Evidence map›Paper›PMID 40297683›Full record

ArticleResearch square2025

A Foundation Model for Sleep-Based Risk Stratification and Clinical Outcomes.

Erhan Bilal, Matheus Lima Diniz Araujo, Kristen L Beck, Catherine M Heinzinger, Samer Ghosn, Carl Y Saab, Nancy Foldvary Schaefer, Jeffrey L Rogers, Reena Mehra

Abstract readPreprint
In one paragraph

Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Erhan BilalDigital Health, IBM Research, T.J. Watson Research Center, Yorktown Heights, USA.ORCID 0009-0002-0778-6635
Matheus Lima Diniz AraujoSleep Disorders Center, Neurological Institute Cleveland Clinic Foundation, Cleveland, USA.
Kristen L BeckDigital Health, IBM Research, IBM Research Almaden Lab, San Jose, USA.
Catherine M HeinzingerSleep Disorders Center, Neurological Institute Cleveland Clinic Foundation, Cleveland, USA.
Samer GhosnDepartment of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, USA.
Carl Y SaabDepartment of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, USA.ORCID 0000-0003-4665-9946
Nancy Foldvary SchaeferSleep Disorders & Epilepsy Centers, Neurological Institute Cleveland Clinic Foundation, Cleveland, USA.
Jeffrey L RogersDigital Health, IBM Research, T.J. Watson Research Center, Yorktown Heights, USA.
Reena MehraDivision of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, USA.ORCID 0000-0002-6222-2675

Funding

National Sleep Research Resource (NSRR)R24HL114473 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI REDLINE, SUSAN S., ZHANG, GUO-QIANG · 2013 to 2017
$7.5M
DATA COORDINATING CENTER FOR SLEEP HEART STUDYU01HL064360 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI DIENER-WEST, MARIE · 1999 to 2007
$4.4M
THE SLEEP HEART HEALTH STUDY: READING CENTER APPLICATIONU01HL063463 · NHLBI · CASE WESTERN RESERVE UNIVERSITY · PI REDLINE, SUSAN S. · 1999 to 2007
$2.8M
The Sleep Heart Health Study (SHHS)U01HL053938 · NHLBI · UNIVERSITY OF ARIZONA · PI QUAN, STUART F. · 1994 to 2007
$2.0M
SLEEP HEART HEALTH STUDYU01HL053931 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI RAPOPORT, DAVID M. · 1994 to 2003
$1.9M
THE SLEEP HEART HEALTH STUDYU01HL053937 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI PUNJABI, NARESH · 1994 to 2007
$1.6M
SLEEP HEART HEALTH STUDYU01HL053916 · NHLBI · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1994 to 2007
$1.5M
THE SLEEP HEART HEALTH STUDYU01HL053934 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI SHAHAR, EYAL · 1994 to 2007
$1.4M
SLEEP HEART HEALTH STUDYU01HL053941 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI O'CONNOR, GEORGE T · 1994 to 2007
$1.4M
Applying Innovative Artificial Intelligence Approaches to a Large Sleep Physiologic Biorepository to Integrate Sleep Disruption in Cardiovascular Risk CalculationR21HL170206 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI LIMA DINIZ ARAUJO, MATHEUS, MEHRA, REENA · 2023 to 2024
$242k
NHLBI NIH HHS R21 HL170206NHLBI NIH HHS R24 HL114473NHLBI NIH HHS U01 HL053916NHLBI NIH HHS U01 HL053931NHLBI NIH HHS U01 HL053934NHLBI NIH HHS U01 HL053937NHLBI NIH HHS U01 HL053938NHLBI NIH HHS U01 HL053941NHLBI NIH HHS U01 HL063463NHLBI NIH HHS U01 HL064360
6 · The paper itself

Abstract

Clinical diagnosis of sleep disorders, which are recognized contributors to morbidity and mortality, often relies on polysomnography (PSG) data. However, the vast physiologic data collected during PSG is underutilized, presenting a key opportunity to enhance characterization of sleep dysfunction and predict clinical outcomes. We introduce a sleep foundation model that uniquely integrates PSG time-series signals and electronic medical record data. Using a diverse dataset (n=10,000; mean observation period 14.5±7.1 years), our transformer-based model generates data-driven representations of latent physiological patterns. When clustered, we identified subpopulations with differential health trajectories. The highest risk-group exhibited strong correlations with all-cause mortality (unadjusted hazard ratio [HR] 4.83, 95% confidence interval [CI] 3.60-6.50, p<0.001) as well as cardiovascular outcomes and neurological outcomes, even after accounting for traditional measures. External validation in a National Sleep Research Resource cohort confirmed findings. We created a novel, clinically applicable framework leveraging information-dense PSG data to inform risk stratification and predict health outcomes beyond traditional methods.

Identifiers

PMID40297683
PMCPMC12036469

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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.