Journal of Clinical Sleep Medicine最新文献

{"title":"Validation of automated detection of REM sleep without atonia using in-laboratory and in-home recordings.","authors":"Daniel J Levendowski, Lana M Chahine, Simon J G Lewis, Thomas J Finstuen, Andrea Galbiati, Chris Berka, Sherri Mosovsky, Hersh Parikh, Jack Anderson, Christine M Walsh, Joyce K Lee-Iannotti, Thomas C Neylan, Luigi Ferini Strambi, Bradley F Boeve, Erik K St Louis","doi":"10.5664/jcsm.11488","DOIUrl":"10.5664/jcsm.11488","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the concordance between visual scoring and automated detection of rapid eye movement sleep without atonia (RSWA) and the validity and reliability of in-home automated-RSWA detection in patients with rapid eye movement sleep behavior disorder (RBD) and a control group.</p><p><strong>Methods: </strong>Sleep Profiler signals were acquired during simultaneous in-laboratory polysomnography in 24 isolated patients with RBD. Chin and arm RSWA measures visually scored by an expert sleep technologist were compared to algorithms designed to automate RSWA detection. In a second cohort, the accuracy of automated-RSWA detection for discriminating between RBD and control group (n = 21 and 42, respectively) was assessed in multinight in-home recordings.</p><p><strong>Results: </strong>For the in-laboratory studies, agreement between visual and auto-scored RSWA from the chin and arm were excellent, with intraclass correlations of 0.89 and 0.95, respectively, and substantial, based on Kappa scores of 0.68 and 0.74, respectively. For classification of patients with iRBD vs controls, specificities derived from auto-detected RSWA densities obtained from in-home recordings were 0.88 for the chin, 0.93 for the arm, and 0.90 for the chin or arm, while the sensitivities were 0.81, 0.81, and 0.86, respectively. The night-to-night consistencies of the respective auto-detected RSWA densities were good based on intraclass correlations of 0.81, 0.79, and 0.84, however some night-to-night disagreements in abnormal RSWA detection were observed.</p><p><strong>Conclusions: </strong>When compared to expert visual RSWA scoring, automated RSWA detection demonstrates promise for detection of RBD. The night-to-night reliability of chin- and arm-RSWA densities acquired in-home were equivalent.</p><p><strong>Citation: </strong>Levendowski DJ, Chahine LM, Lewis SJG, et al. Validation of automated detection of REM sleep without atonia using in-laboratory and in-home recordings. <i>J Clin Sleep Med</i>. 2025;21(3):583-592.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"583-592"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep apnea physiological burdens and markers of white matter injury: the Multi-Ethnic Study of Atherosclerosis.","authors":"Mohammadreza Hajipour, Wen-Hsin Hu, Neda Esmaeili, Scott Sands, Andrew Wellman, Younghoon Kwon, Gonzalo Labarca, Ilya M Nasrallah, R Nick Bryan, Patrick J Strollo, Susan R Heckbert, Susan Redline, Najib T Ayas, Ali Azarbarzin","doi":"10.5664/jcsm.11422","DOIUrl":"10.5664/jcsm.11422","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea is associated with cognitive impairment; however, the underlying mechanisms remain incompletely understood. Obstructive sleep apnea is characterized by periods of interrupted ventilation (ventilatory burden), leading to hypoxemia (hypoxic burden) and/or arousal (arousal burden) from sleep. Although hypoxemia is considered a key mechanism underlying white matter injury, its measurement has been limited. In our primary analysis, we assessed the association of hypoxic burden, a quantitative measure of hypoxemia, with white matter hyperintensity volume, a marker of small vessel disease, and compared it with that of ventilatory burden and arousal burden (quantitative measures of ventilatory deficit and arousals).</p><p><strong>Methods: </strong>Data from participants in the Multi-Ethnic Study of Atherosclerosis with full polysomnograms and brain magnetic resonance imaging were analyzed. Hypoxic burden was defined as the total area under the oxygen desaturation curve per hour of sleep, ventilatory burden was defined as the event-specific area under the ventilation signal, and arousal burden was defined as the normalized cumulative duration of all arousals. The primary outcome was white matter hyperintensity volume, with other magnetic resonance imaging measures considered secondary outcomes.