{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:06:30Z","timestamp":1784178390425,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100016238","name":"Ministerie van Economische Zaken en Klimaat","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016238","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003958","name":"Stichting voor de Technische Wetenschappen","doi-asserted-by":"publisher","award":["14619"],"award-info":[{"award-number":["14619"]}],"id":[{"id":"10.13039\/501100003958","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The correct identification of respiratory events and estimation of total sleep time (TST), done in a sleep clinic with polysomnography (PSG), are central elements in the diagnostic process of sleep\u2010disordered breathing and in the quantification of its severity with the apnoea\u2010hypopnea index (AHI). However, total sleep time may not be available in home\u2010based diagnostic procedures with polygraphy (PG), so the respiratory event index (REI), based on total recording time (TRT), is used in place of AHI. Because of that, severity can be greatly under\u2010estimated in people with high sleep fragmentation or long wake bouts. We propose a device\u2010agnostic method to estimate TST using only the time intervals between respiratory events and the TRT. We produce an initial estimate of TST as a function of the REI uncertainty, quantified through bootstrap sampling of respiratory event intervals. Subsequently, we refine this estimate using a regression model that integrates demographic factors and other TST\u2010independent sleep metrics. We tested the approach on 2037 recordings from the MESA cohort. We obtained a moderately good estimation of TST (Correlation 0.84, agreement 2.0\u2009\u200944.5\u2009min), and better TST\u2010based REI than TRT\u2010based REI (70.3% error reduction, \u00d78 less false negatives) also in presence of low sleep efficiency. Estimates were comparable with state\u2010of\u2010the\u2010art methods based on actigraphy, and further improved by their combined usage, but underperformed against methods using cardio\u2010respiratory signals. It is possible to have a moderate\u2010to\u2010good estimate of the TST employing only minimal information from respiratory events and TRT, improving existing REI estimates without additional signals.<\/jats:p>","DOI":"10.1111\/jsr.70398","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:46:28Z","timestamp":1784177188000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimation of Total Sleep Time From Respiratory Event Intervals in Sleep Disordered Breathing"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8571-3971","authenticated-orcid":false,"given":"Luca","family":"Cerina","sequence":"first","affiliation":[{"name":"Electrical Engineering Eindhoven University of Technology  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele B.","family":"Papini","sequence":"additional","affiliation":[{"name":"Hospital Patient Monitoring, Philips  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan","family":"Overeem","sequence":"additional","affiliation":[{"name":"Electrical Engineering Eindhoven University of Technology  Eindhoven the Netherlands"},{"name":"Center for Sleep Medicine, Kempenhaeghe  Heeze the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Vullings","sequence":"additional","affiliation":[{"name":"Electrical Engineering Eindhoven University of Technology  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Electrical Engineering Eindhoven University of Technology  Eindhoven the Netherlands"},{"name":"Sleep &amp; Respiratory Care, Philips  Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-06413-5_7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9192"},{"key":"e_1_2_10_4_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 2.6","author":"Berry R. B.","year":"2020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-018-0065-7"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6579\/ae2c3c"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac189"},{"issue":"6","key":"e_1_2_10_8_1","first-page":"877","article-title":"Racial\/Ethnic Differences in Sleep Disturbances: The Multi\u2010Ethnic Study of Atherosclerosis (MESA)","volume":"38","author":"Chen X.","year":"2015","journal-title":"Sleep"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3758(91)90013-5"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1013203451"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1109\/JBHI.2025.3565034"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9808"},{"key":"e_1_2_10_13_1","series-title":"ASQC Basic References in Quality Control: Statistical Techniques","volume-title":"How to Detect and Handle Outliers","author":"Iglewicz B.","year":"1993"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.15.2.137"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-90818-y"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0126-9"},{"key":"e_1_2_10_18_1","article-title":"Respiratory Event Index Underestimates Severity of Sleep Apnea Compared to Apnea\u2010Hypopnea Index","volume":"5","author":"Pitk\u00e4nen M.","year":"2023","journal-title":"Sleep Advances: A Journal of the Sleep Research Society"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00422-2022"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7540"},{"key":"e_1_2_10_21_1","volume-title":"Stochastic Processes","author":"Ross S. M.","year":"1995"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2025.102139"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-025-03445-6"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7228"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci9120371"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2019.06.003"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocy064"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70398","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jsr.70398","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:57:35Z","timestamp":1784177855000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.70398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":26,"alternative-id":["10.1111\/jsr.70398"],"URL":"https:\/\/doi.org\/10.1111\/jsr.70398","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"assertion":[{"value":"2026-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70398"}}