Sleep & breathing = Schlaf & Atmung最新文献

{"title":"Association between chronotype preference and sleep characteristics in insomnia patients.","authors":"Yi Wang, Menglong Dong, Xianchao Zhao, Jiafeng Ren, Liping Zhang, Mengmeng Fan, Zhifeng Lin, Yiqing Yang, Qi Wu, Jin-Xiang Cheng, Changjun Su","doi":"10.1007/s11325-026-03814-9","DOIUrl":"10.1007/s11325-026-03814-9","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between chronotype preference and subjective sleep perception, objective sleep parameters, rest-activity rhythms (RAR), as well as light exposure rhythms (LER) in insomnia patients remains insufficiently clarified. This study aimed to explore the differences in nocturnal and diurnal sleep characteristics, RAR and LER between morning-type and intermediate-type insomnia patients, and to screen subjective and objective influencing factors associated with chronotype preference.</p><p><strong>Methods: </strong>A total of 62 enrolled insomnia patients were divided into morning-type and intermediate-type groups according to the Morningness-Eveningness Questionnaire (MEQ). All participants completed relevant subjective scales including the Sleep Hygiene Practice Scale (SHPS) and underwent 7-day continuous wrist actigraphy monitoring. RAR and LER non-parametric indicators were calculated via R software. Group differences in demographic data, subjective sleep scales, and actigraphy-derived nocturnal and diurnal variables were compared, and multivariate linear regression was performed to identify predictors of MEQ scores.</p><p><strong>Results: </strong>Compared with intermediate-type patients, morning-type insomnia patients were significantly older, with poorer subjective sleep quality and more irrational sleep beliefs, and showed higher daytime rhythm stability and more regular activity patterns (all P < 0.05). No significant inter-group differences were observed in most objective sleep parameters. Multivariate linear regression analysis confirmed that SHPS score and the timing of the most active 10 h (M10) were independent influencing factors of chronotype preference.</p><p><strong>Conclusions: </strong>Chronotype preference is closely correlated with age, subjective sleep perception, sleep hygiene level and rest-activity rhythm characteristics. Attention should be paid to individual chronotype characteristics in clinical insomnia management, optimizing sleep hygiene and regulating daily activity rhythm patterns may help improve sleep status in insomnia patients.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of obstructive sleep apnea on skin wound healing - from preclinical perspective to clinical evidence: A narrative review.","authors":"Łukasz Mazurek, Ewa Migacz, Marek Konop, Wojciech Kukwa","doi":"10.1007/s11325-026-03804-x","DOIUrl":"10.1007/s11325-026-03804-x","url":null,"abstract":"<p><strong>Purpose: </strong>Adequate tissue oxygenation is essential for effective skin wound healing. Hypoxia contributes to impaired healing and chronic wound formation. Obstructive sleep apnea (OSA) affects nearly one billion adults worldwide, and up to 80% of cases remain undiagnosed. OSA causes intermittent hypoxia (IH), with repetitive cycles of oxygen desaturation and reoxygenation during sleep. The molecular pathways activated by IH differ from those induced by acute and chronic hypoxia. We propose that OSA may contribute to impaired wound healing in two ways. Indirectly, by promoting comorbidities such as diabetes, hypertension, and obesity. Directly, through IH and its effects at the cellular and tissue level.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, and Web of Science were searched through August 2026 for preclinical and clinical studies on OSA, IH, and wound healing.</p><p><strong>Results: </strong>To our knowledge, this is the first review to integrate cellular mechanisms, preclinical evidence, and clinical data on this topic. We describe the IH-driven mechanisms that may contribute to impaired wound healing, including reduced antioxidant capacity, sustained inflammation, sympathetic activation, and endothelial dysfunction. Preclinical evidence is limited and mostly derives from in vitro scratch assays. It shows that IH delays wound closure, downregulates HIF-2α and VEGF, and shifts macrophages toward a pro-inflammatory phenotype. Clinical data are also limited and heterogeneous. In diabetic foot ulcers, high OSA risk doubled the risk of poor healing. Improved ulcer healing after CPAP has been described only in a small case series.