Total Sleep Time Research Articles

Sleep and Aging. A Polysomnographic Follow-Up Study, Some 40 Years Later.

The aim of the present study was to explore age-related sleep alterations in normal subjects whose sleep had been recorded for the first time 40.4 ± 4.8 years ago. For the follow-up polysomnography (3 nights) 15 participants (5 female, 10 male, age 56-74 years) were recruited. Recording conditions and sleep scoring were adapted to the previous study. In all older participants, the amount of slow-wave sleep and REM sleep was decreased, while stage 1 and wakefulness were increased. There was no significant change in stage 2 or in any of the additional REM sleep parameters (REM density, latency, number and duration of REM cycles). Sleep stage transition analysis showed a markedly reduced stability of SWS from young to older age. While none of the single sleep parameters showed intra-individual stability with age, a pattern analysis, which combined seven sleep parameters (sleep stages, total sleep time and REM density), showed that the concordance rate of the combined sleep parameters correlated significantly with the age at follow-up. The results of this longitudinal study over a period of about 40 years are largely consistent with those of cross-sectional studies. While the lack of significant correlation of the individual sleep parameters between the younger and older age groups did not allow for the identification of any of them as trait markers, the result of the pattern analysis, which combined a set of sleep parameters, indicates that the stability of the sleep structure decreases significantly in the age range between the late 50s and early 70s.

Comparative efficacy of interventions for insomnia in cancer patients: a systematic review and network meta-analysis.

Cancer-related insomnia demonstrates twice the prevalence observed in the general population, with significant implications for disease progression. This network meta-analysis systematically compares the therapeutic efficacy of diverse interventions for managing insomnia in oncological populations. We systematically queried four biomedical databases (PubMed, Embase, Medbase, and Web of Science) for eligible studies assessing insomnia interventions in cancer patients. Primary outcomes encompassed standardized metrics: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). A frequentist approach with random-effects model was employed for comparative effectiveness analysis. The analysis incorporated 21 studies with sample sizes ranging from 16 to 255 participants. Comparative evaluation against standard care revealed that both cognitive behavioral therapy for insomnia (CBT-I) (MD = - 3.04, 95%CI[- 4.49,-1.59]) and electroacupuncture (MD = - 3.80, 95%CI[- 6.50,-1.09]) produced clinically meaningful reductions in ISI scores, while CBT-I (MD = 2.71%, 95%CI[0.89,4.53]) and Tai Chi (MD = 5.26%, 95%CI[0.41,10.11]) exhibited statistically significant improvements in sleep efficiency metrics. CBT-I emerges as an evidence-based intervention for ameliorating insomnia severity and optimizing sleep efficiency in cancer patients. Complementary modalities including electroacupuncture and Tai Chi present viable alternatives. Methodological limitations necessitate future rigorously designed trials to strengthen clinical recommendations.

Active disease, fibromyalgia and glucocorticoids exposure to glucocorticoids differentially associate with sleep and circadian parameters in Behçet's Syndrome.

Sleep disturbances significantly impact Behçet's Syndrome (BS) patients' quality of life. Defining the correlates of BS patients' sleep disturbances is needed to improve their management and, in turn, BS patients' quality of life. In this study, we explored fibromyalgia, disease activity, and glucocorticoid exposure as possible predictors of sleep and circadian rhythm parameters in a cohort of BS patients. Participants' sociodemographic data were collected through a survey. Sleep and circadian parameters were evaluated objectively via a continuous 7-day accelerometric monitoring and subjectively through the Pittsburgh Sleep Quality Index and the reduced Morningness-Eveningness Questionnaire. A comprehensive clinical evaluation investigated disease activity, fibromyalgia, and ongoing pharmacological treatments. Clinical records were systematically reviewed to derive glucocorticoids exposure variables. Possible predictors of sleep and circadian parameters were tested estimating linear regression models. 45 BS patients were enrolled. Both active and fibromyalgic BS patients showed lower reported sleep quality and lower objectively recorded sleep efficiency compared to non-active and non-fibromyalgic BS patients, respectively. Moreover, fibromyalgia was associated with both shorter total sleep time and a more stable day-to-day rest-activity pattern. In parallel, active disease was associated with reduced sleep regularity whereas glucocorticoids exposure was associated with its increase. Fibromyalgia and active disease shape partially diverging sleep and circadian rhythm disruption patterns in BS patients, with glucocorticoids potentially improving BS patients' sleep regularity by limiting disease activity-related sleep disruption. A multidimensional approach to sleep characterization is needed to better identify the correlates of BS patients' sleep disturbances and improve their management.

