A decision support system for automatic sleep staging from EEG signals using tunable Q-factor wavelet transform and spectral features

A Review on Automated Sleep Study

In recent years, research on automated sleep analysis has witnessed significant growth, reflecting advancements in understanding sleep patterns and their impact on overall health. This review synthesizes findings from an exhaustive analysis of 87 papers, systematically retrieved from prominent databases such as Google Scholar, PubMed, IEEE Xplore, and ScienceDirect. The selection criteria prioritized studies focusing on methods employed, signal modalities utilized, and machine learning algorithms applied in automated sleep analysis. The overarching goal was to critically evaluate the strengths and weaknesses of the proposed methods, shedding light on the current landscape and future directions in sleep research. An in-depth exploration of the reviewed literature revealed a diverse range of methodologies and machine learning approaches employed in automated sleep studies. Notably, K-Nearest Neighbors (KNN), Ensemble Learning Methods, and Support Vector Machine (SVM) emerged as versatile and potent classifiers, exhibiting high accuracies in various applications. However, challenges such as performance variability and computational demands were observed, necessitating judicious classifier selection based on dataset intricacies. In addition, the integration of traditional feature extraction methods with deep structures and the combination of different deep neural networks were identified as promising strategies to enhance diagnostic accuracy in sleep-related studies. The reviewed literature emphasized the need for adaptive classifiers, cross-modality integration, and collaborative efforts to drive the field toward more accurate, robust, and accessible sleep-related diagnostic solutions. This comprehensive review serves as a solid foundation for researchers and practitioners, providing an organized synthesis of the current state of knowledge in automated sleep analysis. By highlighting the strengths and challenges of various methodologies, this review aims to guide future research toward more effective and nuanced approaches to sleep diagnostics.

Machine learning-empowered sleep staging classification using multi-modality signals

The goal is to enhance an automated sleep staging system's performance by leveraging the diverse signals captured through multi-modal polysomnography recordings. Three modalities of PSG signals, namely electroencephalogram (EEG), electrooculogram (EOG), and electromyogram (EMG), were considered to obtain the optimal fusions of the PSG signals, where 63 features were extracted. These include frequency-based, time-based, statistical-based, entropy-based, and non-linear-based features. We adopted the ReliefF (ReF) feature selection algorithms to find the suitable parts for each signal and superposition of PSG signals. Twelve top features were selected while correlated with the extracted feature sets' sleep stages. The selected features were fed into the AdaBoost with Random Forest (ADB + RF) classifier to validate the chosen segments and classify the sleep stages. This study's experiments were investigated by obtaining two testing schemes: epoch-wise testing and subject-wise testing. The suggested research was conducted using three publicly available datasets: ISRUC-Sleep subgroup1 (ISRUC-SG1), sleep-EDF(S-EDF), Physio bank CAP sleep database (PB-CAPSDB), and S-EDF-78 respectively. This work demonstrated that the proposed fusion strategy overestimates the common individual usage of PSG signals.

MVF-SleepNet: Multi-View Fusion Network for Sleep Stage Classification

Sleep stage classification is of great importance in human health monitoring and disease diagnosing. Clinically, visual-inspected classifying sleep into different stages is quite time consuming and highly relies on the expertise of sleep specialists. Many automated models for sleep stage classification have been proposed in previous studies but their performances still exist a gap to the real clinical application. In this work, we propose a novel multi-view fusion network named MVF-SleepNet based on multi-modal physiological signals of electroencephalography (EEG), electrocardiography (ECG), electrooculography (EOG), and electromyography (EMG). To capture the relationship representation among multi-modal physiological signals, we construct two views of Time-frequency images (TF images) and Graph-learned graphs (GL graphs). To learn the spectral-temporal representation from sequentially timed TF images, the combination of VGG-16 and GRU networks is utilized. To learn the spatial-temporal representation from sequentially timed GL graphs, the combination of Chebyshev graph convolution and temporal convolution networks is employed. Fusing the spectral-temporal representation and spatial-temporal representation can further boost the performance of sleep stage classification. A large number of experiment results on the publicly available datasets of ISRUC-S1 and ISRUC-S3 show that the MVF-SleepNet achieves overall accuracy of 0.821, F1 score of 0.802 and Kappa of 0.768 on ISRUC-S1 dataset, and accuracy of 0.841, F1 score of 0.828 and Kappa of 0.795 on ISRUC-S3 dataset. The MVF-SleepNet achieves competitive results on both datasets of ISRUC-S1 and ISRUC-S3 for sleep stage classification compared to the state-of-the-art baselines. The source code of MVF-SleepNet is available on Github (https://github.com/YJPai65/MVF-SleepNet).

An Autonomous Sleep-Stage Detection Technique in Disruptive Technology Environment

Autonomous sleep tracking at home has become inevitable in today's fast-paced world. A crucial aspect of addressing sleep-related issues involves accurately classifying sleep stages. This paper introduces a novel approach PSO-XGBoost, combining particle swarm optimisation (PSO) with extreme gradient boosting (XGBoost) to enhance the XGBoost model's performance. Our model achieves improved overall accuracy and faster convergence by leveraging PSO to fine-tune hyperparameters. Our proposed model utilises features extracted from EEG signals, spanning time, frequency, and time-frequency domains. We employed the Pz-oz signal dataset from the sleep-EDF expanded repository for experimentation. Our model achieves impressive metrics through stratified-K-fold validation on ten selected subjects: 95.4% accuracy, 95.4% F1-score, 95.4% precision, and 94.3% recall. The experiment results demonstrate the effectiveness of our technique, showcasing an average accuracy of 95%, outperforming traditional machine learning classifications. The findings revealed that the feature-shifting approach supplements the classification outcome by 3 to 4 per cent. Moreover, our findings suggest that prefrontal EEG derivations are ideal options and could open up exciting possibilities for using wearable EEG devices in sleep monitoring. The ease of obtaining EEG signals with dry electrodes on the forehead enhances the feasibility of this application. Furthermore, the proposed method demonstrates computational efficiency and holds significant value for real-time sleep classification applications.

