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Cited by 15Obstructive Sleep Apnea ResearchReproductive Health and TechnologiesPregnancy and preeclampsia studies

Pregnancy outcomes in infertility patients diagnosed with sleep disordered breathing with wireless wearable sensors

Open access
Walter, Jessica R., Lee, Jong Yoon, Snoll, Brooke, Park, Jun Bin, Kim, Dong Hyun, Xu, Shuai, Barnhart, Kurt·2022·Sleep Medicine
DOI 10.1016/j.sleep.2022.09.026PMC PMC10193447
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Abstract

Objective: To study the feasibility of home-based assessment of sleep disordered breathing (SDB) on early pregnancy success after in vitro fertilization with novel wearable sensors. Design: Prospective observational study. Setting: Patients 18 to 45 years old undergoing autologous IVF at an academic infertility center. Patients: 30 women (24–44 years old) Intervention: Participants provided medical history, completed sleep surveys, and a single night of home sleep monitoring prior to IVF with a novel, FDA-cleared wireless sensor system (ANNE® Sleep, Sibel Health), to collect continuous measurements of heart rate, respiratory rate, pulse oxygenation, respiratory effort/snoring, peripheral arterial tonometry, pulse arrival time, and pulse transit time, an accepted surrogate of continuous blood pressure generated by pulse arrival time and pulse transit time. Sleep nights were reviewed to derive the apnea hypopnea index (AHI), defined as the average number of apnea or hypopnea events per hour. An AHI of greater than or equal to 5 events/hour was considered abnormal. Main outcome measure: Rate of clinical pregnancy (defined as intrauterine gestational sac with a yolk sac) after IVF. Logistic regression models were used to estimate the unadjusted and adjusted odds ratio. Results: The overall rate of sleep disordered breathing of any severity was 57%. Participants with SDB had a mean AHI of 13.4 compared to 2.7 events/hr (p<0.01), were younger, and more likely to have polycystic ovary syndrome. Of the 29 patients undergoing an embryo transfer, clinical pregnancy and livebirth occurred in 35% of women with SDB compared to 58% without SDB (p = 0.22). After adjusting for age, SDB reduced pregnancy rates but was not statistically significant (aOR 0.23, 95% CI: 0.04–1.5, p = 0.12). Though polycystic ovary syndrome was associated with higher rates of SDB it was not independently associated with lower pregnancy rates. Conclusion: Screening for sleep disordered breathing using home-based wireless, wearable sensors was well accepted and easily performed by infertile patients in this cohort. Sleep disordered breathing of any severity was associated with an 77% (95% CI: 0.08–1.8) lower likelihood of clinical pregnancy and live birth independent of underlying diagnosis. Future larger studies will be needed to understand the role of sleep disordered breathing and IVF outcomes.

AI snapshot

Written from the paper’s full text.

TL;DR

In a prospective pilot of 30 women undergoing autologous IVF, home wearable sleep monitoring found sleep disordered breathing (AHI ≥5) in 57%; SDB was associated with lower clinical pregnancy/livebirth (35% vs 58%) but was not statistically significant after adjustment for age. The study supports feasibility of home sensor screening but is small and not powered for pregnancy outcomes.

Key findings

  • SDB prevalence was 57% (17/30); mean AHI was 13.4 events/hr in the SDB group vs 2.7 events/hr without SDB (p<0.01). Among those with SDB, 11 had mild, 5 moderate, and 1 severe SDB.
  • Among 29 patients undergoing embryo transfer, clinical pregnancy and livebirth occurred in 35% of women with SDB vs 58% without SDB (p=0.22). After adjusting for age, SDB reduced pregnancy rates but was not statistically significant (aOR 0.23, 95% CI 0.04–1.5, p=0.12).
  • Women with SDB were younger (31.4 vs 35.4 years, p=0.02) and more likely to have PCOS (41% vs 8%, p=0.04); PCOS was not independently associated with lower pregnancy rates. SDB was also more common among patients with PCOS (87.5% vs 45.5%, p=0.04).
  • The sensor system scored favorably among users, with an average System Usability Scale score of 75.4 (SD 14), and collected high-quality data on all patients with total mean observation data points of 30,000.