Quantifying the sources of discrepancy between total recording time and total sleep time in home sleep apnea testing: insights from home-based polysomnography.

To quantify the contribution of sleep onset latency (SOL), wake after sleep onset (WASO), and wake after sleep offset (WASF) in the discrepancy between total recording time (TRT) and total sleep time (TST) in home-based polysomnography (PSG) using patient-activated and deactivated monitoring devices. This observational study enrolled patients with a high pretest probability of obstructive sleep apnea (OSA) who underwent unattended home-based PSG. We measured the duration of SOL, WASO, and WASF to quantify the discrepancy between TRT and TST. TRT was defined as the interval from device activation to deactivation by the patients. SOL represented the time from device activation to the first epoch of any sleep, WASO was the total amount of time spent awake after the sleep onset epoch until the last epoch of any sleep, and WASF was defined as the time from the last epoch of any sleep until the patient-initiated device deactivation. We also assessed differences in apnea-hypopnea index (AHI) between home-based PSG and type 3 sleep studies by reanalyzing home-based PSG recordings as simulated type 3 studies after omitting type 2 signals. A total of 78 patients were included in the study. The mean TRT exceeded the mean TST by 19%, with TRT at 457±78 min and TST at 383±68 min. The mean difference between TRT and TST was 74±53 min, attributed to SOL (30%), WASO (45%), and WASF (25%). There was considerable variability in the difference between TRT and TST among study participants, ranging from as little as 14 minutes to as much as 233 minutes. The mean AHI in simulated type 3 studies (41±29) was, on average, 23% lower than the mean AHI recorded in home-based PSG (53±30, P <.001). There was significant variability in the gap between TRT and TST among patients with a high pretest probability of OSA undergoing unattended home-based PSG. WASO was identified as the largest contributor to this discrepancy, with notable contributions from SOL and WASF. Additionally, simulated type 3 studies underestimated the true AHI compared to type 2 studies.

Protocol and design of the REPOSE study: a double-blinded, randomised, placebo-controlled trial to evaluate the efficacy of suvorexant to improve postoperative sleep and reduce delirium severity in older patients undergoing non-cardiac surgery

IntroductionPostoperative delirium occurs in up to 40% of older surgical patients and has been associated with prolonged hospital stays, long-term cognitive impairment and increased 1-year postoperative mortality. Postoperative sleep disturbances...

Differential sleep architecture in different subtypes of positional obstructive sleep apnea in children.

Differential sleep architecture in different subtypes of positional obstructive sleep apnea in children.

A randomised crossover trial of daridorexant for the treatment of chronic insomnia and nocturia.

This double-blind, placebo-controlled, two-way crossover trial evaluated the efficacy and safety of daridorexant in patients with chronic insomnia and comorbid nocturia. In total, 60 patients aged ≥55 years with insomnia complaints for ≥3 months, Insomnia Severity Index (ISI) ≥13 and ≥3 voids/night for ≥1 month were randomised (1:1) to daridorexant 50 mg/placebo for 4 weeks followed by crossover after a 14-21-day washout period. The primary endpoint was change from baseline to Week (W) 4 in self-reported total sleep time (sTST). Other endpoints included change in ISI score, sleep depth and quality (visual analogue scale scores), nocturnal voids (mean number, time to first) and daytime functioning (Insomnia Daytime Symptoms and Impacts Questionnaire score [IDSIQ]). At W4, daridorexant significantly increased sTST versus placebo (least-squares mean difference [LSMD] 20.9 min, 95% confidence interval [CI] 8.0-33.7; p = 0.002); significant improvements were also seen at W1-3. Compared with placebo, daridorexant significantly decreased (p < 0.001) ISI at both timepoints, W2 (LSMD -3.7, 95% CI -5.1 to -2.3) and W4 (LSMD -3.3, 95% CI -4.7 to -1.8) and significantly improved (p < 0.05) sleep depth (W1, 2, 3, 4), sleep quality (W1, 2, 3) and IDSIQ total score (W1, 3). Daridorexant versus placebo reduced the number of voids (LSMD [95% CI]: W1-0.6 [-0.9 to -0.3], p < 0.001; W4-0.3 [-0.7 to +0.1], p = 0.090) and increased median time to first void (difference to placebo, W1: +31 min, p = 0.0027; W4: +23 min, p = 0.2026). No adverse events of special interest (falls/urinary incontinence) were reported during daridorexant treatment. In conclusion, in patients with chronic insomnia and nocturia, daridorexant improves both conditions with a favourable safety profile.

