Sleep epidemiology最新文献

{"title":"Sleep quality and its correlates among medical undergraduates in Anhui Province: A cross-sectional study on academic stress, mental health, and lifestyle factors","authors":"Miao Li ,&nbsp;Xiao-Ying Jin ,&nbsp;Han Li ,&nbsp;Meng-Dan Chu ,&nbsp;Zeng-Feng Su","doi":"10.1016/j.sleepe.2025.100109","DOIUrl":"10.1016/j.sleepe.2025.100109","url":null,"abstract":"<div><div>This study investigates the relationship between sleep quality, study stress, and mental health among medical undergraduates in Anhui Province. Utilizing the Pittsburgh Sleep Quality Index (PSQI) and Depression-Anxiety-Stress Scale-21 (DASS-21), data from 550 students were analyzed. Findings reveal that heavy academic burdens, including high weekly course loads and examination stress, significantly impact sleep quality and mental health. Students attending 45–50 classes/week had a significantly higher PSQI score (5.41 ± 3.25) compared to those with lighter loads (e.g., 30–35 classes: 4.61 ± 2.75, <em>p</em> = 0.050; <strong>Table 8</strong>). Although no significant association was found between caffeine and alcohol consumption and mental health, lifestyle factors such as exercise frequency and interpersonal relationships showed notable effects. These results underline the need for targeted interventions, including stress management programs and healthy lifestyle promotion, to enhance student well-being.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291396","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 relationship between ambient neighborhood noise exposure and sleep parameters among Black adults living in the Miami metropolitan area","authors":"Matthew Coppello ,&nbsp;Carolina Scaramutti ,&nbsp;Clarence E. Locklear ,&nbsp;Bruno Oliveira ,&nbsp;Michelle G. Thompson ,&nbsp;Sadeaqua S. Scott ,&nbsp;Joon Chung ,&nbsp;Gabrielle Belony ,&nbsp;Aisha Severe ,&nbsp;Debbie Chung ,&nbsp;Girardin Jean-Louis ,&nbsp;Azizi Seixas","doi":"10.1016/j.sleepe.2025.100116","DOIUrl":"10.1016/j.sleepe.2025.100116","url":null,"abstract":"<div><h3>Objective</h3><div>Black individuals in the US are burdened by sleep health disparities compared to non-Hispanic White individuals. Neighborhood factors could contribute and provide insights into these disparities. This investigation examined associations between environmental noise and sleep parameters among Black adults to deepen the understanding of sleep disparities.</div></div><div><h3>Methods</h3><div>Participant sleep parameters were recorded at-home for seven nights using cardiopulmonary coupling-based SleepImage Ring. Soundscores™ derived from HowLoud were used as a proxy for neighborhood noise. Score are noise estimates based on traffic models and local factors. Participants on average lived in slightly noisy neighborhoods (soundscore <em>M</em> = 70.8). Linear regressions were conducted to assess the relationship between noise and sleep parameters.</div></div><div><h3>Results</h3><div>Analysis of 261 Black adults (aged 18–85 years; 66.7 % female) from South Florida showed quieter environments (higher soundscores) were associated with increased deep sleep and improved sleep quality. When stratified by age and sex, lower noise was associated with decreased nocturnal awakening duration in males aged 18–54 years (<em>β</em> [95 % CI] = -110.76 [-203.18, -18.34]; <em>p</em> = .02; <em>r</em>² = .20) and increased time slept in females aged 55–85 years (<em>β</em> [95 % CI] = 379.48 [5.92, 753.04]; <em>p</em> = .04; <em>r</em>² = .09).</div></div><div><h3>Conclusions</h3><div>To the authors’ knowledge, this investigation is among the first to investigate associations between noise and sleep in Black adults using objective measures. Results showed sleep parameters were associated with noise, with unique demographic variations. Future investigations are necessary to address the effects of neighborhood features on sleep among Black adults.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104652","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":"Erratum to “Racial/ethnic minorities have greater declines in sleep duration with higher risk of cardiometabolic disease: an analysis of the U.S. National Health Interview Survey” [Sleep Epidemiology 2 (2022) 100022]","authors":"Andrew S. Tubbs ,&nbsp;Sadia B. Ghani ,&nbsp;Dora Valencia ,&nbsp;Girardin Jean-Louis ,&nbsp;William D.S. Killgore ,&nbsp;Fabian-Xosé Fernandez ,&nbsp;Michael A. Grandner","doi":"10.1016/j.sleepe.2025.100122","DOIUrl":"10.1016/j.sleepe.2025.100122","url":null,"abstract":"","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100122"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747628","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":"Sleep, fatigue, and altered cognition in healthcare professionals: Evidence from Portugal using the fatigue and altered cognition scale","authors":"Amanda Alencar ,&nbsp;Fábio Abreu ,&nbsp;Carina Fernandes","doi":"10.1016/j.sleepe.2025.100115","DOIUrl":"10.1016/j.sleepe.2025.100115","url":null,"abstract":"<div><div>While the detrimental impact of poor sleep on mental health and cognitive performance is well established, few studies have explored these relationships using