</p><p><strong>Results: </strong>The analysis included polysomnograms from 587 participants (age: 65.5 ± 8.2 years). In the fully adjusted model, each 1 standard deviation increase in hypoxic burden was associated with a 0.09 standard deviation increase in white matter hyperintensity volume (<i>P</i> = .023), after adjusting for demographics, study site, and comorbidities. In contrast, ventilatory burden, arousal burden, and conventional obstructive sleep apnea measures were not associated with outcomes.</p><p><strong>Conclusions: </strong>Hypoxic burden was associated with white matter hyperintensity volume in a racially/ethnically diverse cohort of older individuals with a high prevalence of obstructive sleep apnea .</p><p><strong>Citation: </strong>Hajipour M, Hu W-H, Esmaeili N, et al. Sleep apnea physiological burdens and markers of white matter injury: the Multi-Ethnic Study of Atherosclerosis. <i>J Clin Sleep Med.</i> 2025;21(3):457-466.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"457-466"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agrypnia excitata: a clinical biomarker of acute relapse in anti-N-methyl-D-aspartate receptor encephalitis.","authors":"Lina Jeantin, Louis Cousyn, Vincent Navarro, Vi-Huong Nguyen-Michel","doi":"10.5664/jcsm.11402","DOIUrl":"10.5664/jcsm.11402","url":null,"abstract":"<p><p>Sleep disorders have been described in anti-N-methyl-D-aspartate receptor encephalitis including insomnia, hypersomnia, narcolepsy, and sleep-disordered breathing. A patient presented with typical features of anti-N-methyl-D-aspartate receptor encephalitis associated with a right ovarian teratoma. After 2 months of clinical improvement with immunotherapy, the patient deteriorated. A 24-hour video electroencephalography-polysomnography revealed a severe sleep quantity deficit, a total destruction of sleep architecture consisting of short clusters of N1 and rapid eye movement sleep stages, associated with motor and autonomic hyperactivity. These features were consistent with agrypnia excitata and were associated with disease reactivation due to a left ovarian teratoma. A new course of immunotherapy and surgery improved clinical symptoms and normalized sleep patterns. Agrypnia excitata, the most severe form of status dissociatus, was a sleep biomarker of disease relapse in this patient. Polysomnographic studies in the acute phase of anti-N-methyl-D-aspartate receptor encephalitis are lacking and are needed to better understand the evolution of sleep patterns.</p><p><strong>Citation: </strong>Jeantin L, Cousyn L, Navarro V, Nguyen-Michel V-H. Agrypnia excitata: a clinical biomarker of acute relapse in anti-N-methyl-D-aspartate receptor encephalitis. <i>J Clin Sleep Med</i>. 2025;21(3):599-603.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"599-603"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-emergent central sleep apnea resolves with lower inspiratory pressure.","authors":"William H Noah, Ludovico Messineo, Bernard Hete, Evelyn Thompson, David P White, Robert J Farney, Krishna M Sundar","doi":"10.5664/jcsm.11492","DOIUrl":"10.5664/jcsm.11492","url":null,"abstract":"<p><strong>Study objectives: </strong>Treatment-emergent central sleep apnea (TECSA) is an important problem during therapy with continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea. We tested a device designed to improve CPAP comfort through reducing inspiratory positive airway pressure (IPAP; <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math>) to determine whether such a reduction in IPAP could eliminate central apneas in patients with TECSA. Because increasing tidal volume (potentially via IPAP increments) has been suggested as a possible mechanism contributing to TECSA onset, our hypothesis was that reducing IPAP would yield a drop in the central apnea index.</p><p><strong>Methods: </strong>The addition of a known resistance (<math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> device) that reduces IPAP was implemented into the CPAP circuit during the second half of CPAP titrations in a cohort of community-dwelling patients who developed TECSA during a split-night CPAP titration. Central apnea index was quantified from the sleep periods without and with <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> in place.</p><p><strong>Results: </strong>A total of 1,613 patients underwent CPAP titration, with 19 of them developing TECSA during the titration. The addition of <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> resulted in complete resolution of TECSA in all patients with adequate sleep data under all conditions (n = 13), yielding a significant reduction in the central apnea index (17.3 ± 11.0 vs 1.5 ± 1.7 events/h without and with <math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math>, respectively; <i>P</i> < .001).