Optimizing wearable single-channel electroencephalography sleep staging in a heterogeneous sleep-disordered population using transfer learning.

Study Objectives: Although various wearable electroencephalography devices have been developed, performance evaluation of the devices and their associated automated sleep stage classification models is mostly limited to healthy participants. A major barrier for applying automated wearable electroencephalography sleep staging in clinical populations is the need for large-scale data for model training. We therefore investigated transfer learning as a strategy to overcome limited data availability and optimize automated single-channel electroencephalography sleep staging in people with sleep disorders.
Methods: We acquired 52 single-channel frontopolar headband electroencephalography recordings from a heterogeneous sleep-disordered population with concurrent polysomnography (PSG). We compared 3 model training strategies: "pretraining" (ie, training on a larger dataset of 901 conventional PSGs), "training-from-scratch" (ie, training on wearable headband recordings), and "fine-tuning" (ie, training on conventional PSGs, followed by training on headband recordings). Performance was evaluated on all headband recordings using 10-fold cross-validation.
Results: Highest performance for 5-stage classification was achieved with fine-tuning (κ = .778), significantly higher than with pretraining (κ = .769) and with training-from-scratch (κ = .733). No significant differences or systematic biases were observed with clinically relevant sleep parameters derived from PSG. All sleep disorder categories showed comparable performance.
Conclusions: This study emphasizes the importance of leveraging larger available datasets through deep transfer learning to optimize performance with limited data availability. Findings indicate strong similarity in data characteristics between conventional PSG and headband recordings. Altogether, results suggest the combination of the headband, classification model, and training methodology can be viable for sleep monitoring in the heterogeneous clinical population.
Citation: van der Aar JF, van Gilst MM, van den Ende DA, et al. Optimizing wearable single-channel electroencephalography sleep staging in a heterogeneous sleep-disordered population using transfer learning. J Clin Sleep Med. 2025;21(2):315-323.
(© 2025 American Academy of Sleep Medicine.)