sensitive, population-specific tools. This study offers a novel contribution by examining the associations between sleep quality, fatigue, altered cognition, and symptoms of anxiety and depression among Portuguese healthcare professionals, incorporating the Fatigue and Altered Cognition Scale (FACs), a newly validated instrument for the Portuguese context. A total of 80 healthcare professionals completed standardized measures assessing sleep (Pittsburgh Sleep Quality Index - PSQI and Sleep Health Scale - SHS), emotional well-being (Hospital Anxiety and Depression Scale - HADS), and psychocognitive exhaustion (FACs). The relationships between these variables were statistically analyzed through correlations and comparisons between groups. The results revealed that poorer sleep quality was significantly associated with higher levels of fatigue, perceived cognitive alterations, and symptoms of anxiety and depression. Marital status, physical exercise, and caffeine consumption showed no statistically significant associations, but age was positively correlated with sleep quality. No significant differences were found between professional categories. However, professionals working in shifts reported significantly poorer sleep quality compared to those with regular schedules. The FACs provided a measure of cognitive and fatigue-related difficulties, allowing for a clearer characterization of how poor sleep affects both mental performance and fatigue symptoms. These findings highlight the value of integrating contextually adapted tools in occupational health research and reinforce the need for institutional strategies targeting sleep hygiene and cognitive well-being in healthcare settings.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104656","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 association between subjective and objective sleep parameters and internalizing and externalizing problems in adolescents","authors":"Roan van der Laars ,&nbsp;Diandra C. Bouter ,&nbsp;M. Elisabeth Koopman-Verhoeff ,&nbsp;Milan Zarchev ,&nbsp;Sibel Ercan ,&nbsp;Witte J.G. Hoogendijk ,&nbsp;Nina H. Grootendorst-van Mil","doi":"10.1016/j.sleepe.2025.100107","DOIUrl":"10.1016/j.sleepe.2025.100107","url":null,"abstract":"<div><div>Sleep practices change markedly in adolescence, leading to reductions in both duration and quality. Poor sleep health is a core component of many psychiatric disorders, yet most previous studies have mainly used singular rather than multidimensional sleep measures, which fail to account for all aspects of sleep as a behavior. In an adolescent cohort oversampled for high psychopathology risk (<em>n</em> = 494, mean age 17.88), we used a validated 0–6 composite sleep health score based on sleep diary and actigraphy data. The Youth Self Report (YSR) quantified psychopathology symptoms as a total score, as broadband problem scales (e.g., externalizing problems), and narrowband scales (e.g., aggressive problems). Confounder-adjusted multiple linear regression models examined the association between the sleep composite score and total, broadband, and narrowband problem scores. A higher sleep composite score, indicating better sleep health, was linked to a lower total problems score (B -3.66, 95 % CI [-5.20; -2.12]) and was inversely related to all specific problem scales, including internalizing and externalizing problems, with the sole exception of aggressive problems. Secondary analyses revealed consistent associations between subjective sleep domains and various problem subscales, whereas objective domains showed none. Our study underscores the complementary roles of subjective and objective sleep measures in mental health research, illustrating that subjective measures are consistently associated with psychopathological symptoms and may offer personal relevance, while objective measures might provide accuracy and consistency by capturing detailed sleep patterns. However, limitations include the study's cross-sectional design and potential selection bias in the sleep measurement group.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737823","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":"The associations of screen time and physical activity with sleep health during the COVID-19 crisis","authors":"Julien Coelho ,&nbsp;Ilaria Montagni ,&nbsp;Jean-Arthur Micoulaud-Franchi ,&nbsp;Jacques Taillard ,&nbsp;Pierre Philip ,&nbsp;Sabine Plancoulaine ,&nbsp;Christophe Tzourio","doi":"10.1016/j.sleepe.2025.100119","DOIUrl":"10.1016/j.sleepe.2025.100119","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the associations of screen time (ST) and physical activity (PA) with sleep health, considering mental health.</div></div><div><h3>Methods</h3><div>This cross-sectional study began in April 2020 during the COVID-19 health crisis. Changes in ST over the past 7 days were rated on a 3-point Likert scale (1 = decrease or no increase; 2 = moderate increase; 3 = uncontrolled increase). PA over the past 7 days was also rated on a 3-point Likert scale (1 = no; 2 = yes, but not every day; 3 = yes, every day). Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 scale and the Patient Health Questionnaire-8, respectively.