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Sleep staging is a vital process for evaluating sleep quality and diagnosing sleep-related diseases. Most of the existing automatic sleep staging methods focus on time-domain information and often ignore the transformation relationship between sleep stages. To deal with the above problems, we propose a Temporal-Spectral fused and Attention-based deep neural Network model (TSA-Net) for automatic sleep staging, using a single-channel electroencephalogram (EEG) signal. The TSA-Net is composed of a two-stream feature extractor, feature context learning, and conditional random field (CRF). Specifically, the two-stream feature extractor module can automatically extract and fuse EEG features from time and frequency domains, considering that both temporal and spectral features can provide abundant distinguishing information for sleep staging. Subsequently, the feature context learning module learns the dependencies between features using the multi-head self-attention mechanism and outputs a preliminary sleep stage. Finally, the CRF module further applies transition rules to improve classification performance. We evaluate our model on two public datasets, Sleep-EDF-20 and Sleep-EDF-78. In terms of accuracy, the TSA-Net achieves 86.64% and 82.21% on the Fpz-Cz channel, respectively. The experimental results illustrate that our TSA-Net can optimize the performance of sleep staging and achieve better staging performance than state-of-the-art methods. [ABSTRACT FROM AUTHOR]

The traditional polysomnography (PSG) examination for Obstructive Sleep Apnea (OSA) diagnosis needs to measure several signals, such as EEG, ECG, EMG, EOG and the oxygen level in blood, of a patient who may have to wear many sensors during sleep. After the PSG examination, the Apnea-Hypopnea Index (AHI) is calculated based on the measured data to evaluate the severity of apnea and hypopnea for the patient. This process is obviously complicated and inconvenient. In this paper, we propose an AI-based framework, called RAre Pattern Identification and DEtection for Sleep-stage Transitions (RAPIDEST), to detect OSA based on the sequence of sleep stages from which a novel rarity score is defined to capture the unusualness of the sequence of sleep stages. More importantly, under this framework, we only need EEG signals, thus significantly simplifying the signal collection process and reducing the complexity of the severity determination of apnea and hypopnea. We have conducted extensive experiments to verify the relationship between the rarity score and AHI and demonstrate the effectiveness of our proposed approach. [ABSTRACT FROM AUTHOR]

Machine learning based sleep scoring methods aim to automate the process of annotating polysomnograms with sleep stages. Although sleep signals of multiple modalities and channels should contain more information according to sleep guidelines, most multi-channel multi-modal models in the literature showed only a little performance improvement compared to single-channel EEG models and sometimes even failed to outperform them. In this paper, we investigate whether the high performance of single-channel EEG models can be attributed to specific model features in their deep learning architectures and to which extent multi-channel multi-modal models take the information from different channels of modalities into account. First, we transfer the model features from single-channel EEG models, such as combinations of small and large filters in CNNs, to multi-channel multi-modal models and measure their impacts. Second, we employ two explainability methods, the layer-wise relevance propagation as post-hoc and the embedded channel attention network as intrinsic interpretability methods, to measure the contribution of different channels on predictive performance. We find that i) single-channel model features can improve the performance of multi-channel multi-modal models and ii) multi-channel multi-modal models focus on one important channel per modality and use the remaining channels to complement the information of the focused channels. Our results suggest that more advanced methods for aggregating channel information using complementary information from other channels may improve sleep scoring performance for multi-channel multi-modal models. [ABSTRACT FROM AUTHOR]

Sleep staging is the essential step in sleep quality assessment and sleep disorders diagnosis. However, most current automatic sleep staging approaches use recurrent neural networks (RNN), resulting in a relatively large training burden. Moreover, these methods only extract information of the whole epoch or adjacent epochs, ignoring the local signal variations within epoch. To address these issues, a novel deep learning architecture named segmented attention network (SAN) is proposed in this paper. The architecture can be divided into feature extraction (FE) and time sequence encoder (TSE). The FE module consists of multiple multiscale CNN (MMCNN) and residual squeeze and excitation block (SE block). The former extracts features from multiple equal-length EEG segments and the latter reinforced the features. The TSE module based on a multi-head attention mechanism could capture the temporal information in the features extracted by FE module. Noteworthy, in SAN, we replaced the RNN module with a TSE module for temporal learning and made the network faster. The evaluation of the model was performed on two widely used public datasets, Montreal Archive of Sleep Studies (MASS) and Sleep-EDFX, and one clinical dataset from Huashan Hospital of Fudan University, Shanghai, China (HSFU). The proposed model achieved the accuracy of 85.5%, 86.4%, 82.5% on Sleep-EDFX, MASS and HSFU, respectively. The experimental results exhibited favorable performance and consistent improvements of SAN on different datasets in comparison with the state-of-the-art studies. It also proved the necessity of sleep staging by integrating the local characteristics within epochs and adjacent informative features among epochs. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, more and more people in the world are suffering from somnipathy. Automatic sleep staging is critical for assessing sleep quality and assisting in the diagnosis of psychiatric and neurological disorders caused by somnipathy. Many researchers employ deep learning methods for sleep stage classification and have achieved high performance. However, there are still no effective methods to modeling intrinsic characteristics of salient wave in different sleep stages from physiological signals. And transition rules hidden in signals from one to another sleep stage cannot be identified and captured. In addition, class imbalance problem in dataset is not conducive to building a robust classification model. To solve these problems, we construct a deep neural network combining MSE(Multi-Scale Extraction) based U-structure and CBAM (Convolutional Block Attention Module) to extract the multi-scale salient waves from single-channel EEG signals. The U-structured convolutional network with MSE is utilized to extract multi-scale features from raw EEG signals. After that, the CBAM is used to focus more on salient variation and then learn transition rules between successive sleep stages. Further, a class adaptive weight cross entropy loss function is proposed to solve the class imbalance problem. Experiments in three public datasets show that our model greatly outperform the state-of-the-art results compared with existing methods. The overall accuracy and macro F1-score (Sleep-EDF-39: 90.3%-86.2, Sleep-EDF-153: 89.7%-85.2, SHHS: 86.8%-83.5) on three public datasets suggest that the proposed model is very promising to completely take place of human experts for sleep staging. [ABSTRACT FROM AUTHOR]

Background: Despite the tremendous prog- ress recently made towards automatic sleep staging in adults, it is currently unknown if the most advanced algorithms generalize to the pediatric population, which displays distinctive characteristics in overnight polysomnography (PSG). Methods: To answer the question, in this work, we conduct a large-scale comparative study on the state-of-the-art deep learning methods for pediatric automatic sleep staging. Six different deep neural networks with diverging features are adopted to evaluate a sample of more than 1,200 children across a wide spectrum of obstructive sleep apnea (OSA) severity. Results: Our experimental results show that the individual performance of automated pediatric sleep stagers when evaluated on new subjects is equivalent to the expert-level one reported on adults. Combining the six stagers into ensemble models further boosts the staging accuracy, reaching an overall accuracy of 88.8%, a Cohen’s kappa of 0.852, and a macro F1-score of 85.8%. At the same time, the ensemble models lead to reduced predictive uncertainty. The results also show that the studied algorithms and their ensembles are robust to concept drift when the training and test data were recorded seven months apart and after clinical intervention. Conclusion: However, we show that the improvements in the staging performance are not necessarily clinically significant although the ensemble models lead to more favorable clinical measures than the six standalone models. Significance: Detailed analyses further demonstrate “almost perfect” agreement between the automatic stagers to one another and their similar patterns on the staging errors, suggesting little room for improvement. [ABSTRACT FROM AUTHOR]