Methods

  • Prospective observational study at an academic infertility center; 30 women aged 18–45 undergoing autologous IVF (mean age 33 years, SD 4.6). Exclusions included long-term oocyte/embryo banking, donor oocyte/embryo, gestational carrier cycles, and current CPAP or intraoral device treatment.
  • Participants completed medical history, sleep surveys, and a single night of home sleep monitoring prior to IVF using an FDA-cleared wireless two-sensor system (ANNE Sleep, Sibel Health); AHI ≥5 events/hr was considered abnormal.
  • Primary outcome was clinical pregnancy (intrauterine gestational sac with a yolk sac) after IVF. Comparisons used t-test/Mann-Whitney and chi-square/Fisher tests; multivariable logistic regression adjusted for age.

Limitations

  • The paper states the study was small, not designed or powered to detect an effect on pregnancy rate, used a sample of convenience, was single-site, and could not assess causality or subgroup/interaction effects.
  • The paper notes the sensor was validated in a population with higher baseline SDB risk, so its positive predictive value may be reduced in a lower-prevalence population.
  • Evident from the text: the adjusted model included only age because no other tested covariate changed the odds ratio by at least 10%, and the small number of pregnancy events limits precision.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.sleep.2022.09.026

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 20 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among the 29 patients undergoing embryo transfer, clinical pregnancy occurred in 35% of women with SDB compared with 58% of women without SDB (p = 0.22).

    “Among the 29 patients undergoing an embryo transfer, a smaller proportion of women with sleep disordered breathing achieved a clinical pregnancy (35% vs 58%, p = 0.22) (Table 3).”
    • Also stated in: § Results: · plain
      “Of the 29 patients undergoing an embryo transfer, clinical pregnancy and livebirth occurred in 35% of women with SDB compared to 58% without SDB (p = 0.22).”
    Quote in the paperSubstantial claim
  • Findingown data

    Participants with sleep disordered breathing had a mean AHI of 13.4 events/hour compared with 2.7 events/hour in those without SDB (p < 0.001).

    “The average AHI in the sleep disordered breathing group was 13.4 events/hour (95% CI: 10 to 16.8) versus 2.7 events/hour (95% CI: 2.05 to 3.35) (p < 0.001).”
    • Also stated in: § Results: · plain
      “Participants with SDB had a mean AHI of 13.4 compared to 2.7 events/hr (p<0.01)”
    Quote in the paperSubstantial claim
  • Findingown data

    After adjusting for age, sleep disordered breathing was not significantly associated with likelihood of achieving a clinical pregnancy (adjusted OR 0.23, 95% CI 0.04-1.5, p = 0.12).

    “After adjusting for age, sleep disordered breathing was not significantly associated with likelihood of achieving a clinical pregnancy, adjusted OR of 0.23 (95% CI: 0.04–1.5, p = 0.12).”
    • Also stated in: § Results: · plain
      “After adjusting for age, SDB reduced pregnancy rates but was not statistically significant (aOR 0.23, 95% CI: 0.04–1.5, p = 0.12).”
    Quote in the paperSubstantial claim
  • Findingown data

    Sleep disordered breathing was more commonly encountered among patients with polycystic ovary syndrome (87.5% vs 45.5%, p = 0.04).

    “Sleep disordered breathing was more commonly encountered among patients with PCOS (87.5% versus 45.5%, p = 0.04)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Women with sleep disordered breathing were younger than women without SDB (31.4 vs 35.4 years old, p = 0.02).

    “Women with sleep disordered breathing (AHI ≥ 5 events/hour) were younger (31.4 vs 35.4 years old, p = 0.02) (Table 1).”
    • Also stated in: § Results: · plain
      “were younger”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 14

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    The experimental sensors successfully collected high-quality data on all patients, with total mean observation data points of 30,000.

    “The experimental sensors successfully collected high-quality data on all patients with total mean observation data points of 30,000.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The sensor system was well accepted by users, with an average System Usability Scale score of 75.4 (SD 14).

    “The sensor system scored favorably among users with the average SUS score reported as 75.4 (SD 14).”
    • Also stated in: § Conclusion: · boosted
      “Screening for sleep disordered breathing using home-based wireless, wearable sensors was well accepted and easily performed by infertile patients in this cohort.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    There was no statistically significant difference in BMI between the SDB and non-SDB groups, though mean BMI was lower in the SDB group (28.0 vs 31.6 kg/m2, p = 0.17).

