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Article ; Online: Multimodal integration of sleep electroencephalogram, brain imaging, and cognitive assessments: approaches using noisy clinical data.

Mazzotti, Diego R

2023 Volume 47, Issue 2

MeSH term(s)	Electroencephalography/methods ; Brain/diagnostic imaging ; Sleep ; Cognition ; Neuroimaging
Language	English
Publishing date	2023-11-29
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	424441-2
ISSN	1550-9109 ; 0161-8105
ISSN (online)	1550-9109
ISSN	0161-8105
DOI	10.1093/sleep/zsad305
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Article ; Online: Landscape of biomedical informatics standards and terminologies for clinical sleep medicine research: A systematic review.

Mazzotti, Diego R

Sleep medicine reviews

2021 Volume 60, Page(s) 101529

Abstract: A systematic literature review was conducted to understand the current landscape of standards and terminologies used in clinical sleep medicine. Literature search on PubMed, EMBASE, Medline and Web of Science was performed in March 2021 using terms ... ...

Abstract	A systematic literature review was conducted to understand the current landscape of standards and terminologies used in clinical sleep medicine. Literature search on PubMed, EMBASE, Medline and Web of Science was performed in March 2021 using terms related to sleep, terminologies, standards, harmonization, semantics, ontology, and electronic health records (EHR). Systematic review was carried out according to PRISMA. Among 128 included studies, 35 were eligible for review. Articles were broadly classified into six topics: standard terminology efforts, reporting standards, databases and resources, data integration efforts, EHR abstraction and standards for automated sleep scoring. This review highlights the progress and challenges related to establishing computable terminologies in sleep medicine, and identifies gaps, limitations and research opportunities related to data integration that could improve adoption of clinical research informatics in this field. There is a need for the systematic adoption of standardized terminologies in all areas of sleep medicine. Existing data aggregation resources could be leveraged to support the development of an integrated infrastructure and subsequent deployment in EHR systems within sleep centers. Ultimately, the adoption of standardized practices for documenting sleep disorders and related traits facilitates data sharing, thus accelerating discovery and clinical translation of informatics approaches applied to sleep medicine.
MeSH term(s)	Biomedical Research ; Electronic Health Records ; Humans ; Medical Informatics ; Semantics ; Sleep
Language	English
Publishing date	2021-08-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	1414211-9
ISSN	1532-2955 ; 1087-0792
ISSN (online)	1532-2955
ISSN	1087-0792
DOI	10.1016/j.smrv.2021.101529
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Zs.A 5901: Show issues

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Article: Sex Differences in the Role of Sleep on Cognition in Older Adults.

Wiranto, Yumiko / Siengsukon, Catherine / Mazzotti, Diego R / Burns, Jeffrey M / Watts, Amber

medRxiv : the preprint server for health sciences

2024

Abstract: Study objectives: The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains (executive function, verbal memory, and attention) in older adults.: ... ...

Abstract	Study objectives: The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains (executive function, verbal memory, and attention) in older adults. Methods: We analyzed cross-sectional data from 207 participants with normal cognition or mild cognitive impairment (89 males and 118 females) aged over 60. The relationship between sleep quality and cognitive performance was estimated using generalized additive models. Objective sleep was measured with the GT9X Link Actigraph, and self-reported sleep was measured with the Pittsburgh Sleep Quality Index. Results: We found that females exhibited stable performance of executive function with up to about 400 minutes of total sleep time, with significant declines in performance ( Conclusions: Our findings suggest that the relationships between sleep quality and cognition differ between older males and females, with executive function being the most influenced by objective and self-reported sleep. Interventions targeting sleep quality to mitigate cognitive decline in older adults may need to be tailored according to sex, with distinct approaches for males and females.
Language	English
Publishing date	2024-04-07
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.08.24300996
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Article ; Online: Wake intrusions in the electroencephalogram: a novel application of the odds ratio product in identifying subthreshold arousals.

Gratton, Matthew K P / Hamilton, Nancy A / Gerardy, Bethany / Younes, Magdy / Mazzotti, Diego R

Sleep

2024 Volume 47, Issue 5

MeSH term(s)	Humans ; Electroencephalography/methods ; Arousal/physiology ; Male ; Female ; Wakefulness/physiology ; Odds Ratio ; Adult ; Polysomnography/methods
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	424441-2
ISSN	1550-9109 ; 0161-8105
ISSN (online)	1550-9109
ISSN	0161-8105
DOI	10.1093/sleep/zsae039
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Zs.A 1475: Show issues

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Article ; Online: Automated sleep staging algorithms: have we reached the performance limit due to manual scoring?

de Chazal, Philip / Mazzotti, Diego R / Cistulli, Peter A

Sleep

2022 Volume 45, Issue 9

MeSH term(s)	Algorithms ; Electroencephalography ; Polysomnography ; Sleep ; Sleep Stages
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	424441-2
ISSN	1550-9109 ; 0161-8105
ISSN (online)	1550-9109
ISSN	0161-8105
DOI	10.1093/sleep/zsac159
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Zs.A 1475: Show issues

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Article ; Online: Opportunities for Cardiovascular Benefits in Treating Obstructive Sleep Apnea in the Secondary Prevention Scenario.

