0724 Wake Intrusion Index During NREM Sleep Is Associated with Comorbid Insomnia and Sleep Apnea Exclusively in Men
Bibliographic record
Abstract
Abstract Introduction Sex differences in the clinical presentation of obstructive sleep apnea (OSA) comorbid with insomnia (COMISA) exist. Men typically exhibit more severe OSA during NREM sleep, while women are more prone to insomnia. Yet, little is know about the physiological correlates likely explaining these differences. This study evaluated the association between sleep stage-specific wake intrusions, a measure of 3-second perturbations in the odds ratio product (ORP) during sleep, and insomnia, OSA, and COMISA, and assessed whether sex differences in these associations are observed. Methods Data from the Sleep Heart Health Study (SHHS1; N=5,771) was accessed via the National Sleep Research Resource. Stage-specific wake intrusions were defined as ORP spikes above 2.0, from within N1, N2, N3, and REM. Wake intrusion index (WII) for each sleep stage was calculated as the number of intrusions divided by total sleep time from each stage. Insomnia was determined based on self-report of insomnia symptoms (>15 times/month) including delayed sleep onset, maintenance difficulty, or early morning awakenings (N=617). Obstructive sleep apnea (OSA) was defined by an apnea-hypopnea index (AHI) of ≥15 (N=1,225), and COMISA was defined as having both OSA and insomnia (N=147). Linear regression was used to assess the relationship between sleep disorders and stage-specific WII, adjusted for age and AHI, separately for men and women. Results Among men, adjusted analyses showed that WII during NREM was significantly higher in those with COMISA as compared to those with OSA (β[SE]=73.3[27.3] intrusions/h, p=0.008), with effects likely being driven by higher WII during stage N1 (β[SE]=126.4[39.7] intrusions/h, p=0.008). These associations were not observed among women. No other significant differences were found in WII during N2, N3, or REM sleep. Conclusion Our findings show a sleep stage and sex-specific association between wake intrusion and COMISA. We speculate that men with COMISA may experience more unstable N1 stage, when compared to those with only OSA. These findings suggest the need for sex-specific approaches to characterization and treatment of COMISA. Support (if any) NHLBI (U01HL53916, U01HL53931, U01HL53934, U01HL53937, U01HL64360, U01HL53938, U01HL53940, U01HL53941, U01HL63463, R24HL114473, 75N92019R002).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".