Sleep staging is an important step in analyzing sleep quality. Traditional manual analysis by psychologists is time-consuming. In this paper, we propose an automatic sleep staging model with an improved attention module and hidden Markov model (HMM). The model is driven by single-channel electroencephalogram (EEG) data. It automatically extracts features through two convolution kernels with different scales. Subsequently, an improved attention module based on Squeeze-and-Excitation Networks (SENet) will perform feature fusion. The neural network will give a preliminary sleep stage based on the learned features. Finally, an HMM will apply sleep transition rules to refine the classification. The proposed method is tested on the sleep-EDFx dataset and achieves excellent performance. The accuracy on the Fpz-Cz channel is 84.6%, and the kappa coefficient is 0.79. For the Pz-Oz channel, the accuracy is 82.3% and kappa is 0.76. The experimental results show that the attention mechanism plays a positive role in feature fusion. And our improved attention module improves the classification performance. In addition, applying sleep transition rules through HMM helps to improve performance, especially N1, which is difficult to identify. [ABSTRACT FROM AUTHOR]

Analysis of sleep stages using electroencephalograms (EEGs), a critical procedure in health monitoring, has been researched extensively. Scoring of the sleep stages is highly dependent on experts’ knowledge or hand-crafted features created by experts. Recent advancements in deep learning have, nevertheless, successfully automated the scoring process with accuracy comparable to human performance. Previous methods were less convenient as they employed specific EEG devices designed for the experiments. Such devices are usually expensive and require a special environment and arrangements for their use. In this study, we propose an automatic sleep-stage scoring system using a patch-type wearable EEG sensor based on deep learning. The proposed sensor, namely Haru, is lightweight, inexpensive, and easy to use. As for the training architecture, we implement a model based on the state-of-the-art deep learning algorithm specifically designed for automatic sleep staging. We record three channels of sleep EEGs from 30 subjects at a sampling rate of 250 Hz with the proposed system and a polysomnogram (PSG) device simultaneously. Training datasets are created on the basis of the annotated samples in PSG measurement. In the experiment, we train our model and evaluate the results using the leave-one-out cross-validation method. The results indicate that the proposed Haru Sleep is capable of scoring sleep stages with a scoring accuracy of 78.6% and an F1 score of 73.4%, which is comparable to that obtained by clinical PSG devices.

Sleep EEG signals analysis is an approach that helps researchers identify and understand the different phenomena concealed within sleep EEG data. This research introduces a time-frequency analysis approach to untangle the parameters of the sleep stages classification from EEG data. This approach computes the spectral estimation of a signal based on a set of controlled wavelets using a multitaper with convolution (MT&C) method. In this study, the MT&C methods is implemented to extract the features from a single sleep EEG data channel. Then two separated approaches are applied for sleep stage classification. The first one is based on the EEG waves characteristic definitions of sleep stages (named as Rules-based method) to directly classify each 30 second EEG segment after the feature extraction. The second approach uses a support vector machine with quadratic equation (SVM-Q) classifier to classify the sleep stages based on experts’ scoring. The experimental results are evaluated, and the outcomes show an overall accuracy of 90% with an average sensitivity of 96.2% and an average specificity of 93.2% using an SVM-Q classifier and an 87.6% accuracy for the Rules-based method on healthy subjects. On the other hand, the accuracy on subjects with abnormal sleep EEG data is of 78.1% with the SVM-Q classifier and 73.4% with the Rules-based method.

Automating sleep staging is vital to scale up sleep assessment and diagnosis to serve millions experiencing sleep deprivation and disorders and enable longitudinal sleep monitoring in home environments. Learning from raw polysomnography signals and their derived time-frequency image representations has been prevalent. However, learning from multi-view inputs (e.g., both the raw signals and the time-frequency images) for sleep staging is difficult and not well understood. This work proposes a sequence-to-sequence sleep staging model, XSleepNet,1 that is capable of learning a joint representation from both raw signals and time-frequency images. Since different views may generalize or overfit at different rates, the proposed network is trained such that the learning pace on each view is adapted based on their generalization/overfitting behavior. In simple terms, the learning on a particular view is speeded up when it is generalizing well and slowed down when it is overfitting. View-specific generalization/overfitting measures are computed on-the-fly during the training course and used to derive weights to blend the gradients from different views. As a result, the network is able to retain the representation power of different views in the joint features which represent the underlying distribution better than those learned by each individual view alone. Furthermore, the XSleepNet architecture is principally designed to gain robustness to the amount of training data and to increase the complementarity between the input views. Experimental results on five databases of different sizes show that XSleepNet consistently outperforms the single-view baselines and the multi-view baseline with a simple fusion strategy. Finally, XSleepNet also outperforms prior sleep staging methods and improves previous state-of-the-art results on the experimental databases. [ABSTRACT FROM AUTHOR]

Sleep data are typically characterized by class imbalance, which can cause the model to be overly biased toward frequent classes, resulting in low accuracy of minority class classification. However, the minority class of sleep staging has important value in diagnosing certain disorders, such as an N1 Stage that is too short indicating possible hypersomnia or narcolepsy. To address this problem, we propose a multi-view CNN model based on adaptive margin-aware loss. A novel margin-aware factor that considers the relative sample sizes of both frequent and minority classes can improve the overfitting of minority classes by increasing the regularization strength of minority classes without changing the sample size to maximize the decision margins of minority classes. On this basis, we propose margin-aware cross-entropy and margin-aware complement entropy loss, respectively. Margin-aware complement entropy can be achieved to increase the regularization for minority classes while neutralizing errors for minority classes, thus improving the classification accuracy for minority classes. Finally, the synergy of margin-aware complement entropy and cross-entropy is realized in an adaptive way to improve the sleep staging classification accuracy. We tested on three sleep datasets and compared them with the state-of-the-art, and the results demonstrate that our proposed algorithm not only improves the accuracy of sleep staging in general, but also improves the minority classes to a greater extent. [ABSTRACT FROM AUTHOR]

Electroencephalography (EEG) signals convey information related to different processes that take place in the brain. From the EEG fluctuations during sleep, it is possible to establish the sleep stages and identify short events, commonly related to a specific physiological process or pathology. Some of these short events (called A-phases) present an organization and build up the concept of the Cyclic Alternating Pattern (CAP) phenomenon. In general, the A-phases abruptly modify the EEG fluctuations, and a singular behavior could occur. With the aim to quantify the abrupt changes during A-phases, in this work the wavelet analysis is considered to compute Hölder exponents, which measure the singularity strength. We considered time windows of 2s outside and 5s inside A-phases onset (or offset). A total number of 5121 A-phases from 9 healthy participants and 10 patients with periodic leg movements were analyzed. Within an A-phase the Hölder numerical value tends to be 0.6, which implies a less abrupt singularity. Whereas outside of A-phases, it is observed that the Hölder value is approximately equal to 0.3, which implies stronger singularities, i.e., a more evident discontinuity in the signal behavior. In addition, it seems that the number of singularities increases inside of A-phases. The numerical results suggest that the EEG naturally conveys singularities modified by the A-phase occurrence, and this information could help to conceptualize the CAP phenomenon from a new perspective based on the sharpness of the EEG instead of the oscillatory way. [ABSTRACT FROM AUTHOR]

