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NPJ digital medicine
Published

Real-world deployment of remote sleep monitoring technologies reveals distinct patterns associated with cognitive decline

Authors

Nan Fletcher-Lloyd, Nathalia Céspedes Gómez, Alexander Capstick, Antigone Fogel, Marirena Bafaloukou, Mahan Heydari, Alexandra Cairns, Chloe Walsh, Jessica True, CR T Group, Behnam Shariati, Ramin Nilforooshan, Payam Barnaghi

Abstract

NPJ Digit Med. 2026 Jul 21. doi: 10.1038/s41746-026-02964-0. Online ahead of print.

ABSTRACT

Examining sleep patterns in relation to chronological ageing and dementia can provide insights for risk screening. Integrating predictive models with remote sleep monitoring enables routine assessment of cognitive decline symptoms in high-risk groups, aiding early risk identification. We developed a machine learning pipeline to estimate Sleep Age Index from longitudinal under-the-mattress sleep sensor data in the general population and a dementia cohort (n = 1672; person-samples = 18,369), using it to identify dementia risk. Risk scores were stratified into high, medium and low-risk categories to support clinical decision-making. Our study indicates that sleep patterns in dementia do not follow typical ageing processes, with the pre-trained model showing greater deviation from "normative" age-related patterns. These deviations were associated with irregular bed- and rise-times and reduced night-to-night variability in deep sleep. Chronological age was predicted from sleep data with a mean absolute error of 5.52 (95% CI: 5.37-5.67) on held-out data. In dementia versus control, the model achieved 75.7% (95% CI: 71.4%-79.9%) sensitivity and 74.7% (95% CI: 69.2%-80.0%) specificity post-stratification on unseen data. In a pilot high-risk cohort (n = 50), model predictions showed slight positive bias relative to clinical judgement (mean difference 0.98, limits of agreement -0.83-2.78). These findings demonstrate the potential of remote sleep monitoring and predictive modelling in identifying individuals who may benefit from further clinical evaluation and early intervention.

PMID:42481664 | DOI:10.1038/s41746-026-02964-0

UK DRI Authors

Marirena Bafaloukou

Research Assistant/ PhD student

Developing interpretable machine learning frameworks across proteomics, clinical records, and wearables to decode early Parkinson's disease.

Marirena Bafaloukou

Jessica True

Translational Research & Collaborations Manager

Jessica True

Prof Payam Barnaghi

Group Leader

Combining engineering and technological innovation to produce a secure 'Healthy Home' system

Prof Payam Barnaghi