A study on feature selection using multi-domain feature extraction for automated k-complex detection

Background

K-complex detection plays a significant role in the field of sleep research. However, manual annotation for electroencephalography (EEG) recordings by visual inspection from experts is time-consuming and subjective. Therefore, there is a necessity to implement automatic detection methods based on classical machine learning algorithms. However, due to the complexity of EEG signal, current feature extraction methods always produce low relevance to k-complex detection, which leads to a great performance loss for the detection. Hence, finding compact yet effective integrated feature vectors becomes a crucially core task in k-complex detection.

Method

In this paper, we first extract multi-domain features based on time, spectral analysis, and chaotic theory. Those features are extracted from a 0.5-s EEG segment, which is obtained using the sliding window technique. As a result, a vector containing twenty-two features is obtained to represent each segment. Next, we explore several feature selection methods and compare their performance in detecting k-complex. Based on the analysis of the selected features, we identify compact features which are fewer than twenty-two features and deemed as relevant and proceeded to the next step. Additionally, three classical classifiers are employed to evaluate the performance of the feature selection models.

Results

The results demonstrate that combining different features significantly improved the k-complex detection performance. The best performance is achieved by applying the feature selection method, which results in an accuracy of 93.03%± 7.34, sensitivity of 93.81%± 5.62%, and specificity 94.13± 5.81, respectively, using a smaller number of the combined feature sets.

Conclusion

The proposed method in this study can serve as an efficient tool for the automatic detection of k-complex, which is useful for neurologists or doctors in the diagnosis of sleep research.

Challenges of Applying Automated Polysomnography Scoring at Scale

Automatic polysomnography analysis can be leveraged to shorten scoring times, reduce associated costs, and ultimately improve the overall diagnosis of sleep disorders. Multiple and diverse strategies have been attempted for implementation of this technology at scale in the routine workflow of sleep centers. The field, however, is complex and presents unsolved challenges in a number of areas. Recent developments in computer science and artificial intelligence are nevertheless closing the gap. Technological advances are also opening new pathways for expanding our current understanding of the domain and its analysis.

A convolutional neural network-based decision support system for neonatal quiet sleep detection

Sleep plays an important role in neonatal brain and physical development, making its detection and characterization important for assessing early-stage development. In this study, we propose an automatic and computationally efficient algorithm to detect neonatal quiet sleep (QS) using a convolutional neural network (CNN). Our study used 38-hours of electroencephalography (EEG) recordings, collected from 19 neonates at Fudan Children's Hospital in Shanghai, China (Approval No. (2020) 22). To train and test the CNN, we extracted 12 prominent time and frequency domain features from 9 bipolar EEG channels. The CNN architecture comprised two convolutional layers with pooling and rectified linear unit (ReLU) activation. Additionally, a smoothing filter was applied to hold the sleep stage for 3 minutes. Through performance testing, our proposed method achieved impressive results, with 94.07% accuracy, 89.70% sensitivity, 94.40% specificity, 79.82% F1-score and a 0.74 kappa coefficient when compared to human expert annotations. A notable advantage of our approach is its computational efficiency, with the entire training and testing process requiring only 7.97 seconds. The proposed algorithm has been validated using leave one subject out (LOSO) validation, which demonstrates its consistent performance across a diverse range of neonates. Our findings highlight the potential of our algorithm for real-time neonatal sleep stage classification, offering a fast and cost-effective solution. This research opens avenues for further investigations in early-stage development monitoring and the assessment of neonatal health.

A RUSBoosted tree method for k-complex detection using tunable Q-factor wavelet transform and multi-domain feature extraction

Background

K-complex detection traditionally relied on expert clinicians, which is time-consuming and onerous. Various automatic k-complex detection-based machine learning methods are presented. However, these methods always suffered from imbalanced datasets, which impede the subsequent processing steps.

New method

In this study, an efficient method for k-complex detection using electroencephalogram (EEG)-based multi-domain features extraction and selection method coupled with a RUSBoosted tree model is presented. EEG signals are first decomposed using a tunable Q-factor wavelet transform (TQWT). Then, multi-domain features based on TQWT are pulled out from TQWT sub-bands, and a self-adaptive feature set is obtained from a feature selection based on the consistency-based filter for the detection of k-complexes. Finally, the RUSBoosted tree model is used to perform k-complex detection.

Results

Experimental outcomes manifest the efficacy of our proposed scheme in terms of the average performance of recall measure, AUC, and F10-score. The proposed method yields 92.41 ± 7.47%, 95.4 ± 4.32%, and 83.13 ± 8.59% for k-complex detection in Scenario 1 and also achieves similar results in Scenario 2.

Comparison to state-of-the-art methods

The RUSBoosted tree model was compared with three other machine learning classifiers [i.e., linear discriminant analysis (LDA), logistic regression, and linear support vector machine (SVM)]. The performance based on the kappa coefficient, recall measure, and F10-score provided evidence that the proposed model surpassed other algorithms in the detection of the k-complexes, especially for the recall measure.

Conclusion

In summary, the RUSBoosted tree model presents a promising performance in dealing with highly imbalanced data. It can be an effective tool for doctors and neurologists to diagnose and treat sleep disorders.

Sleep stage classification in EEG signals using the clustering approach based probability distribution features coupled with classification algorithms

Sleep scoring is one of the primary tasks for the classification of sleep stages in Electroencephalogram (EEG) signals. Manual visual scoring of sleep stages is time-consuming as well as being dependent on the experience of a highly qualified sleep expert. This paper aims to address these issues by developing a new method to automatically classify sleep stages in EEG signals. In this research, a robust method has been presented based on the clustering approach, coupled with probability distribution features, to identify six sleep stages with the use of EEG signals. Using this method, each 30-second EEG signal is firstly segmented into small epochs and then each epoch is divided into 60 sub-segments. Each sub-segment is decomposed into five levels by using a discrete wavelet transform (DWT) to obtain the approximation and detailed coefficient. The wavelet coefficient of each level is clustered using the k-means algorithm. Subsequently, features are extracted based on the probability distribution for each wavelet coefficient. The extracted features then are forwarded to the least squares support vector machine classifier (LS-SVM) to identify sleep stages. Comparisons with several existing methods are also made in this study. The proposed method for the classification of the sleep stages achieves an average accuracy rate of 97.4%. It can be an effective tool for sleep stages classification and can be useful for doctors and neurologists for diagnosing sleep disorders.