Sleep is a vital process of our daily life as we roughly spend one-third of our lives asleep. In order to evaluate sleep quality and potential sleep disorders, sleep stage classification is a gold standard method. In this paper, we introduce a novel fully convolutional neural network architecture (SleepFCN) to classify sleep stages into five classes using single-channel electroencephalograms (EEGs). The framework of SleepFCN includes two major parts for feature extraction and temporal sequence encoding namely multi-scale feature extraction (MSFE) and residual dilated causal convolutions (ResDC), respectively. These are then followed by convolutional layers of 1-sized kernels instead of dense layers to build the fully convolutional neural network. Due to the imbalance in the distribution of sleep stages, we incorporate a weight corresponding to the number of samples of each class in our loss function. We evaluated the performance of SleepFCN using the Sleep-EDF and SHHS datasets. Our experimental results show that the proposed method outperforms state-of-the-art works in both classification correctness and learning speed. [ABSTRACT FROM AUTHOR]

Insomnia is a common public health problem and an open biomedical research topic. Insomnia results in various health problems, including memory decline, decreases concentration and weakens problem-solving ability. The insufficient sleep also leads to skin ageing, heart disease, high blood pressure, arrhythmia and stroke. While it remains as a global health concern, sleep quality improvement using modern technologies, such as machine learning, classification technologies, virtual reality (VR), becomes an open and hot research problem. These modern technologies offer new curing solutions under certain conditions. In this paper, we present a sleeping-aid system with a single-channel electroencephalogram (EEG) sleep stage classification algorithm to improve the sleep quality. The sleeping-aid system promotes machine learning integrated VR and multimedia technology for sleep improvement. Ninety participants were invited to test on three different systems with 3D VR, 2D video, and music only. An adequate stimulus of audio-vision can be a complement of the drug treatment. The experimental results showed that the proposed method demonstrated superior performance over existing methods. [ABSTRACT FROM AUTHOR]

A novel jumping knowledge spatial-temporal graph convolutional network (JK-STGCN) is proposed in this paper to classify sleep stages. Based on this method, different types of multi-channel bio-signals, including electroencephalography (EEG), electromyogram (EMG), electrooculogram (EOG), and electrocardiogram (ECG) are utilized to classify sleep stages, after extracting features by a standard convolutional neural network (CNN) named FeatureNet. Intrinsic connections among different bio-signal channels from the identical epoch and neighboring epochs can be obtained through two adaptive adjacency matrices learning methods. A jumping knowledge spatial-temporal graph convolution module helps the JK-STGCN model to extract spatial features from the graph convolutions efficiently and temporal features are extracted from its common standard convolutions to learn the transition rules among sleep stages. Experimental results on the ISRUC-S3 dataset showed that the overall accuracy achieved 0.831 and the F1-score and Cohen kappa reached 0.814 and 0.782, respectively, which are the competitive classification performance with the state-of-the-art baselines. Further experiments on the ISRUC-S3 dataset are also conducted to evaluate the execution efficiency of the JK-STGCN model. The training time on 10 subjects is 2621s and the testing time on 50 subjects is 6.8s, which indicates its highest calculation speed compared with the existing high-performance graph convolutional networks and U-Net architecture algorithms. Experimental results on the ISRUC-S1 dataset also demonstrate its generality, whose accuracy, F1-score, and Cohen kappa achieve 0.820, 0.798, and 0.767 respectively. [ABSTRACT FROM AUTHOR]

Elimination of intra-artifacts in EEG has been overlooked in most of the existing sleep staging systems, especially in deep learning-based approaches. Whether intra-artifacts, originated from the eye movement, chin muscle firing, or heart beating, etc., in EEG signals would lead to a positive or a negative masking effect on deep learning-based sleep staging systems was investigated in this paper. We systematically analyzed several traditional pre-processing methods involving fast Independent Component Analysis (FastICA), Information Maximization (Infomax), and Second-order Blind Source Separation (SOBI). On top of these methods, a SOBI-WT method based on the joint use of the SOBI and Wavelet Transform (WT) is proposed. It offered an effective solution for suppressing artifact components while retaining residual informative data. To provide a comprehensive comparative analysis, these pre-processing methods were applied to eliminate the intra-artifacts and the processed signals were fed to two ready-to-use deep learning models, namely two-step hierarchical neural network (THNN) and SimpleSleepNet for automatic sleep staging. The evaluation was performed on two widely used public datasets, Montreal Archive of Sleep Studies (MASS) and Sleep-EDF Expanded, and a clinical dataset that was collected in Huashan Hospital of Fudan University, Shanghai, China (HSFU). The proposed SOBI-WT method increased the accuracy from 79.0% to 81.3% on MASS, 83.3% to 85.7% on Sleep-EDF Expanded, and 75.5% to 77.1% on HSFU compared with the raw EEG signal, respectively. Experimental results demonstrate that the intra-artifacts bring out a masking negative impact on the deep learning-based sleep staging systems and the proposed SOBI-WT method has the best performance in diminishing this negative impact compared with other artifact elimination methods. [ABSTRACT FROM AUTHOR]

Although the development of computer-aided algorithms for sleep staging is integrated into automatic detection of sleep disorders, most supervised deep learning-based models might suffer from insufficient labeled data. While the adoption of semi-supervised learning (SSL) can mitigate the issue, the SSL models are still limited to the lack of discriminative feature extraction for diverse obstructive sleep apnea (OSA) severity. This model deterioration might be exacerbated during the domain adaptation. Such exploration on the alleviation of domain-shift of SSL model between different OSA conditions has attracted more and more attentions from the clinic. In this work, a co-attention meta sleep staging network (CMS2-net) is proposed to simultaneously deal with two issues: the inter-class disparity problem and the intra-class selection problem. Within CMS2-net, a co-attention module and a triple-classifier are designed to explicitly refine the coarse feature representations by identifying the class boundary inconsistency. Moreover, the mutual information with meta contrastive variance is introduced to supervise the gradient stream from a multi-scale view. The performance of the proposed framework is demonstrated on both public and local datasets. Furthermore, our approach achieves the state-of-the-art SSL results on both datasets. [ABSTRACT FROM AUTHOR]

Personal informatics systems can help people promote their health and well-being. Recent studies have shown that such systems can be used to infer relevant health indicators such as, e.g., stress, anxiety, and sleeping habits. While automatic detection of sleep has been studied extensively, there is a lack of studies exploring how population and personalized models influence the performance of sleep detection. In this article, we address this challenge by investigating the recognition of sleep/wake stages and high/low sleep quality with a focus on the impact of personalized models. To evaluate our approach, we collect a dataset of physiological signals and self-reports about sleep/wake times and sleep quality score. The dataset contains 6557 hours of sensor data collected using wristbands from 16 participants over one month. Our results show that personalized models perform significantly better than population models for sleep quality recognition, and are comparably good for sleep stage detection. The balanced accuracy for sleep/wake and high/low sleep quality are 92.2% and 61.51%, which are significantly higher than baseline classifiers. [ABSTRACT FROM AUTHOR]

Type III sleep studies record cardio-respiratory channels only. Compared with polysomnography, which also records electrophysiological channels, they present many advantages: they are less expensive, less time-consuming, and more likely to be performed at home. However, their accuracy is limited by missing sleep information. That is why many studies present specific cardio-respiratory parameters to assess the causal effects of sleep stages upon cardiac or respiratory activities. For this paper, we gathered many parameters proposed in literature, leading to 1,111 features. The pulse oximeter, the PneaVoX sensor (recording tracheal sounds), respiratory inductance plethysmography belts, the nasal cannula and the actimeter provided the 112 worthiest ones for automatic sleep scoring. Then, a 3-step model was implemented: classification with a multi-layer perceptron, sleep transition rules corrections (from the AASM guidelines), and sequence corrections using a Viterbi hidden Markov model. The whole process was trained and tested using 300 and 100 independent recordings provided from patients suspected of having sleep breathing disorders. Results indicated that the system achieves substantial agreement with manual scoring for classifications into 2 stages (wake vs. sleep: mean Cohen’s Kappa $\kappa$ of 0.63 and accuracy rate $Acc$ of 87.8%) and 3 stages (wake vs. R stage vs. NREM stage: mean $\kappa$ of 0.60 and $Acc$ of 78.5%). It indicates that the method could provide information to help specialists while diagnosing sleep. The presented model had promising results and may enhance clinical diagnosis. [ABSTRACT FROM AUTHOR]