Exploring the Link Between Sleep Patterns and Early Cardiovascular Disease Markers in Young Adults with Chronic Anxiety.

Purpose: Chronic anxiety is commonly associated with poor sleep patterns, which may contribute to an increased risk of cardiovascular disease (CVD) through mechanisms like oxidative stress, vascular dysfunction, and poor blood pressure control. As sleep disturbances, particularly poor sleep quality and/or regularity, have been independently linked to CVD development, this study explored whether sleep quality/regularity in young adults with chronic anxiety are associated with early indicators of CVD risk, specifically oxidative stress, vascular function, and blood pressure control. Methods: Twenty-eight young (24±4 years) participants with a prior clinical diagnosis of generalized anxiety disorder (GAD) or elevated GAD symptoms (GAD7>10) had their sleep quality (total sleep time (TST) and sleep efficiency (SE)) and regularity (via TST/SE standard deviations (SD)) assessed for seven consecutive days. Various precursors to CVD development such as oxidative stress, brachial artery function, microvascular function, and blood pressure control (exercise pressor responses and cardiovagal baroreflex sensitivity (cBRS)), were also evaluated. Pearson's correlations were utilized to determine potential relationships between sleep quality/regularity and CVD precursors. Results: Both sleep irregularity variables (SE-SD (r=0.61; p<0.01) and TST-SD (r=0.39; p=0.04)), but neither of the sleep quality variables, were positively correlated with oxidative stress. TST-SD alone was significantly associated with lower brachial artery function (r=-0.44; p=0.02) and cBRS (r=0.43; p=0.02), with TST-SD median splits further highlighting these differences. Conclusions: The study found that irregular TST in individuals with chronic anxiety was significantly associated with higher oxidative stress, lower brachial artery function, and blunted blood pressure control (lower cBRS), key precursors of CVD.

Disparities in objective sleep measures among individuals who have undergone polysomnographic studies

BackgroundPrevious studies have amply demonstrated shorter self-reported sleep duration for Black patients compared to White patients. Evidence for disparities in objectively measured sleep is still mixed. Our objective is to assess disparities in objectively measured sleep parameters between races/ethnicities using data from an academic medical center in the US.Materials and methodsWe used data extracted through text mining from sleep reports of in-lab polysomnography (PSG) studies conducted for adults aged 18 years or older at the University of Virginia Health System between 2010 and 2021. All studies with total sleep time (TST) &amp;lt;1 h were excluded. In multivariable analyses, we controlled for age, sex, body mass index, marital status, season, health insurance, comorbidities, and use of medications that may interfere with sleep in 1 year prior to the sleep study.ResultsThe study sample included 5,331 patients of whom 69% were non-Hispanic (NH) White, 23% NH Black, 4% Hispanic/Latinx, and 3% other or unknown. They were 57 ± 16, 52 ± 14, 49 ± 14, and 54 ± 14 years old and 45%, 30%, 33%, and 41% male, respectively. Average TST was 342 ± 84 min, sleep efficiency 74%, apnea-hypopnea index (AHI) 15 ± 17, with 69% having obstructive sleep apnea (36% mild; 22% moderate; 12% severe). After adjusting for covariates, Black patients had shorter N3 sleep by 10 min (95% CI = −11.9, −7.6) and longer REM sleep by 7 min (95% CI = 4.8, 8.6) compared to NH White patients. We did not find significant differences in TST, AHI, and sleep efficiency between racial/ethnic groups.ConclusionsOur objective data does not show consistently unfavorable sleep measures for racial and ethnic minorities. More research is needed to better understand how much of these differences are due to underlying physiology vs. social/environmental factors.

A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study.

To describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis (JIA) and their parents. Fifty children, 8-13 years, with JIA and sleep deficiency, and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7-weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline (T1), immediately post-intervention (T2), and one-month post-intervention (T3). Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews. Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and PROMIS sleep disturbance scores immediately post-intervention and one-month follow up; and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores one-month post-intervention. Parents in the SLEEPSMART group had significant improvements in the PROMIS sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately post-intervention and one-month follow-up; and in their self-efficacy scores one-month post-intervention in comparison to parents in the control group. SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with JIA and their parents. Registry: ClinicalTrials.gov, Title: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis (SLEEPMART) Pilot Study, identifier: NCT04066205.