An intelligent model involving multi-channels spectrum patterns based features for automatic sleep stage classification

Effective sleep monitoring from electroencephalogram (EEG) signals is meaningful for the diagnosis of sleep disorders, such as sleep Apnea, Insomnia, Snoring, Sleep Hypoventilation, and restless legs syndrome. Hence, developing an automatic sleep stage scoring method based on EEGs has attracted extensive research attention in recent years. The existing methods of sleep stage classification are insufficient to investigate waveform patterns, texture patterns, and temporal transformation of EEG signals, which are most associated with sleep stages scoring. To address these issues, we proposed an intelligence model based on multi-channels texture colour analysis to automatically classify sleep staging. In the proposed model, a short-time Fourier transform is applied to each EEG 30 s segment to convert it into an image form. Then the resulted spectrum image is analysed using Multiple channels Information Local Binary Pattern (MILBP). The extracted information using MILBP is then deployed to differentiate EEG sleep stages. The extracted features are tested, and the most effective ones are used to the represented EEG sleep stages. The selected characteristics are fed to an ensemble classifier integrated with a genetic algorithm which is used to select the optimal weight for each classifier, to classify EEG signal into designated sleep stages. The experimental results on two benchmark sleep datasets showed that the proposed model obtained the best performance compared with several baseline methods, including accuracy of 0.96 and 0.95, and F1-score of 0.94 and 0.93, thus demonstrating the effectiveness of our proposed model.

Scoring sleep with artificial intelligence enables quantification of sleep stage ambiguity: hypnodensity based on multiple expert scorers and auto-scoring

STUDY OBJECTIVES

To quantify the amount of sleep stage ambiguity across expert scorers and to validate a new auto-scoring platform against sleep staging performed by multiple scorers.

METHODS

We applied a new auto-scoring system to three datasets containing 95 PSGs scored by 6-12 scorers, to compare sleep stage probabilities (hypnodensity; i.e. the probability of each sleep stage being assigned to a given epoch) as the primary output, as well as a single sleep stage per epoch assigned by hierarchical majority rule.

RESULTS

The percentage of epochs with 100% agreement across scorers was 46 ± 9%, 38 ± 10% and 32 ± 9% for the datasets with 6, 9, and 12 scorers, respectively. The mean intra-class correlation coefficient between sleep stage probabilities from auto- and manual-scoring was 0.91, representing excellent reliability. Within each dataset, agreement between auto-scoring and consensus manual-scoring was significantly higher than agreement between manual-scoring and consensus manual-scoring (0.78 vs. 0.69; 0.74 vs. 0.67; and 0.75 vs. 0.67; all p < 0.01).

CONCLUSIONS

Analysis of scoring performed by multiple scorers reveals that sleep stage ambiguity is the rule rather than the exception. Probabilities of the sleep stages determined by artificial intelligence auto-scoring provide an excellent estimate of this ambiguity. Compared to consensus manual-scoring, sleep staging derived from auto-scoring is for each individual PSG noninferior to manual-scoring meaning that auto-scoring output is ready for interpretation without the need for manual adjustment.

An automatic sleep-scoring system in elderly women with osteoporosis fractures using frequency localized finite orthogonal quadrature Fejer Korovkin kernels

Healthy sleep signifies a good physical and mental state of the body. However, factors such as inappropriate work schedules, medical complications, and others can make it difficult to get enough sleep, leading to various sleep disorders. The identification of these disorders requires sleep stage classification. Visual evaluation of sleep stages is time intensive, placing a significant strain on sleep experts and prone to human errors. As a result, it is crucial to develop machine learning algorithms to score sleep stages to acquire an accurate diagnosis. Hence, a new methodology for automated sleep stage classification is suggested using machine learning and filtering electroencephalogram (EEG) signals. The national sleep research resource's (NSRR) study of osteoporotic fractures (SOF) dataset comprising 453 subjects' polysomnograph (PSG) data is used in this study. Only two unipolar EEG derivations C4-A1 and C3-A2 are employed individually and jointly in this work. The EEG signals are decomposed into sub-bands using a frequency-localized finite orthogonal quadrature Fejer Korovkin wavelet filter bank. The wavelet-based entropy features are extracted from sub-bands. Subsequently, extracted features are classified using machine learning techniques. Our developed model obtained the highest classification accuracy of 81.3%, using an ensembled bagged trees classifier with a 10-fold cross-validation method and Cohen's Kappa coefficient of 0.72. The proposed model is accurate, dependable, and easy to implement and can be employed as an alternative to a PSG-based system at home with minimal resources. It is also ready to be tested on other EEG data to evaluate the sleep stages of healthy and unhealthy subjects.

Feature Extraction From Single-Channel EEG Using Tsfresh and Stacked Ensemble Approach for Sleep Stage Classification

The smart world under Industry 4.0 is witnessing a notable spurt in sleep disorders and sleep-related issues in patients. Artificial intelligence and IoT are taking a giant leap in connecting sleep patients remotely with healthcare providers. The contemporary single-channel-based monitoring devices play a tremendous role in predicting sleep quality and related issues. Handcrafted feature extraction is a time-consuming job in machine learning-based automatic sleep classification. The proposed single-channel work uses Tsfresh to extract features from both the EEG channels (Pz-oz and Fpz-Cz) of the SEDFEx database individually to realise a single-channel EEG. The adopted mRMR feature selection approach selected 55 features from the extracted 787 features. A stacking ensemble classifier achieved 95%, 94%, 91%, and 88% accuracy using stratified 5-fold validation in 2, 3, 4, and 5 class classification employing healthy subjects data. The outcome of the experiments indicates that Tsfresh is an excellent tool to extract standard features from EEG signals.