</p><p><strong>Conclusion: </strong>Given its high prevalence and underdiagnosis, OSA may be an overlooked and potentially modifiable factor in impaired wound healing.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxic burden reduction after lateral pharyngoplasty in patients with obstructive sleep apnea: Beyond the apnea-hypopnea index.","authors":"André Luís Pereira Vieira, Bruno Bernardo Duarte, Aurelio Rochael Almeida, Mário Edvin Greters, Vânia Aparecida Leandro-Merhi, José Luís Braga de Aquino","doi":"10.1007/s11325-026-03808-7","DOIUrl":"10.1007/s11325-026-03808-7","url":null,"abstract":"<p><strong>Purpose: </strong>The apnea-hypopnea index (AHI), traditionally used to assess obstructive sleep apnea (OSA) severity and surgical outcomes, has limitations in reflecting cardiovascular risk and pathophysiological burden. Although lateral pharyngoplasty has demonstrated favorable outcomes regarding AHI reduction, its impact on hypoxic burden (HB) remains unknown. This study evaluated HB changes after lateral pharyngoplasty in patients with OSA, including those classified as surgical failures according to Sher's criteria.</p><p><strong>Methods: </strong>This observational, longitudinal study with a mixed retrospective and prospective design included 27 adults with OSA who underwent lateral pharyngoplasty (version 6) between 2016 and 2025, with complete preoperative and postoperative polysomnographic data for HB assessment. HB was calculated using validated commercial software. Nonparametric tests were used for intra- and intergroup comparisons. Surgical success was defined according to Sher's criteria.</p><p><strong>Results: </strong>A significant reduction in HB was observed across all variants: total sleep time (median from 97.1%·min/h to 35.0%·min/h, p < 0.0001), REM sleep, NREM sleep, and supine and non-supine positions, with a significant reduction in median AHI (median from 33.8 to 12.3 events/h, p < 0.0001). Even among surgical failures according to Sher's criteria, HB decreased significantly (median from 102.5%·min/h to 67.3%·min/h, p = 0.0107), suggesting pathophysiological improvement not captured by AHI alone.</p><p><strong>Conclusion: </strong>HB is a potentially more sensitive metric to assess therapeutic response in OSA, incorporating multiple dimensions of nocturnal hypoxemia beyond AHI. Lateral pharyngoplasty promoted consistent HB reduction, including in surgical failures, supporting HB as a complementary tool for therapeutic evaluation, with potential applications in cardiovascular risk stratification.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-rater reliability in drug-induced sleep endoscopy: experience-driven interpretation, decision-making, and the emerging role of artificial intelligence.","authors":"Federico Leone, Filippo Omenetti, Alessandro Bianchi, Giannicola Iannella, Andrea Collettini, Saverio Nicoletti, Maria Elvira Distefano, Yuliya Germini Moysey, Edoardo Rosciano, Giorgio Imbrogno, Andrea Preti, Federica Vultaggio, Franco Minnella, Riccardo Zanzi, Fabrizio Salamanca, Federico Ambrogi, Francesco Mozzanica","doi":"10.1007/s11325-026-03807-8","DOIUrl":"10.1007/s11325-026-03807-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the inter-rater reliability of DISE interpretation using the VOTE classification, assess variability in therapeutic decision-making, and explore the potential role of artificial intelligence (AI) in DISE evaluation.</p><p><strong>Methods: </strong>Twenty DISE recordings were retrospectively and independently evaluated by 12 raters (7 junior and 5 senior) and by a general-purpose AI model without task-specific training. Inter-rater agreement among human raters for obstruction grading and pattern classification was assessed using percentage agreement, Fleiss' kappa, and weighted kappa. Agreement with a reference standard (unanimous expert consensus) was analyzed. Treatment proposals were evaluated using exact match ratio and Jaccard similarity.