Evidence map›Paper›PMID 42547512›Full record

ArticleNature communications2026

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 read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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, NY, USA.ORCID http://orcid.org/0009-0002-0778-6635
Matheus Lima Diniz AraujoSleep Disorders Center, Neurological Institute Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID http://orcid.org/0000-0003-0979-3417
Kristen L BeckDigital Health, IBM Research, Almaden Research Center, San Jose, CA, USA.ORCID http://orcid.org/0000-0002-4603-0235
Catherine M HeinzingerSleep Disorders Center, Neurological Institute Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID http://orcid.org/0000-0002-5407-0296
Samer GhosnDepartment of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID http://orcid.org/0000-0001-5909-605X
Carl Y SaabDepartment of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID http://orcid.org/0000-0003-4665-9946
Nancy Foldvary-SchaeferSleep Disorders & Epilepsy Centers, Neurological Institute Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID http://orcid.org/0000-0001-8900-3280
Jeffrey L RogersDigital Health, IBM Research, T.J. Watson Research Center, Yorktown Heights, NY, USA. jeffrey.rogers@yale.edu.ORCID http://orcid.org/0009-0001-1071-4504
Reena MehraDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/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
NHLBI 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 HL064360NIH HHS 75N92019R002
6 · The paper itself

Abstract

Clinical sleep studies capture multiple physiologic signals, yet interpretation is often reduced to single summary measures of limited prognostic value, such as the apnea-hypopnea index. We present a foundation model that learns rich representations of sleep physiology from more than 10,000 clinical sleep recordings linked to electronic medical records. Here we show that sleep physiology contains latent risk structure invisible to conventional metrics, identifying five patient risk groups with markedly different trajectories for mortality, cardiovascular, and neurological disease. The highest-risk group shows more than double the mortality risk of the lowest, whereas apnea-hypopnea index severity categories show limited predictive value. The framework generalizes to the independent Sleep Heart Health Study, distinguishing high- and low-risk patients despite lower-resolution data. We demonstrate that foundation models recover clinically meaningful risk information embedded in routine sleep recordings that conventional metrics systematically miss, providing a scalable path to precision sleep medicine.

Indexed as

SleepCardiovascular DiseasesElectronic Health RecordsFemaleHumansMaleNervous System DiseasesPolysomnographyRisk AssessmentSleep Apnea Syndromes

Identifiers

PMID42547512
PMCPMC13434717

What OpenQuestion holds

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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.