Automatic sleep staging based on deep learning (DL) has been attracting attention for analyzing sleep quality and determining treatment effects. It is challenging to acquire long-term sleep data from numerous subjects and manually labeling them even though most DL-based models are trained using large-scale sleep data to provide state-of-the-art performance. One way to overcome this data shortage is to create a pre-trained network with an existing large-scale dataset (source domain) that is applicable to small cohorts of datasets (target domain); however, discrepancies in data distribution between the domains prevent successful refinement of this approach. In this paper, we propose an unsupervised domain adaptation method for sleep staging networks to reduce discrepancies by re-aligning the domains in the same space and producing domain-invariant features. Specifically, in addition to a classical domain discriminator, we introduce local discriminators - subject and stage - to maintain the intrinsic structure of sleep data to decrease local misalignments while using adversarial learning to play a minimax game between the feature extractor and discriminators. Moreover, we present several optimization schemes during training because the conventional adversarial learning is not effective to our training scheme. We evaluate the performance of the proposed method by examining the staging performances of a baseline network compared with direct transfer (DT) learning in various conditions. The experimental results demonstrate that the proposed domain adaptation significantly improves the performance though it needs no labeled sleep data in target domain. [ABSTRACT FROM AUTHOR]

In this paper, we introduce a new variation of the Convolutional Neural Network Inception block, called Sinc, for sleep stage classification in premature newborn babies using electroencephalogram (EEG). In practice, there are many medical centres where only a limited number of EEG channels are recorded. Existing automated algorithms mainly use multi-channel EEGs which perform poorly when fewer numbers of channels are available. The proposed Sinc utilizes multi-scale analysis to place emphasis on the temporal EEG information to be less dependent on the number of EEG channels. In Sinc, we increase the receptive fields through Inception while by additionally sharing the filters that have similar receptive fields, overfitting is controlled and the number of trainable parameters dramatically reduced. To train and test this model, 96 longitudinal EEG recordings from 26 premature infants are used. The Sinc-based model significantly outperforms state-of-the-art neonatal quiet sleep detection algorithms, with mean Kappa 0.77 ± 0.01 (with 8-channel EEG) and 0.75 ± 0.01 (with a single bipolar channel EEG). This is the first study using Inception-based networks for EEG analysis that utilizes filter sharing to improve efficiency and trainability. The suggested network can successfully detect quiet sleep stages with even a single EEG channel making it more practical especially in the hospital setting where cerebral function monitoring is predominantly used. [ABSTRACT FROM AUTHOR]

Objective: Nocturnal recordings of heart rate and respiratory rate usually require several separate sensors or electrodes attached to different body parts – a disadvantage for at-home screening tests and for large cohort studies. In this paper, we demonstrate that a state-of-the-art accelerometer placed at subjects’ wrists can be used to derive reliable signal reconstructions of heartbeat (pulse wave intervals) and respiration during sleep. Methods: Based on 226 full-night recordings, we evaluate the performance of our signal reconstruction methodology with respect to polysomnography. We use a phase synchronization analysis metrics that considers individual heartbeats or breaths. Results: The quantitative comparison reveals that pulse-wave signal reconstructions are generally better than respiratory signal reconstructions. The best quality is achieved during deep sleep, followed by light sleep N2 and REM sleep. In addition, a suggested internal evaluation of multiple derived reconstructions can be used to identify time periods with highly reliable signals, particularly for pulse waves. Furthermore, we find that pulse-wave reconstructions are hardly affected by apnea and hypopnea events. Conclusion: During sleep, pulse wave and respiration signals can simultaneously be reconstructed from the same accelerometer recording at the wrist without the need for additional sensors. Reliability can be increased by internal evaluation if the reconstructed signals are not needed for the whole sleep duration. Significance: The presented methodology can help to determine sleep characteristics and improve diagnostics and treatment of sleep disorders in the subjects’ normal sleep environment. [ABSTRACT FROM AUTHOR]

The scoring of sleep stages is an essential part of sleep studies. The main objective of this research is to provide an algorithm for the automatic classification of sleep stages using signals that may be obtained in a non-obtrusive way. After reviewing the relevant research, the authors selected a multinomial logistic regression as the basis for their approach. Several parameters were derived from movement and breathing signals, and their combinations were investigated to develop an accurate and stable algorithm. The algorithm was implemented to produce successful results: the accuracy of the recognition of Wake/NREM/REM stages is equal to 73%, with Cohen's kappa of 0.44 for the analyzed 19324 sleep epochs of 30 seconds each. This approach has the advantage of using the only movement and breathing signals, which can be recorded with less effort than heart or brainwave signals, and requiring only four derived parameters for the calculations. Therefore, the new system is a significant improvement for non-obtrusive sleep stage identification compared to existing approaches. [ABSTRACT FROM AUTHOR]

The design of methods for inference from time sequences has traditionally relied on statistical models that describe the relation between a latent desired sequence and the observed one. A broad family of model-based algorithms have been derived to carry out inference at controllable complexity using recursive computations over the factor graph representing the underlying distribution. An alternative model-agnostic approach utilizes machine learning (ML) methods. Here we propose a framework that combines model-based algorithms and data-driven ML tools for stationary time sequences. In the proposed approach, neural networks are developed to separately learn specific components of a factor graph describing the distribution of the time sequence, rather than the complete inference task. By exploiting stationary properties of this distribution, the resulting approach can be applied to sequences of varying temporal duration. Learned factor graphs can be realized using compact neural networks that are trainable using small training sets, or alternatively, be used to improve upon existing deep inference systems. We present an inference algorithm based on learned stationary factor graphs, which learns to implement the sum-product scheme from labeled data, and can be applied to sequences of different lengths. Our experimental results demonstrate the ability of the proposed learned factor graphs to learn from small training sets to carry out accurate inference for sleep stage detection using the Sleep-EDF dataset, as well as for symbol detection in digital communications with unknown channels. [ABSTRACT FROM AUTHOR]

This paper provides a comprehensive review of available technologies for measurements of vital physiology related parameters that cause sleep disordered breathing (SDB). SDB is a chronic disease that may lead to several health problems and increase the risk of high blood pressure and even heart attack. Therefore, the diagnosis of SDB at an early stage is very important. The essential primary step before diagnosis is measurement. Vital health parameters related to SBD might be measured through invasive or non-invasive methods. Nowadays, with respect to increase in aging population, improvement in home health management systems is needed more than even a decade ago. Moreover, traditional health parameter measurement techniques such as polysomnography are not comfortable and introduce additional costs to the consumers. Therefore, in modern advanced self-health management devices, electronics and communication science are combined to provide appliances that can be used for SDB diagnosis, by monitoring a patient’s physiological parameters with more comfort and accuracy. Additionally, development in machine learning algorithms provides accurate methods of analysing measured signals. This paper provides a comprehensive review of measurement approaches, data transmission, and communication networks, alongside machine learning algorithms for sleep stage classification, to diagnose SDB. [ABSTRACT FROM AUTHOR]