Mazzotti, Diego R / Drager, Luciano F

American journal of respiratory and critical care medicine

2020 Volume 202, Issue 12, Page(s) 1622–1624

MeSH term(s)	Acute Coronary Syndrome ; Humans ; Phenotype ; Secondary Prevention ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/therapy
Language	English
Publishing date	2020-10-21
Publishing country	United States
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202007-2805ED
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Uh II Zs.80: Show issues

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Article: Positive Airway Pressure Therapy Predicts Lower Mortality and Major Adverse Cardiovascular Events Incidence in Medicare Beneficiaries with Obstructive Sleep Apnea.

Mazzotti, Diego R / Waitman, Lemuel R / Miller, Jennifer / Sundar, Krishna M / Stewart, Nancy H / Gozal, David / Song, Xing

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Obesity is associated with obstructive sleep apnea (OSA) and cardiovascular risk. Positive airway pressure (PAP) is the first line treatment for OSA, but evidence on its beneficial effect on major adverse cardiovascular events (MACE) ... ...

Abstract	Background: Obesity is associated with obstructive sleep apnea (OSA) and cardiovascular risk. Positive airway pressure (PAP) is the first line treatment for OSA, but evidence on its beneficial effect on major adverse cardiovascular events (MACE) prevention is limited. Using claims data, the effects of PAP on mortality and incidence of MACE among Medicare beneficiaries with OSA were examined. Methods: A cohort of Medicare beneficiaries with ≥2 distinct OSA claims was defined from multi-state, state-wide, multi-year (2011-2020) Medicare fee-for-service claims data. Evidence of PAP initiation and utilization was based on PAP claims after OSA diagnosis. MACE was defined as a composite of myocardial infarction, heart failure, stroke, or coronary revascularization. Doubly robust Cox proportional hazards models with inverse probability of treatment weights estimated treatment effects controlling for sociodemographic and clinical factors. Results: Among 888,835 beneficiaries with OSA (median age 73 years; 43.9% women; median follow-up 1,141 days), those with evidence of PAP initiation (32.6%) had significantly lower all-cause mortality (HR [95%CI]: 0.53 [0.52-0.54]) and MACE incidence risk (0.90 [0.89-0.91]). Higher quartiles of annual PAP claims were progressively associated with lower mortality (Q2: 0.84 [0.81-0.87], Q3: 0.76 [0.74-0.79], Q4: 0.74 [0.72-0.77]) and MACE incidence risk (Q2: 0.92 [0.89-0.95], Q3: 0.89 [0.86-0.91], Q4: 0.87 [0.85-0.90]). Conclusion: PAP utilization was associated with lower all-cause mortality and MACE incidence among Medicare beneficiaries with OSA. Results might inform trials assessing the importance of OSA therapy towards minimizing cardiovascular risk and mortality in older adults.
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.07.26.23293156
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Article ; Online: Sex differences within symptom subtypes of mild obstructive sleep apnea.

Morris, Jonna L / Mazzotti, Diego R / Gottlieb, Daniel J / Hall, Martica H

Sleep medicine

2021 Volume 84, Page(s) 253–258

Abstract: Objectives: Prior studies have identified symptom subtypes of moderate to severe (AHI >15) obstructive sleep apnea (OSA). They have not yet been consistently examined in those with mild OSA (AHI 5-15 events/hour). This is important as women are more ... ...

Abstract	Objectives: Prior studies have identified symptom subtypes of moderate to severe (AHI >15) obstructive sleep apnea (OSA). They have not yet been consistently examined in those with mild OSA (AHI 5-15 events/hour). This is important as women are more likely than men to present with mild OSA and may present with different OSA symptoms. The objectives of this study were to determine 1) symptom subtypes in mild OSA and 2) if there are sex differences in the distribution of subtypes. Methods: The sample included men (n = 921) and women (n = 797) with mild OSA, aged 39-90 years, evaluated with a single night of in-home polysomnography as part of the Sleep Heart Health Study. Latent class analysis determined symptom subtypes. Testing for sex differences relative to OSA severity and symptom subtype used chi-squared test for independence. Bonferroni corrected z-tests compared column proportions. Results: Symptom subtypes of mild OSA were not significantly different than those identified in prior studies of moderate-severe OSA (p > 0.05): minimally symptomatic (36.4%), disturbed sleep (11.6%), moderately sleepy (37%), and excessively sleepy (15%), p > 0.05. Sex differences within the symptom subtypes were significant [χ Conclusions: Results suggest symptom reporting among individuals with mild OSA differs as a function of sex. These data have important clinical implications for screening men and women for OSA.
MeSH term(s)	Female ; Humans ; Male ; Polysomnography ; Sex Characteristics ; Sleep ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/epidemiology ; Wakefulness
Language	English
Publishing date	2021-06-09
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2012041-2
ISSN	1878-5506 ; 1389-9457
ISSN (online)	1878-5506
ISSN	1389-9457
DOI	10.1016/j.sleep.2021.06.001
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Zs.A 5315: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Five-year Transitions of Symptom Subtypes in Untreated Obstructive Sleep Apnea.

