Abstract

Study objectivesDevelopment of inter-database generalizable sleep staging algorithms represents a challenge due to increased data variability across different datasets. Sharing data between different centers is also a problem due to potential restrictions due to patient privacy protection. In this work, we describe a new deep learning approach for automatic sleep staging, and address its generalization capabilities on a wide range of public sleep staging databases. We also examine the suitability of a novel approach that uses an ensemble of individual local models and evaluate its impact on the resulting inter-database generalization performance.MethodsA general deep learning network architecture for automatic sleep staging is presented. Different preprocessing and architectural variant options are tested. The resulting prediction capabilities are evaluated and compared on a heterogeneous collection of six public sleep staging datasets. Validation is carried out in the context of independent local and external dataset generalization scenarios.ResultsBest results were achieved using the CNN_LSTM_5 neural network variant. Average prediction capabilities on independent local testing sets achieved 0.80 kappa score. When individual local models predict data from external datasets, average kappa score decreases to 0.54. Using the proposed ensemble-based approach, average kappa performance on the external dataset prediction scenario increases to 0.62. To our knowledge this is the largest study by the number of datasets so far on validating the generalization capabilities of an automatic sleep staging algorithm using external databases.ConclusionsValidation results show good general performance of our method, as compared with the expected levels of human agreement, as well as to state-of-the-art automatic sleep staging methods. The proposed ensemble-based approach enables flexible and scalable design, allowing dynamic integration of local models into the final ensemble, preserving data locality, and increasing generalization capabilities of the resulting system at the same time.

Highlights

  • Sleep staging is one of the most important tasks during the clinical examination of polysomnographic sleep recordings (PSGs)

  • Using the proposed ensemble-based approach, average kappa performance on the external dataset prediction scenario increases to 0.62. To our knowledge this is the largest study by the number of datasets so far on validating the generalization capabilities of an automatic sleep staging algorithm using external databases

  • Each epoch can be classified into five possible states according to the observed signal pattern activity in the reference PSG interval

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Summary

Introduction

Sleep staging is one of the most important tasks during the clinical examination of polysomnographic sleep recordings (PSGs). A PSG records the relevant biomedical signals of a patient in the context of Sleep Medicine studies, representing the basic tool for the diagnosis of many sleep disorders. Sleep staging characterizes the patient’s sleep macrostructure leading to the socalled hypnogram. Current standard guidelines for sleep scoring carry out segmentation of the subject’s neurophysiological activity following a discrete 30s-epoch time basis. Each epoch can be classified into five possible states (wakefulness, stages N1, N2, N3, and R) according to the observed signal pattern activity in the reference PSG interval. For sleep staging, neurophysiological activity of interest involves monitoring of different traces of electroencephalographic (EEG), electromyographic (EMG) and electrooculographic (EOG) activity [1]

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