Sleep stage classification is critical for diagnosing sleep quality. While deep neural networks are becoming popular for automatic sleep stage classification with supervised learning, large-scale labeled datasets are still hard to acquire. Recently, self-supervised learning (SSL) has become one of the most prominent approaches to alleviate the burden of labeling works. However, existing SSL methods are mainly designed for non-temporally correlated data and only learning representations from an instance level. Hence, the objective of this paper is to learn robust and generalizable representations for physiological signals with self-supervised learning. Specifically, we make the following contributions: (1) we propose a novel co-training scheme by exploiting complementary information from multiple views (time view and frequency view) of physiological signals to mine more positive samples, which overcomes the drawback of popular InfoNCE and achieves semantic-level representation learning; (2) we extend our framework with a memory module, implemented by a queue and a moving-averaged encoder, to enlarge the pool of negative candidates and keep the up-to-date representation; (3) extensive experiments conducted on sleep stage classification demonstrate state-of-the-art performance compared with SSL baselines, achieving 71.6% and 57.9% accuracies on two sleep datasets, SleepEDF and ISRUC respectively. The code is publicly available at https://github.com/larryshaw0079/CoSleep. [ABSTRACT FROM AUTHOR]

Manual scoring of sleep stages from polysomnography (PSG) records is essential to understand the sleep quality and architecture. Since the PSG requires specialized personnel, a lab environment, and uncomfortable sensors, non-contact sleep staging methods based on machine learning techniques have been investigated over the past years. In this study, we propose an attention-based bidirectional long short-term memory (Attention Bi-LSTM) model for automatic sleep stage scoring using an impulse-radio ultra-wideband (IR-UWB) radar which can remotely detect vital signs. Sixty-five young (30.0 ± 8.6 yrs.) and healthy volunteers underwent nocturnal PSG and IR-UWB radar measurement simultaneously; From 51 recordings, 26 were used for training, 8 for validation, and 17 for testing. Sixteen features including movement-, respiration-, and heart rate variability-related indices were extracted from the raw IR-UWB signals in each 30-s epoch. Sleep stage classification performances of Attention Bi-LSTM model with optimized hyperparameters were evaluated and compared with those of conventional LSTM networks for same test dataset. In the results, we achieved an accuracy of 82.6 ± 6.7% and a Cohen's kappa coefficient of 0.73 ± 0.11 in the classification of wake stage, REM sleep, light (N1+N2) sleep, and deep (N3) sleep which is significantly higher than the conventional LSTM networks (p < 0.01). Moreover, the classification performances were higher than those reported in comparative studies, demonstrating the effectiveness of the attention mechanism coupled with bi-LSTM networks for the sleep staging using cardiorespiratory signals. [ABSTRACT FROM AUTHOR]

Deep learning is widely used in the most recent automatic sleep scoring algorithms. Its popularity stems from its excellent performance and from its ability to process raw signals and to learn feature directly from the data. Most of the existing scoring algorithms exploit very computationally demanding architectures, due to their high number of training parameters, and process lengthy time sequences in input (up to 12 minutes). Only few of these architectures provide an estimate of the model uncertainty. In this study we propose DeepSleepNet-Lite, a simplified and lightweight scoring architecture, processing only 90-seconds EEG input sequences. We exploit, for the first time in sleep scoring, the Monte Carlo dropout technique to enhance the performance of the architecture and to also detect the uncertain instances. The evaluation is performed on a single-channel EEG Fpz-Cz from the open source Sleep-EDF expanded database. DeepSleepNet-Lite achieves slightly lower performance, if not on par, compared to the existing state-of-the-art architectures, in overall accuracy, macro F1-score and Cohen’s kappa (on Sleep-EDF v1-2013 ±30mins: 84.0%, 78.0%, 0.78; on Sleep-EDF v2-2018 ±30mins: 80.3%, 75.2%, 0.73). Monte Carlo dropout enables the estimate of the uncertain predictions. By rejecting the uncertain instances, the model achieves higher performance on both versions of the database (on Sleep-EDF v1-2013 ±30mins: 86.1.0%, 79.6%, 0.81; on Sleep-EDF v2-2018 ±30mins: 82.3%, 76.7%, 0.76). Our lighter sleep scoring approach paves the way to the application of scoring algorithms for sleep analysis in real-time. [ABSTRACT FROM AUTHOR]

Sleep stage classification is essential for sleep assessment and disease diagnosis. Although previous attempts to classify sleep stages have achieved high classification performance, several challenges remain open: 1) How to effectively utilize time-varying spatial and temporal features from multi-channel brain signals remains challenging. Prior works have not been able to fully utilize the spatial topological information among brain regions. 2) Due to the many differences found in individual biological signals, how to overcome the differences of subjects and improve the generalization of deep neural networks is important. 3) Most deep learning methods ignore the interpretability of the model to the brain. To address the above challenges, we propose a multi-view spatial-temporal graph convolutional networks (MSTGCN) with domain generalization for sleep stage classification. Specifically, we construct two brain view graphs for MSTGCN based on the functional connectivity and physical distance proximity of the brain regions. The MSTGCN consists of graph convolutions for extracting spatial features and temporal convolutions for capturing the transition rules among sleep stages. In addition, attention mechanism is employed for capturing the most relevant spatial-temporal information for sleep stage classification. Finally, domain generalization and MSTGCN are integrated into a unified framework to extract subject-invariant sleep features. Experiments on two public datasets demonstrate that the proposed model outperforms the state-of-the-art baselines. [ABSTRACT FROM AUTHOR]

Insomnia affects millions of people worldwide, and non-pharmacological treatment options are limited. A bed excited with multiple vibration sources was used to explore beat frequency vibration (BFV) as a non-pharmacological treatment for insomnia. A repeated measures design pilot study of 14 participants with mild-moderate insomnia symptom severity (self-reported on the Insomnia Severity Index) was conducted to determine the effects of BFV, and traditional standing wave vibration (SWV) on sleep latency and sleep electrocortical activity. Participants were monitored using high-density electroencephalography (HD-EEG). Sleep latency was compared between treatment conditions. A trend of decreasing sleep latency due to BFV was found for unequivocal sleep latency (p ≤ 0.068). Neural complexity during wake, N1, and N2 stages were compared using Multi-Scale Sample Entropy (MSE), which demonstrated significantly lower MSE between wake and N2 stages (p ≤ 0.002). During N2 sleep, BFV showed lower MSE than the control session in the left frontoparietal region. As a measure of information integration, reduced entropy may indicate that BFV decreases conscious awareness during deeper stages of sleep. SWV caused reduced alpha activity and increased delta activity during wake. BFV caused increased delta activity during N2 sleep. These preliminary results suggest that BFV may help decrease sleep latency, reduce conscious awareness, and increase sleep drive expression during deeper stages of sleep. SWV may be beneficial for decreasing expression of arousal and increasing expression of sleep drive during wake, implying that beat frequency vibration may be beneficial to sleep. [ABSTRACT FROM AUTHOR]

Automatic sleep stage mymargin classification is of great importance to measure sleep quality. In this paper, we propose a novel attention-based deep learning architecture called AttnSleep to classify sleep stages using single channel EEG signals. This architecture starts with the feature extraction module based on multi-resolution convolutional neural network (MRCNN) and adaptive feature recalibration (AFR). The MRCNN can extract low and high frequency features and the AFR is able to improve the quality of the extracted features by modeling the inter-dependencies between the features. The second module is the temporal context encoder (TCE) that leverages a multi-head attention mechanism to capture the temporal dependencies among the extracted features. Particularly, the multi-head attention deploys causal convolutions to model the temporal relations in the input features. We evaluate the performance of our proposed AttnSleep model using three public datasets. The results show that our AttnSleep outperforms state-of-the-art techniques in terms of different evaluation metrics. Our source codes, experimental data, and supplementary materials are available at https://github.com/emadeldeen24/AttnSleep. [ABSTRACT FROM AUTHOR]

