The Bern Sleep-Wake Registry: A 25-year multimodal resource for data-driven sleep medicine

Background: Sleep-wake-circadian disorders are prevalent and contribute substantially to morbidity, mortality and reduced quality of life. Evaluation in real-world settings is essential to capture their complexity and association with long-term outcomes. Most sleep-wake registries are restricted to selected populations, lack systematic integration of objective sleep-wake-circadian assessments with the clinical data and provide limited follow-up. To address these limitations, we established the Bern Sleep-Wake Registry based on real-world data from a tertiary University Hospital sleep center. Methods: The registry includes data from patients referred to the multidisciplinary Sleep- Center at Inselspital, University Hospital Bern (funded in 1990), from the year 2000 onwards who underwent at least one objective assessment such as polysomnography, daytime sleep-wake recordings, vigilance tests, and actigraphy. The registry integrates clinical information, questionnaire scores, outputs of objective assessments and raw signal data, and is regularly updated to incorporate new patients and longitudinal follow-up information. Results: As of September 2025, records from over 11000 patients were evaluated (median age: 50 years (interquantile range 36, 61); 65% male). The most common sleep-wake-circadian disorders were sleep-related breathing disorders (67%), insomnia disorders (15%) and central disorders of hypersomnolence (9%). Available assessments included more than 12000 polysomnographies, 2400 multiple sleep latency tests, 2100 maintenance of wakefulness tests, 1800 vigilance tests and 4500 actigraphies. Conclusions: By longitudinally integrating multimodal deep clinical phenotyping with objective assessments and raw physiological signals, the Bern Sleep-Wake Registry provides a foundation for investigating disease trajectories, identifying novel biomarkers and developing data-driven approaches to precise diagnosis, prognosis and individualized treatment.