A novel approach to automatic sleep stage classification using forehead electrophysiological signals

Background

Sleep stage scoring is very important for the effective diagnosis and intervention of sleep disorders. However, the current automatic sleep staging methods generally have the problems of poor model generalization ability and non-portable acquisition equipment.

Method

In this paper, we propose a novel automatic sleep scoring system based on forehead electrophysiological signals that is more effective and convenient than other systems. We extract 3 channel signals from the forehead, named forehead electroencephalogram 1 (Fh1), forehead electroencephalogram 2 (Fh2), and forehead center electrooculogram (Fhz). Spectral features, statistical features, and entropy features are extracted using the discrete wavelet transform (DWT) method. Light gradient boosting machine (LGB), random forest (RF), and support vector machine (SVM) are employed to classify four stages: awake, light sleep (LS), deep sleep (DS), and rapid eye movement (REM).

Result

The performance of the proposed method is validated using databases of the Sleep-EDFX and our Own-data, which include polysomnograms (PSGs) and forehead signals of 28 subjects. The overall classification accuracy of using the combination of Fh1, Fh2, and Fhz can reach up to 90.25% accuracy with a kappa coefficient of 0.857.

Conclusions

The proposed method could provide state-of-art multichannel sleep stage scoring performance with higher portability. This will facilitate the application of long-term monitoring of sleep quality in the future.

A Deep Transfer Learning Framework for Sleep Stage Classification with Single-Channel EEG Signals

The polysomnogram (PSG) is the gold standard for evaluating sleep quality and disorders. Attempts to automate this process have been hampered by the complexity of the PSG signals and heterogeneity among subjects and recording hardwares. Most of the existing methods for automatic sleep stage scoring rely on hand-engineered features that require prior knowledge of sleep analysis. This paper presents an end-to-end deep transfer learning framework for automatic feature extraction and sleep stage scoring based on a single-channel EEG. The proposed framework was evaluated over the three primary signals recommended by the American Academy of Sleep Medicine (C4-M1, F4-M1, O2-M1) from two data sets that have different properties and are recorded with different hardware. Different Time-Frequency (TF) imaging approaches were evaluated to generate TF representations for the 30 s EEG sleep epochs, eliminating the need for complex EEG signal pre-processing or manual feature extraction. Several training and detection scenarios were investigated using transfer learning of convolutional neural networks (CNN) and combined with recurrent neural networks. Generating TF images from continuous wavelet transform along with a deep transfer architecture composed of a pre-trained GoogLeNet CNN followed by a bidirectional long short-term memory (BiLSTM) network showed the best scoring performance among all tested scenarios. Using 20-fold cross-validation applied on the C4-M1 channel, the proposed framework achieved an average per-class accuracy of 91.2%, sensitivity of 77%, specificity of 94.1%, and precision of 75.9%. Our results demonstrate that without changing the model architecture and the training algorithm, our model could be applied to different single-channel EEGs from different data sets. Most importantly, the proposed system receives a single EEG epoch as an input at a time and produces a single corresponding output label, making it suitable for real time monitoring outside sleep labs as well as to help sleep lab specialists arrive at a more accurate diagnoses.

Single-channel EEG sleep staging based on data augmentation and cross-subject discrepancy alleviation

Automatic sleep stage classification is an effective technology compared to conventional artificial visual inspection in the field of sleep staging. Numerous algorithms based on machine learning and deep learning on single-channel electroencephalogram (EEG) have been proposed in recent years, however, category imbalance and cross-subject discrepancy are still the main factors restricting the accuracy of existing methods. This study proposed an innovative end-to-end neural network to solve these problems, specifically, four data augmentation methods were designed to eliminate category imbalance, and domain adaptation modules were designed for the alignment of marginal distribution, conditional distribution, and channel and spatial level distribution of feature maps, as well as the capture of transferable regions on the feature maps using a transfer attention mechanism. We conducted experiments on two publicly available datasets (Sleep-EDF Database Expanded, 2013 and 2018 version), Cohen's kappa coefficient (k) of 0.77 (Fpz-Cz) and 0.73 (Pz-Oz) were realized on the Sleep-EDF-2013 dataset, and a k of 0.75 (Fpz-Cz) and 0.68 (Pz-Oz) were realized on the Sleep-EDF-2018 dataset. An experiment was also conducted on the dataset drawn from the 2018 Physionet challenge, which containing people with sleep disorders, and a performance improvement was still found. Our comparative experiments with similar studies showed that our model was superior to most other studies, indicating our proposed EEG data augmentation and domain adaptation based cross-subject discrepancy alleviation approach is effective to improve the performance of automatic sleep staging.

A large collection of real-world pediatric sleep studies

Despite being crucial to health and quality of life, sleep-especially pediatric sleep-is not yet well understood. This is exacerbated by lack of access to sufficient pediatric sleep data with clinical annotation. In order to accelerate research on pediatric sleep and its connection to health, we create the Nationwide Children's Hospital (NCH) Sleep DataBank and publish it at Physionet and the National Sleep Research Resource (NSRR), which is a large sleep data common with physiological data, clinical data, and tools for analyses. The NCH Sleep DataBank consists of 3,984 polysomnography studies and over 5.6 million clinical observations on 3,673 unique patients between 2017 and 2019 at NCH. The novelties of this dataset include: (1) large-scale sleep dataset suitable for discovering new insights via data mining, (2) explicit focus on pediatric patients, (3) gathered in a real-world clinical setting, and (4) the accompanying rich set of clinical data. The NCH Sleep DataBank is a valuable resource for advancing automatic sleep scoring and real-time sleep disorder prediction, among many other potential scientific discoveries.