</p><p><strong>Conclusions: </strong><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><mtext>-Com</mtext></mrow></math> virtually resolved all instances of TECSA, suggesting that reducing IPAP could be an effective strategy for managing the occurrence of central respiratory events in patients with obstructive sleep apnea using CPAP.</p><p><strong>Citation: </strong>Noah WH, Messineo L, Hete B, et al. Treatment-emergent central sleep apnea resolves with lower inspiratory pressure. <i>J Clin Sleep Med.</i> 2025;21(3):559-564.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"559-564"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enough is enough: strict hypopnea criteria exacerbate sleep-related health disparities in females.","authors":"Lindsay M McCullough, Hrayr Attarian","doi":"10.5664/jcsm.11550","DOIUrl":"10.5664/jcsm.11550","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"453-454"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home sleep apnea testing auto-interpretation.","authors":"Felix W Wireko, Timothy I Morgenthaler","doi":"10.5664/jcsm.11432","DOIUrl":"10.5664/jcsm.11432","url":null,"abstract":"<p><p>Recent advances in sleep medicine have led to the development of various validated diagnostic devices for obstructive sleep apnea. Despite limitations, there has been an increase in the use of home sleep apnea tests. The accuracy of home sleep apnea tests may be limited by the inability of their automated signal analysis to differentiate between artifacts and the target physiological signal, leading to erroneous test interpretations with management implications. We present a 60-year-old male with a mechanical heart valve diagnosed with obstructive sleep apnea. At the 6-month postintervention follow-up, the home sleep apnea test report indicated loud snoring 100% of the time. After carefully reviewing the raw home sleep apnea test data and history, the source of the nonphysiological high-level sound was identified as the mechanical heart valve, and the patient was reassured. This case highlights how trusting only automated analysis can miss important information and arrive at misleading conclusions.</p><p><strong>Citation: </strong>Wireko FW, Morgenthaler TI. Home sleep apnea testing auto-interpretation. <i>J Clin Sleep Med.</i> 2025;21(3):605-607.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"605-607"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data.","authors":"Duaa Fatima, Alexander Sweetman, Nicole Lovato, Andrew Vakulin, Nick Bansback, Marcus Povitz, Nigel Stocks, Mark Fenton, Ching Li Chai-Coetzer, Sachin R Pendharkar","doi":"10.5664/jcsm.11414","DOIUrl":"10.5664/jcsm.11414","url":null,"abstract":"<p><strong>Study objectives: </strong>We aimed to describe similarities and differences in obstructive sleep apnea (OSA) care pathways and their impact on patients in Australia and Canada, including among urban vs rural participants.</p><p><strong>Methods: </strong>In this secondary data analysis of patient surveys exploring OSA care in Australia and Canada, we recruited adults with a prior diagnosis of OSA from market research companies, social media, and patient-facing medical associations. Residential postal codes were used to classify participants as urban or rural. Survey domains included wait times and travel distances for care, providers, and treatments.</p><p><strong>Results: </strong>Data from 589 Canadians (21% rural; 42% female; mean [standard deviation] age = 57 [13] years) and 412 Australians (38% rural; 45% female; mean [standard deviation] age = 58 [14] years) with OSA were included. Participants in both countries most commonly sought initial care for suspected OSA from a primary care practitioner. Canadian participants waited longer to seek care than Australian participants (37% vs 51% within 12 months of symptom onset). Wait times for diagnostic testing were longer in Canada (59% vs 76% within 3 months of initial assessment), especially in urban settings (58% vs 78%). In both countries, > 80% of participants were offered positive airway pressure therapy. Overall, a greater variety of treatments were offered and used by Australian participants.</p><p><strong>Conclusions: </strong>Greater access to diagnostic testing and a greater variety of treatments were found in Australia compared to Canada. Further research is needed to determine whether reduced diagnostic wait times and presentation of increased therapy options found in Australia translate to better patient outcomes.</p><p><strong>Citation: </strong>Fatima D, Sweetman A, Lovato N, et al. Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data. <i>J Clin Sleep Med.</i> 2025;21(3):467-477.