</p><p><strong>Results: </strong>At baseline, agreement among human raters ranged from 43.6% to 68.0% for obstruction grading (weighted κ, 0.255-0.425) and from 60.8% to 79.3% for collapse pattern (Fleiss' κ, 0.287-0.370). Senior raters showed higher baseline agreement than junior raters across all anatomical levels for collapse pattern and at three of four levels for obstruction grading. Agreement with the expert consensus ranged from 70.0% to 90.0% for senior raters and from 35.0% to 85.0% for AI in baseline grading, and from 75.0% to 95.0% and 50.0% to 80.0%, respectively, in baseline pattern classification. For therapeutic recommendations, exact agreement was 70.0% for senior raters, 55.0% for junior raters, and 50.0% for AI; mean Jaccard similarity was 0.867, 0.833, and 0.742, respectively.</p><p><strong>Conclusions: </strong>DISE interpretation remains complex and operator-dependent. Pattern classification appears more reproducible than grading. While a non-task-specific AI model captured clinically relevant patterns, it did not match expert performance in complex decision-making. AI may serve as a supportive tool, particularly for less experienced clinicians.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-defined low tongue posture and CPAP adherence: clinical utility, methodological strengths, and diagnostic clarifications.","authors":"Shamoon Ali Khan","doi":"10.1007/s11325-026-03805-w","DOIUrl":"10.1007/s11325-026-03805-w","url":null,"abstract":"","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptual growth curves of oropharyngeal soft tissues and craniofacial skeletal structures: clinical implications for pediatric airway management.","authors":"Audrey J Yoon, Jocelyn K L Hor, Kyung A Kim","doi":"10.1007/s11325-026-03809-6","DOIUrl":"10.1007/s11325-026-03809-6","url":null,"abstract":"<p><strong>Background: </strong>Pediatric obstructive sleep apnea (OSA) is closely linked to the growth and interaction of upper airway soft tissues. The relevance of Scammon's classical growth curves to site-specific oropharyngeal development has been called into question, despite the fact that they have long provided a fundamental framework for comprehending lymphoid tissue maturation.</p><p><strong>Main body: </strong>This narrative review synthesizes current imaging-based and morphometric evidence on the age-related growth of the adenoids, palatine tonsils, lingual tonsils, and tongue, within the context of craniofacial development. Adenoidal tissue undergoes rapid early growth, peaking between 6 and 8 years - earlier than predicted by Scammon's lymphoid curve. Palatine tonsils reach maximum dimensions between 8 and 10 years before gradual involution. Lingual tonsils lack normative developmental data in healthy children and appear largely absent on MRI in asymptomatic subjects, with hypertrophy representing a compensatory or condition-dependent response rather than normal development. The tongue follows a general-type growth trajectory with marked regional differences: the anterior two-thirds attains near-adult size by 8-10 years, while the posterior third continues enlarging into adolescence. These structure-specific trajectories interact with the differential maturation of craniofacial structures - the cranium, maxilla, and mandible - creating a transient \"window of vulnerability\" between approximately 5 and 10 years of age, during which soft tissue volume disproportionately narrows the upper airway.</p><p><strong>Conclusions: </strong>Oropharyngeal soft tissue growth is structure-specific and does not conform to a single generalized growth curve. A conceptual, site-specific clinical framework integrating the distinct growth trajectories of each tissue and their proportional relationship to craniofacial development is essential for orthodontic assessment, airway risk stratification, and timely intervention in children with or at risk for sleep-disordered breathing.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate hemodynamic stabilization with positive airway pressure: PTT-derived nocturnal blood pressure fluctuations during split-night polysomnography.","authors":"Deepesh Vaidya, Archita Joshi, Saumy Johnson","doi":"10.1007/s11325-026-03812-x","DOIUrl":"10.1007/s11325-026-03812-x","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the immediate hemodynamic effect of positive airway pressure (PAP) therapy on pulse transit time (PTT)-derived nocturnal blood pressure fluctuation (NBPF) during split-night polysomnography and to determine whether this effect differs between hypertensive and non-hypertensive individuals.