0442 Experimenting Automatic Sleep Analysis Application in a Clinical Context

Abstract

Abstract Introduction Multiplication of publications describing groundbreaking automatic sleep analysis processes and algorithms push for real-life experimentation in clinical context, outside of controlled research environments. Methods Various automatic sleep analysis processes from the literature were implemented and orchestrated in a streamlined workflow. Artificial Intelligence algorithms using regular statistical learning or deep learning were re-trained on our own data after repeating the ad-hoc pre-processing steps described in the corresponding articles. For this, we used polysomnographic records previously taped in our clinic, subject to adequate legal authorizations and agreements: 500 nights from single patients with various pathologies. Those trained models were then applied to newly recorded polysomnographies through a platform developed and hosted on premise. For each polysomnography, a standardized and automatized report were generated and transmitted to the clinician in charge of the analysis. This report contains algorithms outputs, including automatic staging and related statistics such as hypnodensity, quantitative electroencephalography (EEG) analysis, spindles detection and automatic diagnosis. Aggregated record statistics are displayed next to our database statistics for benchmarking purposes. Results For sleep staging, we not only reproduced the results of the selected literature but obtained better metrics: a 0.76 Kappa agreement vs 0.69 in the literature. This may be due to our larger training database or the quality of physiologic signals in our data. Clinicians showed interest in the automatic staging part of the analysis. They noticed algorithm errors are mostly focused on ambiguous epochs, just like visual scoring. However, they found help into automated output and explanatory variables (hypnodensity) to score those ambiguous epochs. Conclusion Automatic sleep analysis algorithms used as decision helping tools shows real potential and should be generalized, as long as underlying processes are published and understood by users and clinicians. Support Banque Publique d’Investissement.