Abstract
ObjectiveEvidence suggests Rapid-Eye-Movement (REM) Sleep Behaviour Disorder (RBD) is an early predictor of Parkinson’s disease. This study proposes a fully-automated framework for RBD detection consisting of automated sleep staging followed by RBD identification. MethodsAnalysis was assessed using a limited polysomnography montage from 53 participants with RBD and 53 age-matched healthy controls. Sleep stage classification was achieved using a Random Forest (RF) classifier and 156 features extracted from electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) channels. For RBD detection, a RF classifier was trained combining established techniques to quantify muscle atonia with additional features that incorporate sleep architecture and the EMG fractal exponent. ResultsAutomated multi-state sleep staging achieved a 0.62 Cohen’s Kappa score. RBD detection accuracy improved from 86% to 96% (compared to individual established metrics) when using manually annotated sleep staging. Accuracy remained high (92%) when using automated sleep staging. ConclusionsThis study outperforms established metrics and demonstrates that incorporating sleep architecture and sleep stage transitions can benefit RBD detection. This study also achieved automated sleep staging with a level of accuracy comparable to manual annotation. SignificanceThis study validates a tractable, fully-automated, and sensitive pipeline for RBD identification that could be translated to wearable take-home technology.
Highlights
Rapid-Eye-Movement (REM) Sleep Behaviour Disorder (RBD) is a parasomnia first described in 1986, characterised by loss of normal muscle atonia and dream-enactment motor activity during REM sleep (Schenck et al 1986; Kryger et al 2011)
The following results are presented in three sections, detailing 1) automated sleep stage classification, 2) correlation of EMG and sleep architecture metrics using automatically/manually annotated sleep stages, and 3) RBD detection
The specificity for REM detection remains very high for both cohorts, which will prove pivotal in avoiding false positive REM sleep without atonia (RSWA) results
Summary
Rapid-Eye-Movement (REM) Sleep Behaviour Disorder (RBD) is a parasomnia first described in 1986, characterised by loss of normal muscle atonia and dream-enactment motor activity during REM sleep (Schenck et al 1986; Kryger et al 2011). There are numerous methods in the literature that utilise PSG recordings to classify REM stages either (Kempfner et al 2012; Imtiaz and Rodriguez-Villegas 2014; McCarty et al 2014; Yetton et al 2016) or as part of multi-sleep-stage classification (Virkkala et al 2008; Güneş et al 2010; Fraiwan et al 2012; Liang et al 2012; Bajaj and Pachori 2013; Kempfner et al 2013b; Khalighi et al 2013; Lajnef et al 2015; Sousa et al 2015) Many of these automated sleep scoring algorithms produce results that are comparable to expert annotation of PSG recordings from young healthy controls. Manual sleep scoring remains the clinical gold-standard to date
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