Traditional sleep staging with non-overlapping 30-second epochs overlooks multiple sleep-wake transitions. We aimed to overcome this by analyzing the sleep architecture in more detail with deep learning methods and hypothesized that the traditional sleep staging underestimates the sleep fragmentation of obstructive sleep apnea (OSA) patients. To test this hypothesis, we applied deep learning-based sleep staging to identify sleep stages with the traditional approach and by using overlapping 30-second epochs with 15-, 5-, 1-, or 0.5-second epoch-to-epoch duration. A dataset of 446 patients referred for polysomnography due to OSA suspicion was used to assess differences in the sleep architecture between OSA severity groups. The amount of wakefulness increased while REM and N3 decreased in severe OSA with shorter epoch-to-epoch duration. In other OSA severity groups, the amount of wake and N1 decreased while N3 increased. With the traditional 30-second epoch-to-epoch duration, only small differences in sleep continuity were observed between the OSA severity groups. With 1-second epoch-to-epoch duration, the hazard ratio illustrating the risk of fragmented sleep was 1.14 (p = 0.39) for mild OSA, 1.59 (p < 0.01) for moderate OSA, and 4.13 (p < 0.01) for severe OSA. With shorter epoch-to-epoch durations, total sleep time and sleep efficiency increased in the non-OSA group and decreased in severe OSA. In conclusion, more detailed sleep analysis emphasizes the highly fragmented sleep architecture in severe OSA patients which can be underestimated with traditional sleep staging. The results highlight the need for a more detailed analysis of sleep architecture when assessing sleep disorders. [ABSTRACT FROM AUTHOR]

Background: Despite recent significant progress in the development of automatic sleep staging methods, building a good model still remains a big challenge for sleep studies with a small cohort due to the data-variability and data-inefficiency issues. This work presents a deep transfer learning approach to overcome these issues and enable transferring knowledge from a large dataset to a small cohort for automatic sleep staging. Methods: We start from a generic end-to-end deep learning framework for sequence-to-sequence sleep staging and derive two networks as the means for transfer learning. The networks are first trained in the source domain (i.e. the large database). The pretrained networks are then finetuned in the target domain (i.e. the small cohort) to complete knowledge transfer. We employ the Montreal Archive of Sleep Studies (MASS) database consisting of 200 subjects as the source domain and study deep transfer learning on three different target domains: the Sleep Cassette subset and the Sleep Telemetry subset of the Sleep-EDF Expanded database, and the Surrey-cEEGrid database. The target domains are purposely adopted to cover different degrees of data mismatch to the source domains. Results: Our experimental results show significant performance improvement on automatic sleep staging on the target domains achieved with the proposed deep transfer learning approach. Conclusions: These results suggest the efficacy of the proposed approach in addressing the above-mentioned data-variability and data-inefficiency issues. Significance: As a consequence, it would enable one to improve the quality of automatic sleep staging models when the amount of data is relatively small. 1 The source code and the pretrained models are published at https://github.com/pquochuy/sleep_transfer_learning. [ABSTRACT FROM AUTHOR]

Sleep is indispensable for humans to maintain normal life activities. Sex and individual differences in sleep patterns and quality of sleep cannot be ignored. Nevertheless, the overall population generalities and sex- or individual- differences in cerebral cortical functional connectivity (FC) during sleep have not been well described. Here, we evaluated the characteristic patterns of FC based on whole-night sleep electroencephalography (EEG) recordings. An improved weighted phase lag index (WPLI) algorithm was applied to obtain the FC in delta (0.5-4Hz), theta (4-8Hz), alpha (8-12Hz) and beta band (12-32Hz). FC strength, short-term stability and inter-regional imbalance of FC were studied. We found that the variations in FC-related parameters among sleep stages had overall population commonalities, and these parameters also showed stage- and frequency band-dependent sex differences. With the deepening of no-rapid eye movement (NREM), increased delta and beta FC strength were observed. Rapid eye movement (REM) showed weaker FC strength, higher FC stability, and higher anterior-posterior FC anisotropy than NREM in beta band. Meanwhile, females exhibited higher sleep EEG synchronization and higher delta FC stability in deep NREM sleep than males. Moreover, the dominant hemisphere in terms of FC did not show group generality or stage- and frequency-dependence. Our results add to the understanding of sleep staging function and may provide clues to sex differences in sleep patterns and quality as well as the prevalence and clinical manifestations of sleep-related illness. Short-term stability offers a new perspective in analyzing FC, which cannot be ignored.

Objective: We investigated the nature of interactions between the central nervous system (CNS) and the cardiorespiratory system during sleep. Methods: Overnight polysomnography recordings were obtained from 33 healthy individuals. The relative spectral powers of five frequency bands, three ECG morphological features and respiratory rate were obtained from six EEG channels, ECG, and oronasal airflow, respectively. The synchronous feature series were interpolated to 1 Hz to retain the high time-resolution required to detect rapid physiological variations. CNS-cardiorespiratory interaction networks were built for each EEG channel and a directionality analysis was conducted using multivariate transfer entropy. Finally, the difference in interaction between Deep, Light, and REM sleep (DS, LS, and REM) was studied. Results: Bidirectional interactions existed in central-cardiorespiratory networks, and the dominant direction was from the cardiorespiratory system to the brain during all sleep stages. Sleep stages had evident influence on these interactions, with the strength of information transfer from heart rate and respiration rate to the brain gradually increasing with the sequence of REM, LS, and DS. Furthermore, the occipital lobe appeared to receive the most input from the cardiorespiratory system during LS. Finally, different ECG morphological features were found to be involved with various central-cardiac and cardiac-respiratory interactions. Conclusion: These findings reveal detailed information regarding CNS-cardiorespiratory interactions during sleep and provide new insights into understanding of sleep control mechanisms. Significance: Our approach may facilitate the investigation of the pathological cardiorespiratory complications of sleep disorders. [ABSTRACT FROM AUTHOR]

As an effective method, feature selection can reduce computational complexity and improve classification performance. A number of criteria exist for feature selection using labeled data, unlabeled data and pairwise constraints, most of which are based on the Euclidean distance. In this paper, we propose a filter method for feature selection with pairwise constraints, aiming to jointly evaluate a feature subset based on metric learning. Two criteria are designed based on the well-known Kullback-Leibler divergence for measuring the difference between must-link constraints and cannot-link constraints that can indicate the feature subset discrimination based on Keep It Simple and Straightforward (KISS) metric learning and Cross-view Quadratic Discriminant Analysis (XQDA) metric learning. To address the challenging feature selection problem, we formulate a sequential search algorithm guided by indicators that are simplified from the proposed criteria. Furthermore, we conducted several experiments on sleep staging based on electroencephalogram (EEG) recordings from the Sleep-EDF Database Expanded. The experimental results demonstrate the effectiveness of the proposed method compared with nine representative feature selection methods. On the data set from healthy volunteers and the data set from volunteers that had mild difficulty falling asleep, the classification average accuracies achieve 97.66% and 93.57% by using the proposed method, respectively. [ABSTRACT FROM AUTHOR]