Influence of Repeated Exposure to Neonatal Isoflurane on Sleep Architecture and Neuronal Delta and Theta Oscillations in Adolescent Rats.

Normal sleep architecture is important for brain development, and we previously demonstrated that a single exposure to isoflurane during the neonatal period did not induce changes in the sleep architecture and only minimally altered neuronal beta oscillations in adolescent rats. Here, we hypothesized that a more clinically relevant scenario of repeated shorter exposures to isoflurane during brain development may have more profound effects on sleep and wake behavior and associated delta and theta oscillations, respectively. Male and female rat pups were exposed to sham anesthesia (30% oxygen) or repeated isoflurane delivery for 2 hours each on 3 consecutive days (total exposure of 6 hours). The rat pups were divided into 2 cohorts. In cohort 1, we evaluated the neurotoxic effects of exposure postanesthesia. In cohort 2, electroencephalogram electrodes were implanted into the rat cortex between postnatal days 21-23, and sleep architecture was classified as wake, nonrapid eye movement (NREM), and rapid-eye movement (REM) sleep. Electroencephalogram power spectra were also measured in adolescent rats over a 72-hour period. Isoflurane exposure (n = 11) increased neuroapoptosis to 27. 7 ± 6.5 per mm-2 when compared to the sham group (9. 6 ± 3.0 per mm-2, n = 12, P < .001) and disrupted sleep architecture in adolescent rats. Specifically, there was an increase in the total sleep time (light + dark period) from 89. 9 ± 14.2 minutes in sham group (n = 9) to 111. 2 ± 32.2 minutes in the experimental group (n = 11, P < .05). Furthermore, there were fewer transitions during the dark period from 157. 1 ± 43.3 in sham group (n = 9) to 110. 6 ± 52.5 in the experimental group (n = 11, P < .05). The absolute power of delta oscillations was significantly decreased during the light period of NREM from an average 2217 ± 2016 μV2 in the sham group (n = 8) to 791 ± 659 μV2 in the experimental group (n = 11, P < .05). Further, theta oscillations in the wake stage were significantly decreased in the light period from 1579 ± 885 μV2 in sham group (n = 8) to 690 ± 413 μV2 in the experimental group (n = 11, P < .05) and light + dark period from 1390 ± 808 μV2 in sham group (n = 8) to 691 ± 421 μV2 in the experimental group (n = 11, P < .05). Exposing neonatal rats to isoflurane repeatedly causes significant neurotoxicity, and alters delta and theta thalamocortical oscillations, as well as sleep architecture in adolescence. This contrasts with a single continuous exposure to isoflurane, in which we previously reported no significant effects on sleep-wake architecture and only minimal effect on beta oscillations despite similar acute neurotoxicity.

Polysomnographic Sleep Architectural Disruption Associated with Atrial Fibrillation Development.

To examine the unclear, inconsistent role of sleep architectural disruption in atrial fibrillation (AF) development. Patients (age>18 years) who underwent in-laboratory sleep studies at Cleveland Clinic 2000-2015 were examined (follow-up: 7.8+3.5 years). Primary predictors were arousal index and total sleep time. Secondary predictors included sleep efficiency, wakefulness after sleep onset, sleep and REM latency, and percentage of each sleep stage. Predictors were fit to Cox proportional hazard models predicting time from sleep study to AF by diagnosis code. Covariates included demographics, anthropometrics, tobacco use, sleepiness, apnea hypopnea index, sleep apnea-specific hypoxic burden, cardiovascular risk factors and disease, mood disorders, medications, and positive airway pressure. In our cohort (n=27,232, age: 49.4±14.5 years, 43.7% male, 73.9% White), 2,077 (7.6%) developed incident AF. Arousal index was not associated with AF incidence. For every hour of decreased total sleep time, AF incidence increased 8% (HR=1.08, 95%CI=1.04-1.11). For every 10-unit decrease in sleep efficiency, AF incidence increased 6% (HR=1.06, 95%CI=1.04-1.09). For every hour of increased wakefulness after sleep onset, AF incidence increased 11% (HR=1.11, 95%CI=1.05-1.16). For every 10-unit increase in percent N1, AF incidence increased 6% (HR=1.06, 95%CI=1.01-1.10). Less sleep time and greater sleep disruption were associated with increased incident AF in this large clinical cohort. These results suggest that sleep macro-architecture can influence AF development. Mechanistic and prospective studies are needed to verify whether sleep disruption is a novel target for AF prevention.