Validation Study on Automated Sleep Stage Scoring Using a Deep Learning Algorithm

Background and Objectives: Polysomnography is manually scored by sleep experts. However, manual scoring is a time-consuming and labor-intensive task. The goal of this study was to verify the accuracy of automated sleep-stage scoring based on a deep learning algorithm compared to manual sleep-stage scoring. Materials and Methods: A total of 602 polysomnography datasets from subjects (Male:Female = 397:205) aged 19 to 65 years (mean age, 43.8, standard deviation = 12.2) were included in the study. The performance of the proposed model was evaluated based on kappa value and bootstrapped point-estimate of median percent agreement with a 95% bootstrap confidence interval and R = 1000. The proposed model was trained using 482 datasets and validated using 48 datasets. For testing, 72 datasets were selected randomly. Results: The proposed model exhibited good concordance rates with manual scoring for stages W (94%), N1 (83.9%), N2 (89%), N3 (92%), and R (93%). The average kappa value was 0.84. For the bootstrap method, high overall agreement between the automated deep learning algorithm and manual scoring was observed in stages W (98%), N1 (94%), N2 (92%), N3 (99%), and R (98%) and total (96%). Conclusions: Automated sleep-stage scoring using the proposed model may be a reliable method for sleep-stage classification.

Automatic sleep scoring with LSTM networks: impact of time granularity and input signals

Supervised automatic sleep scoring algorithms are usually trained using sleep stage labels manually annotated on 30 s epochs of PSG data. In this study, we investigate the impact of using shorter epochs with various PSG input signals for training and testing a Long Short Term Memory (LSTM) neural network. An LSTM model is evaluated on the provided 30 s epoch sleep stage labels from a publicly available dataset, as well as on 10 s subdivisions. Additionally, three independent scorers re-labeled a subset of the dataset on shorter time windows. The automatic sleep scoring experiments were repeated on the re-annotated subset.The highest performance is achieved on features extracted from 30 s epochs of a single channel frontal EEG. The resulting accuracy, precision and recall were of 92.22%, 67.58% and 66.00% respectively. When using a shorter epoch as input, the performance decreased by approximately 20%. Re-annotating a subset of the dataset on shorter time epochs did not improve the results and further altered the sleep stage detection performance. Our results show that our feature-based LSTM classification algorithm performs better on 30 s PSG epochs when compared to 10 s epochs used as input. Future work could be oriented to determining whether varying the epoch size improves classification outcomes for different types of classification algorithms.

Comparison of Time-Frequency Analyzes for a Sleep Staging Application with CNN

Sleep staging is the process of acquiring biological signals during sleep and marking them according to the stages of sleep. The procedure is performed by an experienced physician and takes more time. When this process is automated, the processing load will be reduced and the time required to identify disease will also be reduced. In this paper, 8 different transform methods for automatic sleep-staging based on convolutional neural networks (CNNs) were compared to classify sleep stages using single-channel electroencephalogram (EEG) signals. Five different labels were used to stage the sleep. These are Wake (W), Non Rapid Eye Movement (NonREM)-1 (N1), NonREM-2 (N2), NonREM-3 (N3), and REM (R). The classifications were done end-to-end without any hand-crafted features, ie without requiring any feature engineering. Time-Frequency components obtained by Short Time Fourier Transform, Discrete Wavelet Transform, Discrete Cosine Transform, Hilbert-Huang Transform, Discrete Gabor Transform, Fast Walsh-Hadamard Transform, Choi-Williams Distribution, and Wigner-Willie Distribution were classified with a supervised deep convolutional neural network to perform sleep staging. The discrete Cosine Transform-CNN method (DCT-CNN) showed the highest performance among the methods suggested in this paper with an F1 score of 89% and a value of 0.86 kappa. The findings of this study revealed that the transformation techniques utilized for the most accurate representation of input data are far superior to traditional approaches based on manual feature extraction, which acquires time, frequency, or nonlinear characteristics. The results of this article are expected to be useful to researchers in the development of low-cost, and easily portable devices.

Evaluation of a Single-Channel EEG-Based Sleep Staging Algorithm

Sleep staging is the basis of sleep assessment and plays a crucial role in the early diagnosis and intervention of sleep disorders. Manual sleep staging by a specialist is time-consuming and is influenced by subjective factors. Moreover, some automatic sleep staging algorithms are complex and inaccurate. The paper proposes a single-channel EEG-based sleep staging method that provides reliable technical support for diagnosing sleep problems. In this study, 59 features were extracted from three aspects: time domain, frequency domain, and nonlinear indexes based on single-channel EEG data. Support vector machine, neural network, decision tree, and random forest classifier were used to classify sleep stages automatically. The results reveal that the random forest classifier has the best sleep staging performance among the four algorithms. The recognition rate of the Wake phase was the highest, at 92.13%, and that of the N1 phase was the lowest, at 73.46%, with an average accuracy of 83.61%. The embedded method was adopted for feature filtering. The results of sleep staging of the 11-dimensional features after filtering show that the random forest model achieved 83.51% staging accuracy under the condition of reduced feature dimensions, and the coincidence rate with the use of all features for sleep staging was 94.85%. Our study confirms the robustness of the random forest model in sleep staging, which also represents a high classification accuracy with appropriate classifier algorithms, even using single-channel EEG data. This study provides a new direction for the portability of clinical EEG monitoring.

A lightweight automatic sleep staging method for children using single-channel EEG based on edge artificial intelligence

With the development of telemedicine and edge computing, edge artificial intelligence (AI) will become a new development trend for smart medicine. On the other hand, nearly one-third of children suffer from sleep disorders. However, all existing sleep staging methods are for adults. Therefore, we adapted edge AI to develop a lightweight automatic sleep staging method for children using single-channel EEG. The trained sleep staging model will be deployed to edge smart devices so that the sleep staging can be implemented on edge devices which will greatly save network resources and improving the performance and privacy of sleep staging application. Then the results and hypnogram will be uploaded to the cloud server for further analysis by the physicians to get sleep disease diagnosis reports and treatment opinions. We utilized 1D convolutional neural networks (1D-CNN) and long short term memory (LSTM) to build our sleep staging model, named CSleepNet. We tested the model on our childrens sleep (CS) dataset and sleep-EDFX dataset. For the CS dataset, we experimented with F4-M1 channel EEG using four different loss functions, and the logcosh performed best with overall accuracy of 83.06% and F1-score of 76.50%. We used Fpz-Cz and Pz-Oz channel EEG to train our model in Sleep-EDFX dataset, and achieved an accuracy of 86.41% without manual feature extraction. The experimental results show that our method has great potential. It not only plays an important role in sleep-related research, but also can be widely used in the classification of other time sequences physiological signals.