We present the model, design, and implementation of SMARS, the first practical Sleep Monitoring system that exploits Ambient Radio Signals to recognize sleep stages and assess sleep quality. This will enable a future smart home that monitors daily sleep in a ubiquitous, non-invasive and contactless manner, without instrumenting the subject's body or the bed. The key enabler underlying SMARS is a statistical model that accounts for all reflecting and scattering multipaths, allowing highly accurate and instantaneous breathing estimation with best-ever performance achieved on commodity devices. On this basis, SMARS then recognizes different sleep stages, including wake, rapid eye movement (REM), and non-REM (NREM), which was previously only possible with dedicated hardware. We implement a real-time system on commercial WiFi chipsets and deploy it in 6 homes, resulting in 32 nights of data in total. Our results demonstrate that SMARS yields a median absolute error of 0.47 breaths per minute (BPM) and a 95 percent-tile error of only 2.92 BPM for breathing estimation, and detects breathing robustly even when a person is 10 meters away from the link, or behind a wall. SMARS achieves a sleep staging accuracy of 88 percent, outperforming the prevalent unobtrusive commodity solutions using bed sensor or UWB radar. The performance is also validated upon a public sleep dataset of 20 patients. By achieving promising results with merely a single commodity RF link, we believe that SMARS will set the stage for a practical in-home sleep monitoring solution. [ABSTRACT FROM AUTHOR]

Sleep stage scoring is the first step towards quantitative analysis of sleep using polysomnography (PSG) recordings. However, although PSG is a gold standard method for assessing sleep, it is obtrusive and difficult to apply for long-term sleep monitoring. Further, because human experts manually classify sleep stages, it is time-consuming and exhibits inter-rater variability. Therefore, this article proposes a long short-term memory (LSTM) model for automatic sleep stage scoring using a polyvinylidene fluoride (PVDF) film sensor that can provide unconstrained long-term physiological monitoring. Signals were recorded using a PVDF sensor during PSG. From 60 recordings, 30 were used for training, 10 for validation, and 20 for testing. Sixteen parameters, including movement, respiration-related, and heart rate variability, were extracted from the recorded signals and then normalized. From the selected LSTM architecture, four sleep stage classification performances were evaluated for a test dataset and the results were compared with those of conventional machine learning methods. According to epoch-by-epoch (30 s) analysis, the classification performance for the four sleep stages had an average accuracy of 73.9% and a Cohen's kappa coefficient of 0.55. When compared with other machine learning methods, the proposed method achieved the highest classification performance. The use of LSTM networks with the PVDF film sensor has potential for facilitating automatic sleep scoring, and it can be applied for long-term sleep monitoring at home. [ABSTRACT FROM AUTHOR]

Sleep staging is to score the sleep state of a subject into different sleep stages such as Wake and Rapid Eye Movement (REM). It plays an indispensable role in the diagnosis and treatment of sleep disorders. As manual sleep staging through well-trained sleep experts is time consuming, tedious, and subjective, many automatic methods have been developed for accurate, efficient, and objective sleep staging. Recently, deep learning based methods have been successfully proposed for electroencephalogram (EEG) based sleep staging with promising results. However, most of these methods directly take EEG raw signals as input of convolutional neural networks (CNNs) without considering the domain knowledge of EEG staging. Apart from that, to capture temporal information, most of the existing methods utilize recurrent neural networks such as LSTM (Long Short Term Memory) which are not effective for modelling global temporal context and difficult to train. Therefore, inspired by the clinical guidelines of sleep staging such as AASM (American Academy of Sleep Medicine) rules where different stages are generally characterized by EEG waveforms of various frequencies, we propose a multi-scale deep architecture by decomposing an EEG signal into different frequency bands as input to CNNs. To model global temporal context, we utilize the multi-head self-attention module of the transformer model to not only improve performance, but also shorten the training time. In addition, we choose residual based architecture which makes training end-to-end. Experimental results on two widely used sleep staging datasets, Montreal Archive of Sleep Studies (MASS) and sleep-EDF datasets, demonstrate the effectiveness and significant efficiency (up to 12 times less training time) of our proposed method over the state-of-the-art. [ABSTRACT FROM AUTHOR]

Sleep stage classification constitutes an important element of sleep disorder diagnosis. It relies on the visual inspection of polysomnography records by trained sleep technologists. Automated approaches have been designed to alleviate this resource-intensive task. However, such approaches are usually compared to a single human scorer annotation despite an inter-rater agreement of about 85% only. The present study introduces two publicly-available datasets, DOD-H including 25 healthy volunteers and DOD-O including 55 patients suffering from obstructive sleep apnea (OSA). Both datasets have been scored by 5 sleep technologists from different sleep centers. We developed a framework to compare automated approaches to a consensus of multiple human scorers. Using this framework, we benchmarked and compared the main literature approaches to a new deep learning method, SimpleSleepNet, which reach state-of-the-art performances while being more lightweight. We demonstrated that many methods can reach human-level performance on both datasets. SimpleSleepNet achieved an F1 of 89.9% vs 86.8% on average for human scorers on DOD-H, and an F1 of 88.3% vs 84.8% on DOD-O. Our study highlights that state-of-the-art automated sleep staging outperforms human scorers performance for healthy volunteers and patients suffering from OSA. Considerations could be made to use automated approaches in the clinical setting. [ABSTRACT FROM AUTHOR]

Automatic sleep staging methods usually extract hand-crafted features or network trained features from signals recorded by polysomnography (PSG), and then estimate the stages by various classifiers. In this study, we propose a classification approach based on a hierarchical neural network to process multi-channel PSG signals for improving the performance of automatic five-class sleep staging. The proposed hierarchical network contains two stages: comprehensive feature learning stage and sequence learning stage. The first stage is used to obtain the feature matrix by fusing the hand-crafted features and network trained features. A multi-flow recurrent neural network (RNN) as the second stage is utilized to fully learn temporal information between sleep epochs and fine-tune the parameters in the first stage. The proposed model was evaluated by 147 full night recordings in a public sleep database, the Montreal Archive of Sleep Studies (MASS). The proposed approach can achieve the overall accuracy of 0.878, and the F1-score is 0.818. The results show that the approach can achieve better performance compared to the state-of-the-art methods. Ablation experiment and model analysis proved the effectiveness of different components of the proposed model. The proposed approach allows automatic sleep stage classification by multi-channel PSG signals with different criteria standards, signal characteristics, and epoch divisions, and it has the potential to exploit sleep information comprehensively. [ABSTRACT FROM AUTHOR]

Respiratory sound is able to differentiate sleep stages and provide a non-contact and cost-effective solution for the diagnosis and treatment monitoring of sleep-related diseases. While most of the existing respiratory sound-based methods focus on a limited number of sleep stages such as sleep/wake and wake/rapid eye movement (REM)/non-REM, it is essential to detect sleep stages at a finer level for sleep quality evaluation. In this paper, we for the first time study a sleep stage detection method aiming at classifying sleep states into four sleep stages: wake, REM, light sleep, and deep sleep from the respiratory sound. In addition to extracting time-domain features, frequency-domain features of respiratory sound, non-linear features of snoring sound are devised to better characterize snoring-related signals of respiratory sound. To effectively fuse the three sets of features, a novel feature fusion technique combining the generalized canonical correlation analysis with the ReliefF algorithm is proposed for discriminative feature selection. Final stage detection is achieved with popular classifiers including decision tree, support vector machines, K-nearest neighbor, and the ensemble classifier. To evaluate our proposed method, we built an in-house dataset, which is comprised of 13 nights of sleep audio data from a sleep laboratory. Experimental results indicate that our proposed method outperforms the existing related ones and is promising for large-scale non-contact sleep monitoring. [ABSTRACT FROM AUTHOR]