</div></div><div><h3>Results</h3><div>In total, 2036 participants were enrolled (mean age: 29.4 years; 79 % female). Longer ST was associated with worse sleep health, with an odds ratio (OR) of 1.70 (95 % confidence interval [CI]: 1.42–2.05) for a moderate increase and 3.40 (95 % CI: 2.69–4.30) for an uncontrolled increase, compared with no increase. Lower PA was also associated with worse sleep health, with an OR of 1.25 (95 % CI: 1.05–1.50) for weekly practice and 1.72 (95 % CI: 1.35–2.19) for no practice, relative to daily practice. The effects of ST and PA were cumulative. Additional adjustments for anxiety and depressive symptoms did not explain or alter the associations.</div></div><div><h3>Conclusions</h3><div>ST and PA are both critical for sleep health. Interventions aimed at improving sleep should systematically consider their roles. Longitudinal studies conducted in a more stable health context are needed to confirm these findings.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361996","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":"Heart rate variability, sleep quality and physical activity in medical students","authors":"Samuel Filipe Lopes Alves ,&nbsp;Thaísy Andressa Bastos Primo de Sousa Santos ,&nbsp;Marianne Lucena da Silva ,&nbsp;Katiane da Costa Cunha","doi":"10.1016/j.sleepe.2024.100105","DOIUrl":"10.1016/j.sleepe.2024.100105","url":null,"abstract":"<div><h3>Aims</h3><div>The present study aims to investigate the sleep quality, levels of physical activity, and their relationship with heart rate variability (HRV) in medical students.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study with 105 medical students from Brazil. Data were collected through sociodemographic questionnaires, Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire Short Form (IPAQ-SF), anthropometric measurements, and resting HRV. One-way ANOVA analysed sociodemographic variables, PSQI, and IPAQ scores. Spearman correlation assessed the relationship between anthropometric data and HRV parameters. Multiple Linear Regression examined the relationship between PSQI, IPAQ, and HRV, with a significance level of 5%.</div></div><div><h3>Results</h3><div>A predominance of poor sleep quality and high physical activity levels were observed in medical students. Multivariate analysis revealed a significant association between HRV, IPAQ, and sleep quality in the SDNN (F reg=3.08; <em>p</em> = 0.0486) and LF (F reg=2.95; <em>p</em> = 0.0553) components. However, when analysing each variable independently, the correlation was statistically relevant only for the PSQI. The correlation was inversely proportional, indicating poorer sleep quality associated with lower HRV values.</div></div><div><h3>Conclusion</h3><div>The results indicate that poor sleep quality is common among medical students and is correlated with a reduction in HRV, which may have an adverse impact on the cardiovascular health of this population.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157179","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":"The translation and validation of the Arabic language version of the biphasic sleep scale among young adults","authors":"Waqar Husain ,&nbsp;Khaled Trabelsi ,&nbsp;Hadeel Ghazzawi ,&nbsp;Achraf Ammar ,&nbsp;Ahmed S. BaHammam ,&nbsp;Seithikurippu R. Pandi-Perumal ,&nbsp;Amir H. Pakpour ,&nbsp;Michael V. Vitiello ,&nbsp;Haitham Jahrami","doi":"10.1016/j.sleepe.2025.100118","DOIUrl":"10.1016/j.sleepe.2025.100118","url":null,"abstract":"<div><h3>Background</h3><div>Biphasic sleep (segmented sleep) has been documented in preindustrial societies. The Biphasic Sleep Scale (BiSS) was recently developed to measure this pattern. This study aimed to translate and validate the BiSS into Arabic.</div></div><div><h3>Methods</h3><div>The BiSS was translated following international cross-cultural adaptation guidelines. A cross-sectional survey of 511 Arabic-speaking young adults (mean age = 22.1 years; 73.8 % female) used the Arabic BiSS and Glasgow Sleep Effort Scale. Analysis included descriptive statistics, confirmatory factor analysis (CFA), reliability analysis (Cronbach's α and McDonald's ω), correlations, and regression models examining age, sex, and marital status effects.</div></div><div><h3>Results</h3><div>CFA confirmed the original three-factor structure—likelihood of first sleep, consequences of first sleep, and sleep disturbance—with acceptable fit (RMSEA = 0.05, 90 % CI [0.02, 0.06]; SRMR = 0.04; CFI &gt; 0.9; TLI &gt; 0.9). Internal consistency was robust for the total scale, α = 0.9 and ω = 0.9. Internal consistency was also acceptable for subscales: likelihood of first sleep (α/ω = 0.8), consequences of first sleep (α/ω = 0.8), and borderline for sleep disturbance (α/ω = 0.6). Age (β = 0.1, p = 0.03) and marital status (single vs. married; β = -0.4, p = 0.02 for likelihood; β = -0.4, p = 0.01 for consequences significantly predicted biphasic sleep tendencies, while sex showed no significant effect.</div></div><div><h3>Conclusion</h3><div>The Arabic BiSS demonstrates sound psychometric properties for assessing biphasic sleep. Future research should examine applicability in diverse populations, including older adults and married individuals, and further validate the sleep disturbance dimension.