techniques maintaining explainability.

Language: Английский

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Advances in Research on Artificial Intelligence in Sleep Disorders

Advances in Clinical Medicine, Journal Year: 2025, Volume and Issue: 15(02), P. 1121 - 1127

Published: Jan. 1, 2025

Language: Английский

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