Objective: Advances in sensor miniaturization and computational power have served as enabling technologies for monitoring human physiological conditions in real-world scenarios. Sleep disruption may impact neural function, and can be a symptom of both physical and mental disorders. This study proposes wearable in-ear electroencephalography (ear-EEG) for overnight sleep monitoring as a 24/7 continuous and unobtrusive technology for sleep quality assessment in the community. Methods: A total of 22 healthy participants took part in overnight sleep monitoring with simultaneous ear-EEG and conventional full polysomnography recordings. The ear-EEG data were analyzed in the both structural complexity and spectral domains. The extracted features were used for automatic sleep stage prediction through supervized machine learning, whereby the PSG data were manually scored by a sleep clinician. Results: The agreement between automatic sleep stage prediction based on ear-EEG from a single in-ear sensor and the hypnogram based on the full PSG was 74.1% in the accuracy over five sleep stage classification. This is supported by a substantial agreement in the kappa metric (0.61). Conclusion: The in-ear sensor is feasible for monitoring overnight sleep outside the sleep laboratory and also mitigates technical difficulties associated with PSG. It, therefore, represents a 24/7 continuously wearable alternative to conventional cumbersome and expensive sleep monitoring. Significance: The “standardized” one-size-fits-all viscoelastic in-ear sensor is a next generation solution to monitor sleep—this technology promises to be a viable method for readily wearable sleep monitoring in the community, a key to affordable healthcare and future eHealth. [ABSTRACT FROM AUTHOR]

Objective: The goal of this work is to objectively evaluate the effectiveness of responsive (or closed-loop) Vagus nerve stimulation (VNS) therapy in sleep quality in patients with medically refractory epilepsy. Methods: Using quantitative features obtained from electroencephalography, we first developed a new automatic sleep-staging framework that consists of a multi-class support vector machine (SVM) classification, based on a decision tree approach. To train and evaluate the performance of the framework, we used polysomnographic data of 23 healthy subjects from the PhysioBank database where the sleep stages have been visually annotated. We then used the trained classifier to label the sleep stages using data from 22 patients with epilepsy, treated with short term responsive VNS therapy during an epilepsy-monitoring unit visit, one month after VNS implantation, and ten VNS-naïve patients with epilepsy. Results: Application of multi-class SVM classifier to classify the three sleep stages of awake, light sleep + rapid eye movement, and deep sleep achieved a classification accuracy of 90%. Results of the application of this methodology to VNS-treated and VNS-naïve patients revealed that the patients treated with short term responsive VNS therapy showed significant increase in sleep efficiency, and significant decrease in seizures plus interictal epileptiform discharges and awakenings. Conclusion: These results indicate that VNS treatment can reduce the epileptiform activities and thus help in achieving better sleep quality for patients with epilepsy. Significance: The proposed approach can be used to investigate the effect of long-term VNS therapy on sleep quality. [ABSTRACT FROM AUTHOR]

Objective: A multiscale functional clustering approach is proposed to investigate the organization of the epileptic networks during different sleep stages and in relation with the occurrence of seizures. Method: Stereo-electroencephalographic signals from seven pharmaco-resistant epileptic patients (focal cortical dysplasia type II) were analyzed. The discrete wavelet transform provided a multiscale framework on which a data-driven functional clustering procedure was applied, based on multivariate measures of integration and mutual information. The most interacting functional clusters (FCs) within the sampled brain areas were extracted. Results: FCs characterized by strongly integrated activity were observed mostly in the beta and alpha frequency bands, immediately before seizure onset and in deep sleep stages. These FCs generally included the electrodes from the epileptogenic zone. Furthermore, repeatable patterns were found across ictal events in the same patient. Conclusion: In line with previous studies, our findings provide evidence of the important role of beta and alpha activity in seizures generation and support the relation between epileptic activity and sleep stages. Significance: Despite the small number of subjects included in the study, the present results suggest that the proposed multiscale functional clustering approach is a useful tool for the identification of the frequency-dependent mechanisms underlying seizure generation. [ABSTRACT FROM AUTHOR]

Correctly identifying sleep stages is important in diagnosing and treating sleep disorders. This paper proposes a joint classification-and-prediction framework based on convolutional neural networks (CNNs) for automatic sleep staging, and, subsequently, introduces a simple yet efficient CNN architecture to power the framework. Given a single input epoch, the novel framework jointly determines its label (classification) and its neighboring epochs’ labels (prediction) in the contextual output. While the proposed framework is orthogonal to the widely adopted classification schemes, which take one or multiple epochs as contextual inputs and produce a single classification decision on the target epoch, we demonstrate its advantages in several ways. First, it leverages the dependency among consecutive sleep epochs while surpassing the problems experienced with the common classification schemes. Second, even with a single model, the framework has the capacity to produce multiple decisions, which are essential in obtaining a good performance as in ensemble-of-models methods, with very little induced computational overhead. Probabilistic aggregation techniques are then proposed to leverage the availability of multiple decisions. To illustrate the efficacy of the proposed framework, we conducted experiments on two public datasets: Sleep-EDF Expanded (Sleep-EDF), which consists of 20 subjects, and Montreal Archive of Sleep Studies (MASS) dataset, which consists of 200 subjects. The proposed framework yields an overall classification accuracy of 82.3% and 83.6%, respectively. We also show that the proposed framework not only is superior to the baselines based on the common classification schemes but also outperforms existing deep-learning approaches. To our knowledge, this is the first work going beyond the standard single-output classification to consider multitask neural networks for automatic sleep staging. This framework provides avenues for further studies of different neural-network architectures for automatic sleep staging. [ABSTRACT FROM AUTHOR]

Automatic sleep staging has been often treated as a simple classification problem that aims at determining the label of individual target polysomnography epochs one at a time. In this paper, we tackle the task as a sequence-to-sequence classification problem that receives a sequence of multiple epochs as input and classifies all of their labels at once. For this purpose, we propose a hierarchical recurrent neural network named SeqSleepNet (source code is available at http://github.com/pquochuy/SeqSleepNet). At the epoch processing level, the network consists of a filterbank layer tailored to learn frequency-domain filters for preprocessing and an attention-based recurrent layer designed for short-term sequential modeling. At the sequence processing level, a recurrent layer placed on top of the learned epoch-wise features for long-term modeling of sequential epochs. The classification is then carried out on the output vectors at every time step of the top recurrent layer to produce the sequence of output labels. Despite being hierarchical, we present a strategy to train the network in an end-to-end fashion. We show that the proposed network outperforms the state-of-the-art approaches, achieving an overall accuracy, macro F1-score, and Cohen’s kappa of 87.1%, 83.3%, and 0.815 on a publicly available dataset with 200 subjects. [ABSTRACT FROM AUTHOR]

Deep brain stimulation (DBS) is an established treatment for patients with Parkinson’s disease (PD). Sleep disorders are common complications of PD and affected by subthalamic DBS treatment. To achieve more precise neuromodulation, chronicsleepmonitoringand closed-loop DBS toward sleep–wake cycles could potentially be utilized. Local field potential (LFP) signals that are sensed by the DBS electrode could be processed as primary feedback signals. This is the first study to systematically investigate the sleep-stage classification based on LFPs in subthalamic nucleus (STN). With our newly developed recording and transmission system, STN-LFPs were collected from 12 PD patients during wakefulness and nocturnal polysomnography sleep monitoring at one month after DBS implantation. Automatic sleep-stage classificationmodels were built with robust and interpretable machine learning methods (support vector machine and decision tree). The accuracy, sensitivity, selectivity, and specificity of the classification reached high values (above90% at most measures) at group and individual levels. Features extracted in alpha (8–13 Hz), beta (13–35 Hz), and gamma (35–50 Hz) bandswere found to contribute the most to the classification. These results will directly guide the engineering development of implantable sleepmonitoring and closed-loopDBS and pave the way for a better understanding of the STN-LFP sleep patterns. [ABSTRACT FROM AUTHOR]