</p><p><strong>Methods: </strong>This retrospective cohort study included 464 adults undergoing split-night polysomnography between 2015 and 2023. NBPF was defined as the standard deviation of systolic blood pressure (SBP) derived from PTT calibrated using manufacturer-validated algorithms. Within-group changes were assessed using paired t-tests, between-group comparisons used independent t-tests, and multivariable linear regression adjusted for age and baseline NBPF. Effect sizes (Cohen's d) and 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>NBPF decreased significantly after PAP therapy in both hypertensive (mean reduction 20.71 ± 24.25 mmHg, p < 0.001) and non-hypertensive groups (18.97 ± 23.58 mmHg, p < 0.001). Effect sizes were large (Cohen's d = 0.96 and 0.90, respectively). The adjusted between-group difference in NBPF reduction was not significant (β = 1.42 mmHg; 95% CI - 3.21 to 6.05; p = 0.54).</p><p><strong>Conclusions: </strong>PAP therapy during split-night studies produces immediate hemodynamic stabilization, reflected by a large and significant reduction in nocturnal BP variability in both hypertensive and non-hypertensive patients. These findings support early PAP initiation to mitigate nocturnal BP lability regardless of baseline hypertension status.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of sleep efficiency with cardiac autonomic modulation in young and professional soccer players during pre-season.","authors":"Nathaniel Gomes Oliveira, Lucas Miquéias Silva Abreu, Felipe Bispo Ribeiro, Bianca Fernanda Almeida Silva, Tanara Nubia Furtado Monteiro, Michele Brito Correia, Manuelly Estefanny Vieira Pereira, Herickson Araújo Costa, Cristiano Teixeira Mostarda, Carlos Alberto Alves Dias Filho, Jefferson Fernando Coelho Rodrigues, Janaina de Oliveira Brito Monzani, Emerson Silami Garcia, Christian Emmanuel Torres Cabido, Carlos José Moraes Dias","doi":"10.1007/s11325-026-03811-y","DOIUrl":"10.1007/s11325-026-03811-y","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between sleep efficiency and cardiac autonomic modulation in young and professional soccer players during pre-season.</p><p><strong>Methods: </strong>A cross-sectional quantitative study was conducted with 53 male soccer players divided into three categories: U-15 (n = 12), U-17 (n = 15), and professionals (n = 26). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), cardiac autonomic modulation via heart rate variability (HRV) recorded by a 10-lead electrocardiograph and analyzed with Kubios HRV 2.0, and cardiorespiratory capacity estimated through the Yo-Yo Intermittent Recovery Test. Body composition was assessed by tetrapolar electrical bioimpedance. Statistical analyses included one-way ANOVA, Welch's ANOVA, chi-square and Fisher's exact tests, Pearson correlation, and simple linear regression, with significance set at p < 0.05.</p><p><strong>Results: </strong>Professional athletes demonstrated significantly higher VO₂max (50.5 ± 4.56 ml·kg⁻¹·min⁻¹; p < 0.001), lower resting heart rate (54.9 ± 8.65 bpm; p = 0.03), and greater parasympathetic modulation (RMSSD: 82.8 ± 17.5 ms; p < 0.001) compared to youth categories. Sleep efficiency was significantly higher in professionals (90.7 ± 6.13%; p = 0.01) and positively correlated with RMSSD. A significant association was found between RMSSD levels and global sleep quality (p = 0.004; X² = 0.50), as well as between RMSSD and VO₂max classification (p = 0.01; X² = 0.40).</p><p><strong>Conclusion: </strong>Sleep efficiency is positively associated with cardiac autonomic modulation and aerobic performance in soccer players. While the superior physiological profile of professionals reflects a synergy between training adaptations and biological maturation, HRV and PSQI constitute complementary monitoring tools for integrated athlete assessment across competitive categories.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of sleep disturbances in the subacute phase after stroke: a longitudinal actigraphy study.","authors":"Ruani Araújo Tenório, Isadora Grade Biasibetti, Maria Tereza Mota Alvarenga, Luci Fuscaldi Teixeira-Salmela, Patrick Roberto Avelino, Andressa Silva, Aline Alvim Scianni","doi":"10.1007/s11325-026-03810-z","DOIUrl":"10.1007/s11325-026-03810-z","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are common after stroke and may negatively impact recovery and quality of life. However, monitoring sleep parameters over time with objective measures remains underreported.