{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:09Z","timestamp":1787015649816,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Sleep\u2010disordered breathing is an important health issue for children. The objective of this study was to develop a machine learning classifier model for the identification of sleep apnea events taken exclusively from nasal air pressure measurements acquired during overnight polysomnography for paediatric patients. A secondary objective of this study was to differentiate site of obstruction exclusively from hypopnea event data using the model. Computer vision classifiers were developed via transfer learning to either normal breathing while asleep, obstructive hypopnea, obstructive apnea or central apnea. A separate model was trained to identify site of obstruction as either adeno\u2010tonsillar or tongue base. In addition, a survey of board\u2010certified and board\u2010eligible sleep physicians was completed to compare clinician versus model classification performance of sleep events, and indicated very good performance of our model relative to human raters. The nasal air pressure sample database available for modelling comprised 417 normal, 266 obstructive hypopnea, 122 obstructive apnea and 131 central apnea events derived from 28 paediatric patients. The four\u2010way classifier achieved a mean prediction accuracy of 70.0% (95% confidence interval [67.1\u201372.9]). Clinician raters correctly identified sleep events from nasal air pressure tracings 53.8% of the time, whereas the local model was 77.5% accurate. The site of obstruction classifier achieved a mean prediction accuracy of 75.0% (95% confidence interval [68.7\u201381.3]). Machine learning applied to nasal air pressure tracings is feasible and may exceed the diagnostic performance of expert clinicians. Nasal air pressure tracings of obstructive hypopneas may \u201cencode\u201d information regarding the site of obstruction, which may only be discernable by machine learning.<\/jats:p>","DOI":"10.1111\/jsr.13851","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T01:52:52Z","timestamp":1676944372000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Paediatric sleep apnea event prediction using nasal air pressure and machine learning"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9950-0985","authenticated-orcid":false,"given":"Matthew G.","family":"Crowson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery, Mass Eye &amp; Ear  Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S.","family":"Gipson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonary Medicine Mass General Hospital for Children  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Sleep Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orna Katz","family":"Kadosh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery, Mass Eye &amp; Ear  Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hartnick","sequence":"additional","affiliation":[{"name":"Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Grealish","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald G.","family":"Keamy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery, Mass Eye &amp; Ear  Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Bernard","family":"Kinane","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonary Medicine Mass General Hospital for Children  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Sleep Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Hartnick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery, Mass Eye &amp; Ear  Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"4097","volume-title":"IEEE Engineering in Medicine and Biology Society. Annual International Conference","author":"Ahmed S.","year":"2018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820985000"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/s21041491"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2020.104167"},{"key":"e_1_2_11_6_1","volume-title":"The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications","author":"Berry R.","year":"2020"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-0944-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252353"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering7040131"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201708-1688ED"},{"key":"e_1_2_11_11_1","first-page":"248","volume-title":"2009 IEEE conference on computer vision and pattern recognition","author":"Deng J."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.26861"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29808"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25423"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-06413-5_8"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201705-0930OC"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201510-2099OC"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/e22060670"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6772"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7126"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5870"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1672"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2132"},{"key":"e_1_2_11_24_1","unstructured":"Journal of Clinical Sleep Medicine 10"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812463193"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204409"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7632"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00521-016-2365-x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1109\/jbhi.2020.3048901"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1109\/EMBC44109.2020.9176342"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.13851","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jsr.13851","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.13851","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T06:36:09Z","timestamp":1692340569000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.13851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,20]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/jsr.13851"],"URL":"https:\/\/doi.org\/10.1111\/jsr.13851","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,20]]},"assertion":[{"value":"2022-08-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13851"}}