Hybrid Sleep Stage Classification for Clinical Practices across Different Polysomnography Systems Using Frontal EEG

Automatic bio-signal processing and scoring have been a popular topic in recent years. This includes sleep stage classification, which is time-consuming when carried out by hand. Multiple sleep stage classification has been proposed in recent years. While effective, most of these processes are trained and validated against a singular set of data in uniformed pre-processing, whilst in a clinical environment, polysomnography (PSG) may come from different PSG systems that use different signal processing methods. In this study, we present a generalized sleep stage classification method that uses power spectra and entropy. To test its generality, we first trained our system using a uniform dataset and then validated it against another dataset with PSGs from different PSG systems. We found that the system achieved an accuracy of 0.80 and that it is highly consistent across most PSG records. A few samples of NREM3 sleep were classified poorly, and further inspection showed that these samples lost crucial NREM3 features due to aggressive filtering. This implies that the system’s effectiveness can be evaluated by human knowledge. Overall, our classification system shows consistent performance against PSG records that have been collected from different PSG systems, which gives it high potential in a clinical environment.

Evaluation of Automated Hypnogram Analysis on Multi-Scored Polysomnographies

A new method for automated sleep stage scoring of polysomnographies is proposed that uses a random forest approach to model feature interactions and temporal effects. The model mostly relies on features based on the rules from the American Academy of Sleep Medicine, which allows medical experts to gain insights into the model. A common way to evaluate automated approaches to constructing hypnograms is to compare the one produced by the algorithm to an expert's hypnogram. However, given the same data, two expert annotators will construct (slightly) different hypnograms due to differing interpretations of the data or individual mistakes. A thorough evaluation of our method is performed on a multi-labeled dataset in which both the inter-rater variability as well as the prediction uncertainties are taken into account, leading to a new standard for the evaluation of automated sleep stage scoring algorithms. On all epochs, our model achieves an accuracy of 82.7%, which is only slightly lower than the inter-rater disagreement. When only considering the 63.3% of the epochs where both the experts and algorithm are certain, the model achieves an accuracy of 97.8%. Transition periods between sleep stages are identified and studied for the first time. Scoring guidelines for medical experts are provided to complement the certain predictions by scoring only a few epochs manually. This makes the proposed method highly time-efficient while guaranteeing a highly accurate final hypnogram.

A Novel Sleep Staging Network Based on Data Adaptation and Multimodal Fusion

Sleep staging is one of the important methods to diagnosis and treatment of sleep diseases. However, it is laborious and time-consuming, therefore, computer assisted sleep staging is necessary. Most of the existing sleep staging researches using hand-engineered features rely on prior knowledges of sleep analysis, and usually single channel electroencephalogram (EEG) is used for sleep staging task. Prior knowledge is not always available, and single channel EEG signal cannot fully represent the patient’s sleeping physiological states. To tackle the above two problems, we propose an automatic sleep staging network model based on data adaptation and multimodal feature fusion using EEG and electrooculogram (EOG) signals. 3D-CNN is used to extract the time-frequency features of EEG at different time scales, and LSTM is used to learn the frequency evolution of EOG. The nonlinear relationship between the High-layer features of EEG and EOG is fitted by deep probabilistic network. Experiments on SLEEP-EDF and a private dataset show that the proposed model achieves state-of-the-art performance. Moreover, the prediction result is in accordance with that from the expert diagnosis.

Roza: a new and comprehensive metric for evaluating classification systems

Many metrics such as accuracy rate (ACC), area under curve (AUC), Jaccard index (JI), and Cohen's kappa coefficient are available to measure the success of the system in pattern recognition and machine/deep learning systems. However, the superiority of one system to one other cannot be determined based on the mentioned metrics. This is because such a system can be successful using one metric, but not the other ones. Moreover, such metrics are insufficient when the number of samples in the classes is unequal (imbalanced data). In this case, naturally, by using these metrics, a sensible comparison cannot be made between two given systems. In the present study, the comprehensive, fair, and accurate Roza (Roza means rose in Persian. When different permutations of the metrics used are superimposed in a polygon format, it looks like a flower, so we named it Roza.) metric is introduced for evaluating classification systems. This metric, which facilitates the comparison of systems, expresses the summary of many metrics with a single value. To verify the stability and validity of the metric and to conduct a comprehensive, fair, and accurate comparison between the systems, the Roza metric of the systems tested under the same conditions are calculated and comparisons are made. For this, systems tested with three different strategies on three different datasets are considered. The results show that the performance of the system can be summarized by a single value and the Roza metric can be used in all systems that include classification processes, as a powerful metric.

Home-Use and Real-Time Sleep-Staging System Based on Eye Masks and Mobile Devices with a Deep Learning Model

Purpose

Sleep is an important human activity. Comfortable sensing and accurate analysis in sleep monitoring is beneficial to many healthcare and medical applications. From 2020, owing to the COVID‑19 pandemic that spreads between people when they come into close physical contact with one another, the willingness to go to hospital for receiving care has reduced; care-at-home is the trend in modern healthcare. Therefore, a home-use and real-time sleep-staging system is developed in this paper.

Methods

We developed and implemented a real-time sleep staging system that integrates a wearable eye mask for high-quality electroencephalogram/electrooculogram measurement and a mobile device with MobileNETV2 deep learning model for sleep-stage identification. In the experiments, 25 all-night recordings were acquired, 17 of which were used for training, and the remaining eight were used for testing.