</p><p><strong>Objective: </strong>To investigate longitudinal changes in actigraphy-derived sleep parameters from the subacute to later stages after stroke.</p><p><strong>Methods: </strong>This longitudinal observational study included 18 individuals with stroke who completed seven-day wrist-actigraphy monitoring at baseline and at the most distal valid follow-up assessment obtained more than three months after stroke. The median interval between assessments was 161 days (IQR 102.3-194.0). Time in bed, total sleep time, sleep latency, sleep efficiency, wake after sleep onset (WASO), and number of awakenings were compared using paired t-tests. Mean paired differences, 95% confidence intervals (CIs), and Cohen's d effect sizes were calculated.</p><p><strong>Results: </strong>No statistically significant longitudinal changes were detected. Mean changes were - 0.12 h for time in bed (95% CI - 0.73 to 0.49), - 0.05 h for total sleep time (95% CI - 0.59 to 0.50), - 7.93 min for sleep latency (95% CI - 19.55 to 3.69), - 0.36% points for sleep efficiency (95% CI - 4.19 to 3.48), 3.63 min for WASO (95% CI - 9.22 to 16.48), and 0.43 for number of awakenings (95% CI - 0.74 to 1.59). Effect sizes were small, and exploratory individual-level analysis showed increased sleep efficiency in 10 participants and decreased sleep efficiency in 8.</p><p><strong>Conclusion: </strong>The analysis showed no statistically significant changes in sleep patterns between the subacute phase and the follow-up. While sleep metrics remained outside normal ranges at both time points, the small and heterogeneous sample, along with wide confidence intervals, prevents any definitive conclusions about long-term trends or causes.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECG-based artificial intelligence for obstructive sleep apnea detection: a mechanism-oriented diagnostic meta-analysis.","authors":"Ayşe Bulut, Ömer Engin Bulut","doi":"10.1007/s11325-026-03798-6","DOIUrl":"10.1007/s11325-026-03798-6","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI)-based approaches have shown promising performance in the detection of obstructive sleep apnea (OSA) using electrocardiography (ECG)-based physiological signals. However, existing studies primarily focus on diagnostic accuracy, while the underlying physiological mechanisms driving AI-based detection remain largely unexplored. This study aimed to evaluate the diagnostic performance of segment-level AI models and to provide a mechanism-oriented interpretation of their physiological basis.</p><p><strong>Methods: </strong>A systematic review and diagnostic meta-analysis were conducted in accordance with PRISMA 2020 and PRISMA-DTA guidelines. PubMed, Scopus, Web of Science, and IEEE Xplore databases were systematically searched. Studies utilizing AI models for segment-level OSA detection based on physiological signals were included. Sensitivity and specificity values were extracted, and 2 × 2 contingency tables were reconstructed using a standardized approach to enable cross-study comparability. A bivariate random-effects model was applied, and summary receiver operating characteristic (SROC) curves were generated.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria. The pooled sensitivity and specificity were 0.88 and 0.89, respectively, indicating high diagnostic performance. The SROC curve demonstrated excellent discriminative ability (AUC > 0.90), with moderate between-study heterogeneity. Notably, consistent performance across diverse model architectures suggests that AI models rely on stable physiological signal patterns rather than dataset-specific features.</p><p><strong>Conclusions: </strong>AI-based models using physiological signals achieve high diagnostic accuracy for segment-level OSA detection. Importantly, these findings suggest that AI systems may not directly detect airway obstruction but instead may identify downstream physiological responses, particularly autonomic nervous system alterations reflected in cardiovascular signals.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"30 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}