BackgroundVital information about a person's physical and emotional health can be perceived in their voice. After sleep loss, altered voice quality is noticed. The circadian rhythm controls the sleep cycle, and when it is askew, it results in fatigue, which is manifested in speech. Using MATLAB statistical techniques and the k-nearest neighbour (KNN) machine learning algorithm, this study assessed the efficacy of the harmonic-to-noise ratio (HNR) as a speech biomarker in differentiating fatigued and normal voice after sleep deprivation of one night. MethodsAfter one night of sleep deprivation, acoustic samples for sustained vowel/a/and visual reaction time were recorded from n = 32 healthy young Indian male volunteers (20–40 yrs). One-way ANOVA established significant changes in voice characteristics with progressive sleep deprivation. The effectiveness of speech HNR as a biomarker for the detection of healthy and fatigued voice was researched, using the KNN classifier in a machine learning algorithm. ResultsThe HNR voice feature was taken from an acoustic sample for three times: baseline (Time 1), 3 AM (Time 2), and 7 AM (Time 3) towards an incremental one-night sleep loss. At 3AM, the HNR changed significantly p<0.05. Utilizing an iterative signal extrapolation approach, the KNN classifier divided the submitted voice signal sample into normal and fatigued categories. ConclusionThe findings imply that the HNR can be used to link fatigue from sleep deprivation with vocal alterations by classifying voice samples in a KNN classifier. Along with the multimodal diagnostic features, this method may also offer an additional acoustic biomarker for the diagnosis of fatigue post sleep loss.