    “There was not a statistically significant difference in BMI between the two groups, though unexpectedly the mean BMI was lower in the group with sleep disordered breathing (28.0 vs 31.6 kg/m2, p = 0.17).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Self-reported sleep pathology was prevalent: 63% reported poor sleep quality (PSQI ≥ 5), 43% had at least subclinical insomnia, and 10% reported abnormal daytime somnolence.

    “Overall, 10% (n = 3) of participants reported an abnormal level of daytime somnolence, 63% (n = 19) reported poor sleep quality (PSQI score greater than or equal to 5), and 43% (n = 13) of participants had at least subclinical insomnia, while 7% (n = 2) had moderate to severe insomnia.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    All participants completed baseline surveys and the monitored sleep night, but one patient never had an embryo transfer.

    “All participants completed baseline surveys and the monitored sleep night, but one patient never had an embryo transfer.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The effects of SDB on early reproductive outcomes, including fertility, fecundity, and conception, are not well understood, and the majority of studies disproportionately address complications of established pregnancies, fetal or neonatal outcomes.

    “The effects of SDB on early reproductive outcomes, including fertility, fecundity, and conception are not well understood and the majority of studies disproportionately address complications of established pregnancies, fetal or neonatal outcomes [8,9].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8] Fung, 2013, Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study, PLoS One source

      Not checked in the free run.

    • cites [9] Bublitz, 2018, Obstructive sleep apnea in gestational diabetes: a pilot study of the role of the hypothalamic-pituitary-adrenal Axis, J Clin Sleep Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Each sleep night was independently scored by two reviewers, discrepancies were adjudicated by a third reviewer, and all reviewers were blinded to subject characteristics and outcomes.

    “Each night was independently scored by two reviewers and discrepancies were adjudicated by a third reviewer. All reviewers were blinded to subject characteristics and outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The elevated risk of SDB among PCOS patients appears independent of underlying weight.

    “The elevated risk among PCOS patients appears independent of underlying weight, a common risk factor for SDB [2].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Cooney, 2018, Beyond fertility: polycystic ovary syndrome and long-term health, Fertil Steril source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    This study was not designed to find a hypothesized effect on pregnancy rate and the sample size was small.

    “First, this study was not designed to find a hypothesized effect on pregnancy rate and the sample size was small.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Airway dysfunction causes autonomic nervous system dysregulation, sleep fragmentation, insulin resistance, systemic inflammation, oxidative stress, and vascular endothelial dysfunction.

    “Airway dysfunction causes autonomic nervous system dysregulation, sleep fragmentation, insulin resistance, systemic inflammation, oxidative stress, and vascular endothelial dysfunction [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Gottlieb, 2020, Diagnosis and management of obstructive sleep apnea: a review, JAMA source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous reports validated the performance of an FDA-cleared physiological monitoring system against gold standard monitoring platforms.

    “Previous reports validated the performance of an FDA-cleared physiological monitoring system against gold standard monitoring platforms [18–23].”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [18] Chung, 2019, Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care, Science source

      Not checked in the free run.

    • cites [19] Chung, 2020, Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units, Nat Med source

      Not checked in the free run.

    • cites [20] Xu, 2019, Skin sensors are the future of health care, Nature source

      Not checked in the free run.

    • cites [21] Ryu, 2021, Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings, Proc Natl Acad Sci U S A source

      Not checked in the free run.

    • cites [22] Lee, 2021, Comparative study of wireless sensors versus type III home sleep apnea test for home-based diagnosis of obstructive sleep apnea, Sleep

      Not checked in the free run.

    • cites [23] Lee, 2020, Mechano-acoustic sensing of physiological processes and body motions via a soft wireless device placed at the suprasternal notch, Nat Biomed Eng source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    This pilot study provides preliminary evidence that SDB of any severity is a negative risk factor for clinical pregnancy, with a possible trend towards worsening pregnancy outcomes with more severe SDB.

    “This pilot study provides preliminary evidence that SDB of any severity is a negative risk factor for clinical pregnancy with a possible trend towards worsening pregnancy outcomes with more severe SDB.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Nearly one third of women with polycystic ovary syndrome have sleep disordered breathing.

    “Nearly one third of women with polycystic ovary syndrome (PCOS), for example, have SDB.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Cooney, 2018, Beyond fertility: polycystic ovary syndrome and long-term health, Fertil Steril source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The underlying mechanism and temporality of how disordered sleep may influence IVF success were not assessed.

