Work

Expert-level probabilistic breathing event detector informs phenotyping of sleep apnea

Year: 2026

Type: article

Abstract: Diagnosing sleep disordered breathing requires manual annotation of events from sleep studies, such as nocturnal polysomnography, a process that is time-intensive, costly, and prone to inter-rater variability. Automatic approaches exist but lack generalizability due to signal variability across centers. We develop an automatic apneic breathing event detector to localize and classify obstructive apneas, central apneas, hypopneas, and isolated respiratory events without arousals or desaturations. The model is trained on 5456 polysomnographies and tested on 1099 polysomnographies from six cohorts uses an end-to-end deep learning architecture. The model's predictions show a strong correlation with expert annotations for apnea-hypopnea index (r² = 0.84) and achieve an F1 score of 0.78 across apnea event types, with specific F1 scores of 0.71, 0.51, and 0.65 for obstructive apnea, central apnea, and hypopnea events, respectively. In two independent, multi-scored datasets, The model performs comparably or better than individual expert raters. The model's probabilistic output, termed "apnotyping," provides insights into sleep disordered breathing etiology, with event probabilities correlating more strongly with key sleep apnea traits-such as loop gain and pharyngeal muscle compensation-than traditional apnea indexes. This probabilistic approach may enhance diagnostic accuracy and support personalized treatment strategies, leading to improved patient outcomes.

Source: Nature Communications

DOI: 10.1038/s41467-026-69163-z

Authors: Magnus Ruud Kjaer, Umaer Hanif, Andreas Brink-Kjaer, Mads Olsen, Oliver Sum-Ping, Oscar Carrillo, Scott A. Sands, Susan Redline, Katie L. Stone, Poul Jennum, Emmanuel Mignot

Institutions: Glostrup Hospital, Rigshospitalet, Technical University of Denmark, Stanford University, Brigham and Women's Hospital, Harvard University, University of California, San Francisco, California Pacific Medical Center, University of Copenhagen

Language: English

Topic: Obstructive Sleep Apnea Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $6,990

Funders: Danmarks Tekniske Universitet, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Center for Advancing Translational Sciences

Awards: G1004221941, G109384441, G1108988672, G1126256569, G1261793039, G1276754516, G1294553593, Outcomes of Sleep Disorders in Older Men-Minneapolis, ASSOCIATION OF SLEEP DISORDERS WITH CARDIOVASCULAR HEALTH ACROSS ETHNIC GROUPS, G1549444152, G1640378483, G17239878, G1778197659, G1787333407, G1982334678, G1983464145, G2082624215, G2095942735, G2130630498, G2144938473, G2160302164, G22458031, G2440874276, G2441403366, G2519937635, G2544295915, G2553732570, G2585438117, G2597636997, G2704506787, G2726417417, G2733059257, G2837638605, G2862297731, G286372155, G288989767, G2905571579, G290884426, G291913881, G2929263391, G2948719655, G3093995152, G3243374678, G327188308, G33312777, Familial Aggregation and Natural History of Sleep Apnea, G3396628412, G3581052147, G3595232572, G3608505449, G3609537244, G3627259325, G3638870585, G3667269547, G370977179, G3925316322, G3955673373, G3990106893, G3990748671, G402576333, G4065540706, G4092387480, G4222455271, G4249524944, G4253755194, G4276072587, G4296437920, G4309390892, G4400189231, G4401650913, G4495113589, G4509871131, G4590187187, G4680823173, G4712859843, G4894370356, G4986157935, G5075046117, G5108002584, G5184662507, G5234713383, G5281952516, G5358148953, G5382728535, G5390111733, G5531298794, G555405467, G555675153, G562502316, G5653954166, G5654179670, G5797542657, G585648573, G593019010, G5961507559, Outcomes of Sleep Disorders in Older Men-Portland, G6210582792, G624497702, Institute for Clinical and Translational Research, G6422850347, G6436857277, G6566566152, G659495149, G6605751293, G66341962, G670555432, G6742279884, G6856766826, G687823276, G6986132784, G7058527481, G715275891, G7166352866, G7172347143, G7176072369, G7315168720, G7385293372, G7399262704, G7446983892, G7511203839, Outcomes of Sleep Disorders in Older Men, G7660265321, Outcomes of Sleep Disorders in Older Men-Birmingham, G78770644, G7928184020, G7991420222, G805458286, Clinical and Translational Science Award, G8145863542, G818071322, Outcomes of Sleep Disorders in Older Men - Pittsburgh, G8298419571, G841832496, G8511401681, G870119955, G8751278327, G8811786671, G8827260454, G8852914737, G8909198566, G9000004549, G9000004784, G9000005319, G9000006353, G9000009611, G9000012074, G9000017360, G9000019818, G9000025517, G9000032347, G9000033571, G9000036658, G9000038858, G9000050931, G9000063950, G9000065698, G9000066146, G9000068995, G9000076961, G9000085452, G9000088132, G9000102855, G9000111449, G9000125773, G9000130823, G9000132197, G9000153370, G9000160606, G9000195997, G9000236575, G9000239259, G9000283869, G9000288314, G9000295694, G9000324732, G9000347892, G91634571, G91958607, G94668252, G991334795

OpenAlex ID: W7128550139

FWCI: 3.926

Cites: 68

Cited by: 1

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