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361997","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":"Sleep quality, daytime sleepiness, and obstructive sleep apnea risk among iranian commercial airline pilots","authors":"Asghar Akhavan ,&nbsp;Mahdieh Hasanalifard ,&nbsp;Reyhaneh Abolghasemi ,&nbsp;Abolfazl Khamaki ,&nbsp;Shokofeh Radfar ,&nbsp;Taleb Badri","doi":"10.1016/j.sleepe.2025.100111","DOIUrl":"10.1016/j.sleepe.2025.100111","url":null,"abstract":"<div><h3>Introduction</h3><div>Sufficient sleep is one of the most important factors in maintaining focus and attention in pilots. In this matched cross-sectional comparative study, the sleep status and related factors in commercial airline flight pilots were evaluated.</div></div><div><h3>Methods</h3><div>All pilots and the healthy sex- and age-matched controls who met the inclusion criteria and signed informed consent were included in the study. Information about sleep quality was collected using the Pittsburgh sleep quality index. The Epworth sleepiness scale assessed the subjective daytime sleepiness. The Stop-Bang sleep apnea questionnaire was a tool for the risk of obstructive sleep apnea screening.</div></div><div><h3>Results</h3><div>One hundred and seven airline pilots and 100 healthy control people were included in this study. The results showed that the risk of obstructive sleep apnea was significantly equal in pilot and control groups. The sleep quality and daytime sleepiness were significantly worse in the pilot group. In the pilot group, the marital status, sleep duration of 24 hours, education level, physical activity, and exercise correlated to sleep quality. The sleep apnea state was correlated to age, Body Mass Index, marital status, and morning headache. The flight hours and distances were correlated with at least one of the sleep questionnaires results. The regression model analysis showed that none of the independent variables had a significant effect on the probability of the Stop-Bang questionnaire and PSQI scores. But nine independent variables had a significant effect on the Epworth sleepiness scale.</div></div><div><h3>Discussion</h3><div>Among the Iranian commercial airline pilots, the risk of sleep apnea is not higher than those in the control group. Even though they are at higher risk of reducing sleep quality and increasing daytime sleepiness. Appropriate intervention on demographic factors and blood parameters improves pilots' sleep status.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830826","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":"Data driven phenotyping and longitudinal feature modeling of sleep apnea subtypes using interpretable machine learning","authors":"Shireen Fathima,&nbsp;Maaz Ahmed","doi":"10.1016/j.sleepe.2025.100113","DOIUrl":"10.1016/j.sleepe.2025.100113","url":null,"abstract":"<div><div>Sleep apnea is a heterogeneous disorder with distinct physiological mechanisms such as obstructive sleep apnea (OSA), central sleep apnea (CSA), and mixed forms, yet many subjects exhibit diagnostically ambiguous events that do not fit these categories. We define such cases as a novel Borderline (BL) Apnea phenotype, which our longitudinal analysis revealed to often behave as a transitional stage between normal breathing and pathological subtypes. Most machine learning (ML) studies adopt binary classification frameworks, overlooking phenotypic diversity, risk stratification, and longitudinal patterns. This study proposes a comprehensive framework integrating rule-based phenotyping, observational and statistical profiling, multiclass ML, and interpretable modeling to classify subjects from the Sleep Heart Health Study (SHHS) cohort into Normal, OSA, CSA, Both (mixed), or BL Apnea types using apnea–hypopnea index (AHI) thresholds: total (AHI_A), obstructive (AHI_O), and central (AHI_C). The BL group captures individuals with elevated total AHI but subthreshold OSA and CSA components, representing a diagnostically ambiguous, underexplored phenotype. Demographic, anthropometric, and lifestyle traits were compared across subtypes to enable risk stratification . Dimensionality reduction (PCA, t-SNE) revealed substantial overlap, justifying non-linear modeling. Among nine classifiers, Gradient Boosting and LightGBM performed best (macro AUC <span><math><mrow><mo>&gt;</mo><mn>0</mn><mo>.</mo><mn>83</mn></mrow></math></span>, accuracy <span><math><mo>&gt;</mo></math></span>84%, specificity <span><math><mo>&gt;</mo></math></span>88%). SHAP interpretation consistently identified neck circumference, minimum O₂ saturation, Epworth Sleepiness Score, and arousal index as top predictors. Longitudinal analysis using SHHS Visit 2 showed heterogeneous outcomes for BL Apnea: 44% reverted to Normal and 22% progressed to ’Both’ type, highlighting its transitional nature and potential clinical utility for risk stratification, disease monitoring, and personalized management.</div></div>","PeriodicalId":74809,"journal":{"name":"Sleep epidemiology","volume":"5 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048271","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}