    “The underlying mechanism and temporality of how disordered sleep may influence IVF success were not assessed and warrant additional exploration.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    The study was a sample of convenience, and the findings may not be generalizable to other populations.

    “Additionally, our study was a sample of convenience. The findings may not be generalizable to other populations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The presented data do not address potential causality.

    “The presented data do not address potential causality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Current home sleep apnea tests are bulky, uncomfortable, and have failure rates ranging from 2% to 33%.

    “Current home sleep apnea tests (HSATs) are bulky, uncomfortable, and failure rates ranging from 2% to 33% [12–17].”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [12] Collop, 2007, Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine, J Clin Sleep Med source

      Not checked in the free run.

    • cites [13] Ken He, 2016, Home- vs. Laboratory-based management of OSA: an economic review, Current Sleep Medicine Reports source

      Not checked in the free run.

    • cites [14] Pietzsch, 2011, An integrated health-economic analysis of diagnostic and therapeutic strategies in the treatment of moderate-to-severe obstructive sleep apnea, Sleep

      Not checked in the free run.

    • cites [15] Rundo, 2019, Polysomnography, Handb Clin Neurol. source

      Not checked in the free run.

    • cites [16] Golpe, 2002, Home sleep studies in the assessment of sleep apnea/hypopnea syndrome, Chest source

      Not checked in the free run.

    • cites [17] He, 2020, Comparison of sleep specialist vs primary care driven home sleep apnea testing in routine practice, SLEEP source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    This is a single-site study, which limits broader generalizability.

    “Third, this is a single-site study which limits broader generalizability.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    This single-arm, prospective, observational pilot study provides preliminary evidence that SDB is prevalent and may be a risk factor for treatment failure in an IVF population.

    “This single-arm, prospective, observational pilot study provides preliminary evidence that SDB is prevalent and may be a risk factor for treatment failure in an IVF population.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Participants refrained from caffeine, alcohol, and napping for 8 hours prior to going to bed and from any use of sleep aids.

    “Participants refrained from caffeine, alcohol, and napping for 8 h prior to going to bed and any use of sleep aids.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    This study was approved by the University of Pennsylvania Institutional Review Board (Protocol #842992).

    “This study was approved by the University of Pennsylvania Institutional Review Board (Protocol #842992).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The monitored sleep night was performed in the week preceding IVF stimulation to avoid effects from exogenous hormones on the sleep study and perceived ill effects of wearing the sleep sensors on cycle stimulation or pregnancy outcome.

    “The monitored sleep night was performed in the week preceding IVF stimulation to avoid any effects from exogenous hormones on the sleep study and perceived ill effects of wearing the sleep sensors on cycle stimulation or pregnancy outcome and have as accurate a reflection of sleep as possible.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All participants signed written informed consent prior to enrollment.

    “All participants signed written informed consent prior to enrollment.”
    Quote in the paperNot a substantial claim
23 of 23

  • The paper relies on this without support.

    Routine screening for sleep pathology in the infertility clinic is uncommon.

    “Despite efforts to optimize periconceptional health, such as tobacco use, obesity, or diabetes, routine screening for sleep pathology in the infertility clinic is uncommon.”

  • The paper relies on this without support.

    This is the first prospective study to investigate the relationship between SDB and early pregnancy outcomes in an IVF population.

    “This is the first prospective study to investigate the relationship between SDB and early pregnancy outcomes in an IVF population.”

  • The paper relies on this without support.

    The paucity of research and screening for SDB and reproduction is likely a reflection of logistical challenges to objectively studying sleep.

    “The paucity of both research and screening for SDB and reproduction is likely a reflection of logistical challenges to objectively studying sleep.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The use of wearables such as activity and sleep trackers, as well as mobile apps for symptom tracking, can keep clinicians informed about patients' progress, consequently promoting communication and engagement.

    “The use of wearables such as activity [78,79] and sleep trackers [77,80], as well as mobile apps for symptom tracking [53,54], can keep clinicians informed about patients’ progress, consequently promoting communication and engagement.”

    From Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review (2024) · cites this paper as [77]

    The Introduction and Study participants > Primary exposure describe wearable sensors used for home sleep monitoring and diagnosis. The Discussion says they may reduce access barriers, but the paper does not report that they keep clinicians informed about patients’ progress or promote communication and engagement. Page numbers were not available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The sample size of included wearable studies ranged from 30 to 151, mean age of participants ranged from 15.4 years to 35.4 years, and mean BMI ranged from 20.4 kg/m2 to 38.1 kg/m2.

