•Automated scoring on HSAT devices underestimate REI compared to manual scoring.•Automated scoring underestimated OSA severity in up to 44.5% of moderate cases.•Misclassification occurs near clinically relevant severity thresholds.•Hypopnea index was significantly lower with automated compared to manual scoring.•Findings highlight targets for improving automated and AI scoring.
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Khadadah et al. (2026) studied this question.
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