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"467-477"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of consumer wrist-worn sleep tracking devices compared to polysomnography: a meta-analysis.","authors":"Young Jeong Lee, Jae Yong Lee, Jae Hoon Cho, Yun Jin Kang, Ji Ho Choi","doi":"10.5664/jcsm.11460","DOIUrl":"10.5664/jcsm.11460","url":null,"abstract":"<p><strong>Study objectives: </strong>The use of sleep tracking devices is increasing as people become more aware of the importance of sleep and interested in monitoring their patterns. With many devices on the market, we conducted a meta-analysis comparing sleep scoring data from consumer wrist-worn sleep tracking devices with polysomnography to validate the accuracy of these devices.</p><p><strong>Methods: </strong>We retrieved studies from the databases of SCOPUS, EMBASE, Cochrane Library, PubMed, Web of Science, and KoreaMed and OVID Medline up to March 2024. We compared personal data about participants and information on objective sleep parameters.</p><p><strong>Results: </strong>From 24 studies, data of 798 patient using Fitbit, Jawbone, myCadian watch, WHOOP strap, Garmin, Basis B1, Zulu Watch, Huami Arc, E4 wristband, Fatigue Science Readiband, Apple Watch, or Xiaomi Mi Band 5 were analyzed. There were significant differences in total sleep time (mean difference, -16.854; 95% confidence interval, [-26.332; -7.375]), sleep efficiency (mean difference, -4.691; 95% confidence interval, [-7.079; -2.302]), sleep latency (mean difference, 2.574; 95% confidence interval, [0.606; 4.542]), and wake after sleep onset (mean difference, 13.255; 95% confidence interval, [4.522; 21.988]) between all consumer sleep tracking devices and polysomnography. In subgroup analysis, there was no significant difference in wake after sleep onset between Fitbit and polysomnography. There was also no significant difference in sleep latency between other devices and polysomnography. Fitbit measured sleep latency longer than other devices, and other devices measured wake after sleep onset longer. Based on Begg and Egger's test, there was no publication bias in total sleep time and sleep efficiency.</p><p><strong>Conclusions: </strong>Wrist-worn sleep tracking devices, although popular, are not as reliable as polysomnography in measuring key sleep parameters such as total sleep time, sleep efficiency, and sleep latency. Physicians and consumers should be aware of their limitations and interpret results carefully, though they can still be useful for tracking general sleep patterns. Further improvements and clinical studies are needed to enhance their accuracy.</p><p><strong>Citation: </strong>Lee YJ, Lee JY, Cho JH, Kang YJ, Choi JH. Performance of consumer wrist-worn sleep tracking devices compared to polysomnography: a meta-analysis. <i>J Clin Sleep Med.</i> 2025;21(3):573-582.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"573-582"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3-minute central apneas: enhanced expiratory rebreathing space to the rescue.","authors":"Kenneth Wojnowski, Gabriella Primera, Karin G Johnson","doi":"10.5664/jcsm.11582","DOIUrl":"https://doi.org/10.5664/jcsm.11582","url":null,"abstract":"<p><p>This case report presents an atypical case of central sleep apnea (CSA) treated with continuous positive airway pressure (CPAP), enhanced expiratory rebreathing space (EERS) and oxygen. A 69-year-old female with morbid obesity and congestive heart failure who previously failed multiple positive airway pressure (PAP) modalities for presumed obstructive sleep apnea (OSA) was referred for re-titration with transcutaneous CO₂ (TCCO₂) monitoring. Titration with CPAP, bilevel PAP, and intelligent volume-assured pressure support resulted in 3-4 minute central apneas with an oxygen saturation nadir of 49%, and an average TCCO₂ of 27 mmHg. Subsequent split night polysomnography revealed CSA without OSA. CPAP and adaptive servoventilation alone and CPAP with oxygen were inadequate. Addition of EERS and oxygen supplementation to CPAP led to an improved Epworth Sleepiness Score (12 to 3) and overnight oximetry confirmed a satisfactory oxygen saturation nadir of 92%. This case highlights the use of TCCO2 monitoring in the recognition of hypocapnic CSA leading to successful treatment with CPAP, EERS and oxygen.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study on generative artificial intelligence to extract the fundamental sleep parameters from polysomnography notes.","authors":"Arash Maghsoudi, Amir Sharafkhaneh, Mehrnaz Azarian, Amin Ramezani, Max Hirshkowitz, Javad Razjouyan","doi":"10.5664/jcsm.11594","DOIUrl":"https://doi.org/10.5664/jcsm.11594","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}