    “The sample size of included studies ranged from 30 [77] to 151 [78], whilst the mean age of participants ranged from 15.4 years [79] to 35.4 years [77], and the mean BMI ranged from 20.4 kg/m2 [86] to 38.1 kg/m2 [79].”

    From Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review (2024) · cites this paper as [77]

    The Results report 30 participants, supporting the sample-size figure attributed to this paper. They give an overall mean age of 33 years; 35.4 years is the mean for participants without sleep-disordered breathing, not for the full study sample. The other range endpoints are attached to different citations and are not judged here. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Publication dates of wearable studies spanned from 2009 to 2022, with three originating from China, two from Brazil, two from the USA, and one each from Croatia, Poland, and the UK.

    “Publication dates spanned from 2009 to 2022, with three of them originating from China [81,85,86], two from Brazil [78,82], two from the USA [77], and one each from Croatia [84], Poland [83], and the UK [80].”

    From Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review (2024) · cites this paper as [77]

    The Study participants section describes a wearable-sensor study approved by the University of Pennsylvania Institutional Review Board, supporting its identification as a US study; the cited paper was published in 2022. As the sole citation attached to “two from the USA,” however, this paper establishes only one study and does not substantiate the count of two. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Ten studies included information regarding the use of wearables.

    “Ten studies included information regarding the use of wearables [77,78,79,80,81,82,83,84,85,86] (Supplementary File S3).”

    From Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review (2024) · cites this paper as [77]

  • Studies using wearable sleep sensors found that sleep-disordered breathing was more common among patients with PCOS (87.5% vs. 45.5%).

    “Studies using wearable sleep sensors found that sleep-disordered breathing was more common among patients with PCOS (87.5% vs. 45.5%) [77]”

    From Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review (2024) · cites this paper as [77]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Age-adjusted reduction is reported as both 84% and 77%

    Major

    The discussion says the age-adjusted likelihood was reduced by 84%, whereas the abstract reports 77%. The reported adjusted odds ratio of 0.23 corresponds to a 77% reduction in odds.

  • Mild SDB percentage uses the wrong stated denominator

    Minor

    The sentence describes participants with SDB, of whom there were 17. Eleven of 17 is 64.7%, not 37%; 37% is approximately the share of the entire 30-person cohort.

    Reported 37 · recomputed 64.705882

  • Moderate SDB count does not match the reported percentage

    Minor

    Five of the 30 participants is 16.7%, not 13%. The reported 13% does not match the count even when the entire cohort is used as the denominator.

    Reported 13 · recomputed 16.666667

  • Conclusion gives a different confidence interval for the adjusted effect

    Minor

    The conclusion reports a 95% confidence interval of 0.08-1.8 for the 77% lower likelihood, but the results give 0.04-1.5 for the age-adjusted odds ratio of 0.23 that yields that 77% figure.

4 of 4

Cites

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Related

Authors
Walter, J. R., Lee, J. Y., Snoll, B., Park, J. B., Kim, D. H., Xu, S., & Barnhart, K.
Affiliations
  • University of Pennsylvania (US)
  • Sibel (United States) (US)
  • University of Leeds (GB)
  • Northwestern University (US)
Corresponding author
Walter, Jessica R.
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2022-12
Volume
100
Pages
511-517
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2022.09.026
PMC
PMC10193447
OpenAlex
W4304689424
Semantic Scholar
ae4394517926d4c9240008b132aab759c339deec
Cited by
15
References
38
Citations by year
2026: 7 · 2025: 3 · 2024: 1 · 2023: 4
FWCI
1.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Sleep Medicine (acceptedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • NIH
  • University of Pennsylvania
  • NICHD
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords
sleep-disordered breathing, obstructive sleep apnea, in vitro fertilization, pregnancy outcomes, home sleep monitoring, wearable sensors, wireless sensors, clinical pregnancy, live birth, polycystic ovary syndrome, infertility, apnea-hypopnea index, pulse transit time, pulse arrival time, peripheral arterial tonometry, embryo transfer
MeSH terms
Wearable Electronic Devices, Adolescent, Adult, Female, Humans, Infertility, Middle Aged, Polycystic Ovary Syndrome, Pregnancy, Pregnancy Outcome, Sleep Apnea Syndromes, Young Adult

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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