Evidence map›Paper›PMID 39364956›Full record

ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2025

Arousal burden is highest in supine sleeping position and during light sleep.

Minna Pitkänen, Juho Huovinen, Marika Rissanen, Henna Pitkänen, Samu Kainulainen, Thomas Penzel, Francesco Fanfulla, Ulla Anttalainen, Tarja Saaresranta, Ludger Grote and 6 more

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Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Minna PitkänenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Juho HuovinenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Marika RissanenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Henna PitkänenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Samu KainulainenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Thomas PenzelCenter of Sleep Medicine, University Hospital Charité Berlin, Berlin, Germany.
Francesco FanfullaRespiratory Function and Sleep Unit, Clinical Scientific Institutes Maugeri IRCCS, Pavia and Montescano, Italy.
Ulla AnttalainenDivision of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Central Hospital, Turku, Finland.
Tarja SaaresrantaDivision of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Central Hospital, Turku, Finland.
Ludger GroteCenter for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Jan HednerCenter for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Richard StaatsUniversity of Lisbon, Lisbon, Portugal.
Brett DuceSleep Disorders Centre, Department of Respiratory & Sleep Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Juha TöyräsDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Arie OksenbergSleep Disorders Unit, Loewenstein Hospital-Rehabilitation Center, Ra'anana, Israel.
Timo LeppänenDepartment of Technical Physics, University of Eastern Finland, Kuopio, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesArousal burden (AB) is defined as the cumulative duration of arousals during sleep divided by the total sleep time. However, in-depth analysis of AB related to sleep characteristics is lacking. Based on previous studies addressing the arousal index, we hypothesized that the AB would peak in the supine sleeping position and during non-rapid eye movement stage 1 and show high variability between scorers.

methodsNine expert scorers analyzed polysomnography recordings of 50 participants, the majority with an increased risk for obstructive sleep apnea. AB was calculated in different sleeping positions and sleep stages. A generalized estimating equation was used to test the association between AB and sleeping positions, sleep stages, and scorers. The correlation between AB and arousal index was tested with Spearman's rank-order correlation.

resultsAB significantly differed between sleeping positions (

conclusionsAB depends on the sleeping position, sleep stage, and scorer, as hypothesized. AB behaved similarly to the arousal index, but the high variability in the ABs between scorers indicates a potential limitation caused by subjective manual scoring. Thus, the development of more accurate techniques for scoring arousals is required before AB can be reliably used. CITATION: Pitkänen M, Huovinen J, Rissanen M, et al. Arousal burden is highest in supine sleeping position and during light sleep.

Indexed as

ArousalSleepSleep StagesAdultFemaleHumansMaleMiddle AgedPolysomnographySleep Apnea, ObstructiveSupine Positionarousal burdenarousal indexpolysomnographysleeping positionsleep stage

Identifiers

PMID39364956
PMCPMC11789257

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.