Electric-field induced sleep promotion and lifespan extension in Gaucher's disease model flies.

Electric-field induced sleep promotion and lifespan extension in Gaucher's disease model flies.

Effects of contextual stress on Black mothers' self-reported and actigraph-estimated postpartum sleep.

To evaluate the impact of contextual stressors on postpartum sleep among Black mothers. This prospective observational study examined associations of racial discrimination and financial strain (measured at 1 week postpartum) with self-reported maternal sleep difficulties at 1, 8, and 16 weeks postpartum and actigraph-estimated maternal sleep at 8 weeks postpartum. Mothers (N = 212) were Black/African American (100%) and non-Hispanic (98.6%) and averaged 22.7 (SD = 4.5) years of age. Multivariate regression models found unique associations between racial discrimination and financial strain and mothers' postpartum sleep, even after controlling for covariates expected to predict mothers' sleep (including infant sleep). Specifically, past year racial discrimination measured at 1 week postpartum was associated with poorer concurrent self-reported sleep (b = 1.24, p < .001) as well as greater actigraph-estimated night-to-night variability in total sleep time at 8 weeks postpartum (b = 12.89, p = .005). Financial strain reported at 1 week postpartum was prospectively associated with more self-reported sleep difficulties at 16 weeks postpartum (b = .52, p = .007) and with more actigraph-estimated sleep timing variability at 8 weeks postpartum (b = 9.77, p = .02). Experiences of racial discrimination and financial strain may negatively impact Black mothers' sleep in the postpartum period, beyond the effects of their infant's sleep.

Effectiveness of Acupressure on Sleep Quality Among Inpatients: A Systematic Review and Meta-Analysis.

Sleep quality in adult inpatients is frequently and severely disturbed by various factors such as noise, pain, and unfamiliar surroundings, which can impair disease recovery. Acupressure is widely used to improve sleep quality in hospitalized patients, but its overall effectiveness is unclear. This meta-analysis aims to analyze the efficacy of acupressure therapy on sleep quality and sleep parameters in adult inpatients. Eight electronic databases were searched for randomized controlled trials published before April 2024. Two researchers independently screened, assessed, and extracted data from the included studies. A total of 41 studies involving 3680 subjects were included. The meta-analysis showed a significant difference between the acupressure and control groups in sleep quality (SMD = -1.58, 95% CI [-1.85, -1.31]), total sleep time (SMD = 1.12, 95% CI [0.40, 1.83]), sleep efficiency (SMD = 0.90, 95% CI [0.29, 1.52]), sleep onset latency (SMD = -0.73, 95% CI [-1.14, -0.33]), and wake after sleep onset (SMD = -1.32, 95% CI [-2.55, -0.09]). The meta-regression results suggested that the number of sessions daily and the duration of each session were significant factors influencing heterogeneity. Acupressure is an effective intervention to improve sleep quality and sleep parameters in inpatients.

Independent associations of sleep and physical activity with cognition are mediated by hippocampal microstructure in middle-aged and older adults.

Independent associations of sleep and physical activity with cognition are mediated by hippocampal microstructure in middle-aged and older adults.

Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea.

Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea.

COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA MAY IMPROVE SLEEP AND PAIN IN PATIENTS WITH CROHN’S DISEASE: A WAITLIST CONTROLLED PILOT TRIAL