Morris, Jonna L / Scott, Paul W / Magalang, Ulysses / Keenan, Brendan T / Patel, Sanjay R / Pack, Allan I / Mazzotti, Diego R

medRxiv : the preprint server for health sciences

2023

Abstract: Objectives: It is unknown if symptom subtypes of obstructive sleep apnea (OSA) transition over time and what clinical factors may predict transitions.: Methods: Data from 2,643 participants of the Sleep Heart Health Study with complete baseline and 5- ...

Abstract	Objectives: It is unknown if symptom subtypes of obstructive sleep apnea (OSA) transition over time and what clinical factors may predict transitions. Methods: Data from 2,643 participants of the Sleep Heart Health Study with complete baseline and 5-year follow-up visits were analyzed. Latent Class Analysis on 14 symptoms at baseline and follow up determined symptom subtypes. Individuals without OSA (AHI<5) were incorporated as a known class at each time point. Multinomial logistic regression assessed the effect of age, sex, body mass index (BMI) and AHI on specific class transitions. Results: The sample consisted of 1,408 women (53.8%) and mean (SD) age 62.4 (10.5) years. We identified four OSA symptom subtypes at both baseline and follow-up visits: Interpretation: While over half of the sample did not transition their subtype over 5 years, among those who did, the likelihood of transitioning between subtypes was significantly associated with a higher baseline age, higher baseline BMI and with women, but was not predicted by AHI. Clinical trials: Sleep Heart Health Study (SHHS) Data Coordinating Center, (SHHS) https://clinicaltrials.gov/ct2/show/NCT00005275 , NCT00005275. Statement of significance: There is very little research assessing symptom progression and its contributions to clinical heterogeneity in OSA. In a large sample with untreated OSA, we grouped common OSA symptoms into subtypes and assessed if age, sex, or BMI predicted transitions between the subtypes over 5 years. Approximately half the sample transitioned to a different symptom subtype and improvements in symptom subtype presentation were common. Women and older individuals were more likely to transition to less severe subtypes, while increased BMI predicted transition to more severe subtype. Determining whether common symptoms like disturbed sleep or excessive daytime sleepiness occur early in the course of the disease or as a result of untreated OSA over an extended period can improve clinical decisions concerning diagnosis and treatment.
Language	English
Publishing date	2023-05-19
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.05.18.23290191
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Article ; Online: The relationship between alcohol- and sleep-related traits: Results from polygenic risk score and Mendelian randomization analyses.

Chakravorty, Subhajit / Kember, Rachel L / Mazzotti, Diego R / Dashti, Hassan S / Toikumo, Sylvanus / Gehrman, Philip R / Kranzler, Henry R

Drug and alcohol dependence

2023 Volume 251, Page(s) 110912

Abstract: Study objectives: We investigated whether genetic risk for insomnia and sleep duration abnormalities are associated with AUD and alcohol consumption. We also evaluated the causal relationships between sleep- and alcohol-related traits.: Methods: ... ...

Abstract	Study objectives: We investigated whether genetic risk for insomnia and sleep duration abnormalities are associated with AUD and alcohol consumption. We also evaluated the causal relationships between sleep- and alcohol-related traits. Methods: Individual-level phenotype and genotype data from the Million Veteran Program were used. Polygenic risk scores (PRS) were computed using summary statistics from two recent discovery GWAS of insomnia (N= 453,379 European-ancestry (EA) individuals) and sleep duration (N= 446,118 EAs) and tested for association with lifetime AUD diagnosis (N= 34,658 EA cases) and past-year Alcohol Use Disorders Identification Test-Consumption scale scores (AUDIT-C, N= 200,680 EAs). Bi-directional two-sample Mendelian Randomization (MR) analyses assessed causal associations between the two sleep traits and the two alcohol-related traits. Results: The insomnia PRS was positively associated with AUD at 2/9 PRS thresholds, with p<0.01 being the most significant (OR = 1.02, p = 3.48 × 10 Conclusion: The genetic risk for insomnia shows pleiotropy with AUD, and sleep continuity abnormalities have a causal influence on the development of AUD.
MeSH term(s)	Humans ; Sleep Initiation and Maintenance Disorders/epidemiology ; Sleep Initiation and Maintenance Disorders/genetics ; Alcoholism/epidemiology ; Alcoholism/genetics ; Mendelian Randomization Analysis ; Risk Factors ; Sleep/genetics ; Phenotype ; Genome-Wide Association Study
Language	English
Publishing date	2023-07-27
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	519918-9
ISSN	1879-0046 ; 0376-8716
ISSN (online)	1879-0046
ISSN	0376-8716
DOI	10.1016/j.drugalcdep.2023.110912
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