Abstract

Good sleep is crucial for human life. Research has shown that poor-quality sleep is related to several cardiovascular and metabolic disorders. Sleep disorders are well categorized, and most of them have defined diagnostic criteria, with level 1 polysomnography being the gold standard. With the increasing use of technology, specifically smartphones, in people’s everyday lives, the search for alternative ways of monitoring sleep disorders or certain sleep parameters has been gaining relevance.

Abstract
Background: Cardiac resynchronization therapy (CRT) is an established therapeutic option for heart failure, but despite careful selection around 30% of the patients still do not respond to this therapy. The standard electrocardiogram (ECG) is a practical and inexpensive tool to assess potential responders to CRT but with conflicting evidence regarding the value of different ECG parameters. As such, we conducted a systematic review of real-world studies to assess the value of pre-implantation standard ECG parameters in predicting response to CRT. Methods: We searched on PubMed, Scopus, and Web of Knowledge online databases to identify analytic studies and synthesized results through evidence tables. Results: Sixty-two eligible articles were included in this review. Traditional predictors of response were QRS duration =150 ms and the presence of left bundle branch block morphology. Contemporary ECG parameters, such as the presence of QRS notching or fragmentation, the S wave assessment, the time to intrinsicoid deflection (ID) in lateral leads, and a lead one ratio =12 also showed great potential in assessing response to CRT. Conclusions: This review highlights the promising capability of the standard ECG in predicting response to CRT, particularly when using more contemporary predictors, while emphasizing the necessity for further research to validate the prognostic value of these predictors. © 2025 Elsevier B.V., All rights reserved.

Abstract
Obstructive sleep apnea (OSA) is a sleep disorder marked by repeated episodes of airway obstruction, leading to apneas (complete blockage) or hypopneas (partial blockage) during sleep. The standard diagnostic metric, the apnea-hypopnea index (AHI), quantifies the number of these events per hour of sleep but has limitations, such as its dependence on manual interpretation and lack of attention to event duration, which can be clinically significant. To address these issues, this study developed an algorithm to detect respiratory events from nasal airflow signals and measure their duration, using data from 22 patients at St. Vincent's University Hospital, sourced from the PhysioNet dataset. Signal processing techniques, including filtering and envelope analysis, were applied to extract features, and apnea/hypopnea events were identified based on American Academy of Sleep Medicine (AASM) guidelines. Events were classified by duration into three groups: 10-20 seconds, 20-40 seconds, and over 40 seconds. Preliminary results showed detection accuracy of 60% for apnea and 93% for hypopnea events. The study also explored relations between event duration and demographic factors, such as age, gender, body mass index (BMI), and Epworth Sleepiness Scale (ESS) scores, to assess whether longer events were linked to greater severity. These findings suggest that incorporating event duration and automated detection into OSA diagnosis could improve accuracy and provide better insight into the condition, potentially leading to more personalized treatments.

Abstract
This work introduces a web application for extracting, processing, and visualizing data from sleep studies reports. Using Optical Character Recognition (OCR) and Natural Language Processing (NLP), the pipeline extracts over 75 key data points from four types of sleep reports. The web application offers an intuitive interface to view individual reports' details and aggregate data from multiple reports. The pipeline demonstrated 100% accuracy in extracting targeted information from a test set of 40 reports, even in cases with missing data or formatting inconsistencies. The developed tool streamlines the analysis of OSA reports, reducing the need for technical expertise and enabling healthcare providers and researchers to utilize sleep study data efficiently. Future work aims to expand the dataset for more complex analyses and imputation techniques.

Abstract
Background and objectives: Timely treatment of pediatric obstructive sleep apnea (OSA) can prevent or reverse neurocognitive and cardiovascular morbidities. However, whether distinct phenotypes exist and account for divergent treatment effectiveness remains unknown. In this study, our goal is threefold: i) to define new data-driven pediatric OSA phenotypes, ii) to evaluate possible treatment effectiveness differences among them, and iii) to assess phenotypic information in predicting OSA resolution. Methods: We involved 22 sociodemographic, anthropometric, and clinical data from 464 children (5-10 years old) from the Childhood Adenotonsillectomy Trial (CHAT) database. Baseline information was used to automatically define pediatric OSA phenotypes using a new unsupervised subject-based association network. Follow-up data (7 months later) were used to evaluate the effects of the therapeutic intervention in terms of changes in the obstructive apnea-hypopnea index (OAHI) and the resolution of OSA (OAHI < 1 event per hour). An explainable artificial intelligence (XAI) approach was also developed to assess phenotypic information as OSA resolution predictor at baseline. Results: Our approach identified three OSA phenotypes (PHOSA1-PHOSA3), with PHOSA2 showing significantly lower odds of OSA recovery than PHOSA1 and PHOSA3 when treatment information was not considered (odds ratios, OR: 1.64 and 1.66, 95 % confidence intervals, CI: 1.03-2.62 and 1.01-2.69, respectively). The odds of OSA recovery were also significantly lower in PHOSA2 than in PHOSA3 when adenotonsillectomy was adopted as treatment (OR: 2.60, 95 % CI: 1.26-5.39). Our XAI approach identified 79.4 % (CI: 69.9-88.0 %) of children reaching OSA resolution after adenotonsillectomy, with a positive predictive value of 77.8 % (CI: 70.3 %-86.0 %). Conclusions: Our new subject-based association network successfully identified three clinically useful pediatric OSA phenotypes with different odds of therapeutic intervention effectiveness. Specifically, we found that children of any sex, >6 years old, overweight or obese, and with enlarged neck and waist circumference (PHOSA2) have less odds of recovering from OSA. Similarly, younger female children with no enlarged neck (PHOSA3) have higher odds of benefiting from adenotonsillectomy.

Abstract