Abstract BACKGROUND 75% of people with active Crohn’s disease (CD) suffer from poor sleep, which prospectively predicts greater likelihood of symptom flares, surgery, and/or hospitalization. Two-thirds of people with active symptoms of CD experience symptoms of insomnia and most people with CD believe that sleep is closely related to CD symptoms. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended first line treatment for chronic insomnia disorder. It also reduces pain intensity and pain interference; less clear is the impact on inflammation. Herein, we sought to investigate whether CBT-I impacts sleep continuity, pain, and inflammation in patients with self-reported active CD symptoms. METHOD Patients were recruited from the Dartmouth Hitchcock IBD Center. Inclusion criteria: self-reported symptoms consistent with insomnia disorder and mild-to-moderate CD. Exclusion criteria: other sleep disorders, significant psychiatric concerns, and/or presence of other common behavioral or physiological influences on sleep. Participants completed assessments of sleep, pain, and inflammation then were randomized to either receive CBT-I immediately, or wait 12 weeks then repeat the baseline assessment and complete CBT-I. Participants we re-assessed immediately post- CBT-I and 1 month later. CBT-I consisted of 5 45-minute telehealth visits + 3 brief phone calls over 7-8 weeks; intervention included sleep restriction, stimulus control, sleep hygiene, arousal reduction, and cognitive therapy. RESULTS 26 participants completed the study (Table 1). At baseline, CBT-I and waitlist groups did not differ significantly by age, insomnia severity, CD symptom severity, or pain intensity. Groups differed significantly by gender (p=.04). Longitudinal data were analyzed using linear mixed effects modeling (Table 2). Analyses were conducted by treatment group to assess efficacy and combined to assess changes pre- to post-treatment. In group X time models, CBT-I led to significantly greater change in insomnia severity (p &amp;lt;.001) and wake after sleep onset (p=.02) compared to waitlist. In combined analyses, participants reported significant improvements in insomnia severity, sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, CD symptom severity, pain intensity, and pain interference. C- reactive protein (CRP) trended toward improvement and fecal calprotectin did not change significantly. Exploratory analyses showed significant improvements in fatigue, anxiety, and depression symptoms. DISCUSSION CBT-I resulted in improved self-reported sleep, pain, and CD symptoms, with a trend toward improved CRP. Results highlight the importance of addressing sleep concerns in IBD, particularly in people with persistent pain or fatigue. Future trials powered to detect short- and long-term changes in pain and inflammation post-treatment are warranted. Table 1. Participant demographics. Table 2. Results of linear mixed effects models comparing pre- and post-intervention sleep, pain, and inflammation.

Performance evaluation of an under-mattress sleep sensor versus polysomnography in > 400 nights with healthy and unhealthy sleep.

Consumer sleep trackers provide useful insight into sleep. However, large-scale performance evaluation studies are needed to properly understand sleep tracker accuracy. This study evaluated performance of an under-mattress sensor to estimate sleep and wake versus polysomnography in a large sample, including individuals with and without sleep disorders and during day versus night sleep opportunities, across multiple in-laboratory studies. One-hundred and eighty-three participants (51%/49% male/female, mean [SD] age = 45 [18] years) attended the sleep laboratory for a research study including simultaneous polysomnography and under-mattress sensor (Withings Sleep Analyser) recordings. Epoch-by-epoch analyses determined accuracy, sensitivity and specificity of the Withings Sleep Analyser versus polysomnography. Bland-Altman plots examined bias in sleep duration, efficiency, onset-latency, and wake after sleep onset. Overall Withings Sleep Analyser sleep-wake classification accuracy was 83%, sensitivity 95% and specificity 37%. The Withings Sleep Analyser significantly overestimated total sleep time (48 [81] min), sleep efficiency (9 [15]%) and sleep-onset latency (6 [26] min), and underestimated wake after sleep onset (54 [78] min). Accuracy and specificity were higher for night versus daytime sleep opportunities in healthy individuals (89% and 47% versus 82% and 26%, respectively, p < 0.05). Accuracy and sensitivity were also higher for healthy individuals (89% and 97%) versus those with sleep disorders (81% and 91%, p < 0.05). Withings Sleep Analyser performance is comparable to other consumer sleep trackers, with high sensitivity but poor specificity compared with polysomnography. Withings Sleep Analyser performance was reasonably stable, but more variable in daytime sleep opportunities and in people with a sleep disorder. Contactless, under-mattress sleep sensors show promise for accurate sleep monitoring, noting the tendency to over-estimate sleep particularly where wake time is high.

A case study on generative artificial intelligence to extract the fundamental sleep parameters from polysomnography notes.

Generative artificial intelligence (AI) utilizing transformer technology is widely seen as a groundbreaking advancement in applied artificial intelligence. The technology creates a unique opportunity to extract unstructured data from medical notes. In the current experiments, we extracted fundamental sleep parameters from polysomnography (PSG) notes of veterans in the Corporate Data Warehouse (CDW) national database using large language models. The "SOLAR-10.7B-Instruct" model extracted values associated with total sleep time (TST), sleep onset latency (SOL), and sleep efficiency (SE) from the PSG notes. The model's performance was evaluated using 464 human annotated notes. The analysis showed close accuracy for the large language model (LLM) compared to the human TST and SE extraction, and a considerable accuracy improvement (7.6%) in extracting SOL for the machine compared to human annotation. The LLM shows negligible hallucination (no more than 3.6%), and it has the capability to perform complicated reasoning to extract the desired sleep parameter.