Results

The averaged scoring agreements for the wake, light sleep, deep sleep, and rapid eye movement stages were 85.20%, 87.17%, 82.87%, and 89.30%, respectively, for our system compared with the manual scoring of PSG recordings. In addition, the mean absolute errors of four objective sleep measurements, including sleep efficiency, total sleep time, sleep onset time, and wake after sleep onset time were 1.68%, 7.56 min, 5.50 min, and 3.94 min, respectively. No significant differences were observed between the proposed system and manual PSG scoring in terms of the percentage of each stage and the objective sleep measurements.

Conclusion

These experimental results demonstrate that our system provides high scoring agreements in sleep staging and unbiased sleep measurements owing to the use of EEG and EOG signals and powerful mobile computing based on deep learning networks. These results also suggest that our system is applicable for home-use real-time sleep monitoring.

Automatic Sleep Staging Algorithm Based on Time Attention Mechanism

The most important part of sleep quality assessment is the automatic classification of sleep stages. Sleep staging is helpful in the diagnosis of sleep-related diseases. This study proposes an automatic sleep staging algorithm based on the time attention mechanism. Time-frequency and non-linear features are extracted from the physiological signals of six channels and then normalized. The time attention mechanism combined with the two-way bi-directional gated recurrent unit (GRU) was used to reduce computing resources and time costs, and the conditional random field (CRF) was used to obtain information between tags. After five-fold cross-validation on the Sleep-EDF dataset, the values of accuracy, WF1, and Kappa were 0.9218, 0.9177, and 0.8751, respectively. After five-fold cross-validation on the our own dataset, the values of accuracy, WF1, and Kappa were 0.9006, 0.8991, and 0.8664, respectively, which is better than the result of the latest algorithm. In the study of sleep staging, the recognition rate of the N1 stage was low, and the imbalance has always been a problem. Therefore, this study introduces a type of balancing strategy. By adopting the proposed strategy, SEN-N1 and ACC of 0.7 and 0.86, respectively, can be achieved. The experimental results show that compared to the latest method, the proposed model can achieve significantly better performance and significantly improve the recognition rate of the N1 period. The performance comparison of different channels shows that even when the EEG channel was not used, considerable accuracy can be obtained.

Inter-database validation of a deep learning approach for automatic sleep scoring

STUDY OBJECTIVES

Development 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.

METHODS

A 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.

RESULTS

Best 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.

CONCLUSIONS

Validation 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.

Spindle-AI: Sleep spindle number and duration estimation in infant EEG

OBJECTIVE

Sleep spindle features show developmental changes during infancy and have the potential to provide an early biomarker for abnormal brain maturation. Manual identification of sleep spindles in the electroencephalogram (EEG) is time-consuming and typically requires highly-trained experts. Automated detection of sleep spindles would greatly facilitate this analysis. Research on the automatic detection of sleep spindles in infant EEG has been limited to-date.

METHODS

We present a random forest-based sleep spindle detection method (Spindle-AI) to estimate the number and duration of sleep spindles in EEG collected from 141 ex-term born infants, recorded at 4 months of age. The signal on channel F4-C4 was split into a training set (81 ex-term) and a validation set (30 ex-term). An additional 30 ex-term infant EEGs (channel F4-C4 and channel F3-C3) were used as an independent test set. Fourteen features were selected for input into a random forest algorithm to estimate the number and duration of spindles and the results were compared against sleep spindles annotated by an experienced clinical physiologist.

RESULTS

The prediction of the number of sleep spindles in the independent test set demonstrated 93.3% to 93.9% sensitivity, 90.7% to 91.5% specificity, and 89.2% to 90.1% precision. The duration estimation of sleep spindle events in the independent test set showed a percent error of 5.7% to 7.4%.

CONCLUSION AND SIGNIFICANCE

Spindle-AI has been implemented as a web server that has the potential to assist clinicians in the fast and accurate monitoring of sleep spindles in infant EEGs.

A major depressive disorder classification framework based on EEG signals using statistical, spectral, wavelet, functional connectivity, and nonlinear analysis

BACKGROUND

Major depressive disorder (MDD) is a prevalent mental illness that is diagnosed through questionnaire-based approaches; however, these methods may not lead to an accurate diagnosis. In this regard, many studies have focused on using electroencephalogram (EEG) signals and machine learning techniques to diagnose MDD.

NEW METHOD

This paper proposes a machine learning framework for MDD diagnosis, which uses different types of EEG-derived features. The features are extracted using statistical, spectral, wavelet, functional connectivity, and nonlinear analysis methods. The sequential backward feature selection (SBFS) algorithm is also employed to perform feature selection. Various classifier models are utilized to select the best one for the proposed framework.

RESULTS

The proposed method is validated with a public EEG dataset, including the EEG data of 34 MDD patients and 30 healthy subjects. The evaluation of the proposed framework is conducted using 10-fold cross-validation, providing the metrics such as accuracy (AC), sensitivity (SE), specificity (SP), F1-score (F1), and false discovery rate (FDR). The best performance of the proposed method has provided an average AC of 99%, SE of 98.4%, SP of 99.6%, F1 of 98.9%, and FDR of 0.4% using the support vector machine with RBF kernel (RBFSVM) classifier.

COMPARISON WITH EXISTING METHODS

The obtained results demonstrate that the proposed method outperforms other approaches for MDD classification based on EEG signals.

CONCLUSIONS

According to the obtained results, a highly accurate MDD diagnosis would be provided using the proposed method, while it can be utilized to develop a computer-aided diagnosis (CAD) tool for clinical purposes.

