Abstract

To overcome the disadvantage of clinical manual sleep staging, a convenient, economical, and efficient multi-class automatic sleep staging method is proposed based on long short-term memory network (LSTM) using single-lead electrocardiogram signals. From electrocardiogram signals, heart rate variability and respiratory signals were calculated, and, then, totally 25 features were extracted. Four different classifiers, including the two-class classifier to distinguish between wake and sleep, the three-class classifier to distinguish wake, non-rapid eye movement sleep, and rapid eye movement, the four-class classifier to distinguish wake, light sleep, slow wave sleep, and rapid eye movement, and the five-class classifier to distinguish wake, sleep stage N1, sleep stage N2, sleep stage N3, and rapid eye movement, were constructed using the LSTM. The single-lead electrocardiogram data from 238 patients with full sleep stages during sleep were used for the training set and the data from other 60 patients were regarded as a validation set. The rest of 75 patients have left aside for testing set. The accuracy of two-class, three-class, four-class, and five-class sleep staging was 89.84%, 84.07%, 77.76%, and 71.16% and the Cohen’s kappa statistic $k$ was 0.52, 0.58, 0.55, and 0.52, respectively, which realized the moderate agreement with clinical analysis. When expanding the dataset to extra 1068 patients with missing sleep stages, the accuracy has no obvious reduction but the Cohen’s kappa statistic $k$ dropped to 0.51, 0.52, 0.48, and 0.43, respectively. The proposed method, in this paper, is promising for low-cost, efficient, and convenient sleep staging in home care monitoring.

Highlights

  • Sleep is one of the most important physiological activities of human body, and sleep staging is one of the most efficient approaches to evaluate the equality of sleep

  • Sleep staging accuracy po is calculated by the sum of correctly classified samples for each class divided by the total number of samples

  • Cohen’s kappa statistic k is calculated as: k =/(1 − pe) where pe = (t1 × p1 + t2 × p2 + . . . + tn × pn) / (N × N ), and t is the number of true samples of each class, p is the number of predicted number of each class, n is the number of total classes, N is the total number of samples

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Summary

Introduction

Sleep is one of the most important physiological activities of human body, and sleep staging is one of the most efficient approaches to evaluate the equality of sleep. The most authoritative sleep staging standard is set by the American Academy of Sleep Medicine (AASM). Based on polysomnography (PSG) and the AASM Manual for the Scoring of Sleep and Associated Events Rules, sleep activities can be divided into five stages: wake (W), stage I (N1), stage II (N2), stage III (N3), and rapid eye movement (REM) [1]. In non-clinical applications, there are different standards of sleep staging, such as 2-class to distinguish W and sleep, and 3-class to distinguish W, non-rapid eye movement (NREM) and REM, 4-class to distinguish W, light sleep (LS), slow wave sleep (SWS), and REM [3]. The main purpose of this paper is to explore a general, convenient, and economical sleep staging method

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