Dimensionality reduction for EEG-based sleep stage detection: comparison of autoencoders, principal component analysis and factor analysis

Methods developed for automatic sleep stage detection make use of large amounts of data in the form of polysomnographic (PSG) recordings to build predictive models. In this study, we investigate the effect of several dimensionality reduction techniques, i.e., principal component analysis (PCA), factor analysis (FA), and autoencoders (AE) on common classifiers, e.g., random forests (RF), multilayer perceptron (MLP), long-short term memory (LSTM) networks, for automated sleep stage detection. Experimental testing is carried out on the MGH Dataset provided in the "You Snooze, You Win: The PhysioNet/Computing in Cardiology Challenge 2018". The signals used as input are the six available (EEG) electoencephalographic channels and combinations with the other PSG signals provided: ECG - electrocardiogram, EMG - electromyogram, respiration based signals - respiratory efforts and airflow. We observe that a similar or improved accuracy is obtained in most cases when using all dimensionality reduction techniques, which is a promising result as it allows to reduce the computational load while maintaining performance and in some cases also improves the accuracy of automated sleep stage detection. In our study, using autoencoders for dimensionality reduction maintains the performance of the model, while using PCA and FA the accuracy of the models is in most cases improved.

Expert-level automated sleep staging of long-term scalp electroencephalography recordings using deep learning

STUDY OBJECTIVES

Develop a high-performing, automated sleep scoring algorithm that can be applied to long-term scalp electroencephalography (EEG) recordings.

METHODS

Using a clinical dataset of polysomnograms from 6,431 patients (MGH-PSG dataset), we trained a deep neural network to classify sleep stages based on scalp EEG data. The algorithm consists of a convolutional neural network for feature extraction, followed by a recurrent neural network that extracts temporal dependencies of sleep stages. The algorithm's inputs are four scalp EEG bipolar channels (F3-C3, C3-O1, F4-C4, and C4-O2), which can be derived from any standard PSG or scalp EEG recording. We initially trained the algorithm on the MGH-PSG dataset and used transfer learning to fine-tune it on a dataset of long-term (24-72 h) scalp EEG recordings from 112 patients (scalpEEG dataset).

RESULTS

The algorithm achieved a Cohen's kappa of 0.74 on the MGH-PSG holdout testing set and cross-validated Cohen's kappa of 0.78 after optimization on the scalpEEG dataset. The algorithm also performed well on two publicly available PSG datasets, demonstrating high generalizability. Performance on all datasets was comparable to the inter-rater agreement of human sleep staging experts (Cohen's kappa ~ 0.75 ± 0.11). The algorithm's performance on long-term scalp EEGs was robust over a wide age range and across common EEG background abnormalities.

CONCLUSION

We developed a deep learning algorithm that achieves human expert level sleep staging performance on long-term scalp EEG recordings. This algorithm, which we have made publicly available, greatly facilitates the use of large long-term EEG clinical datasets for sleep-related research.

Deep Learning in Automatic Sleep Staging With a Single Channel Electroencephalography

This study centers on automatic sleep staging with a single channel electroencephalography (EEG), with some significant findings for sleep staging. In this study, we proposed a deep learning-based network by integrating attention mechanism and bidirectional long short-term memory neural network (AT-BiLSTM) to classify wakefulness, rapid eye movement (REM) sleep and non-REM (NREM) sleep stages N1, N2 and N3. The AT-BiLSTM network outperformed five other networks and achieved an accuracy of 83.78%, a Cohen's kappa coefficient of 0.766 and a macro F1-score of 82.14% on the PhysioNet Sleep-EDF Expanded dataset, and an accuracy of 81.72%, a Cohen's kappa coefficient of 0.751 and a macro F1-score of 80.74% on the DREAMS Subjects dataset. The proposed AT-BiLSTM network even achieved a higher accuracy than the existing methods based on traditional feature extraction. Moreover, better performance was obtained by the AT-BiLSTM network with the frontal EEG derivations than with EEG channels located at the central, occipital or parietal lobe. As EEG signal can be easily acquired using dry electrodes on the forehead, our findings might provide a promising solution for automatic sleep scoring without feature extraction and may prove very useful for the screening of sleep disorders.

A Multi-Class Automatic Sleep Staging Method Based on Photoplethysmography Signals

Automatic sleep staging with only one channel is a challenging problem in sleep-related research. In this paper, a simple and efficient method named PPG-based multi-class automatic sleep staging (PMSS) is proposed using only a photoplethysmography (PPG) signal. Single-channel PPG data were obtained from four categories of subjects in the CAP sleep database. After the preprocessing of PPG data, feature extraction was performed from the time domain, frequency domain, and nonlinear domain, and a total of 21 features were extracted. Finally, the Light Gradient Boosting Machine (LightGBM) classifier was used for multi-class sleep staging. The accuracy of the multi-class automatic sleep staging was over 70%, and the Cohen's kappa statistic k was over 0.6. This also showed that the PMSS method can also be applied to stage the sleep state for patients with sleep disorders.

Sleep-wake stage detection with single channel ECG and hybrid machine learning model in patients with obstructive sleep apnea

Sleep staging is an important step in the diagnosis of obstructive sleep apnea (OSA) and this step is performed by a physician who visually scores the electroencephalography, electrooculography and electromyography signals taken by the polysomnography (PSG) device. The PSG records must be taken by a technician in a hospital environment, this may suggest a drawback. This study aims to develop a new method based on hybrid machine learning with single-channel ECG for sleep-wake detection, which is an alternative to the sleep staging procedure used in hospitals today. For this purpose, the heart rate variability signal was derived using electrocardiography (ECG) signals of 10 OSA patients. Then, QRS components in different frequency bands were obtained from the ECG signal by digital filtering. In this way, nine more signals were obtained in total. 25 features from each of the 9 signals, a total of 225 features have been extracted. Fisher feature selection algorithm and principal component analysis were used to reduce the number of features. Finally, features were classified with decision tree, support vector machines, k-nearest neighborhood algorithm and ensemble classifiers. In addition, the proposed model has been checked with the leave one out method. At the end of the study, it was shown that sleep-wake detection can be performed with 81.35% accuracy with only three features and 87.12% accuracy with 10 features. The sensitivity and specificity values for the 3 features were 0.85 and 0.77, and for 10 features the sensitivity and specificity values were 0.90 and 0.85 respectively. These results suggested that the proposed model could be used to detect sleep-wake stages during the OSA diagnostic process.