Expert-level sleep staging using an electrocardiography-only feed-forward neural network

Reliable classification of sleep stages is crucial in sleep medicine and neuroscience research for providing valuable insights, diagnoses, and understanding of brain states. The current gold standard method for sleep stage classification is polysomnography (PSG). Unfortunately, PSG is an expensive and cumbersome process involving numerous electrodes, often conducted in an unfamiliar clinic and annotated by a professional. Although commercial devices like smartwatches track sleep, their performance is well below PSG. To address these disadvantages, we present a feed-forward neural network that achieves gold-standard levels of agreement using only a single lead of electrocardiography (ECG) data. Specifically, the median five-stage Cohen's kappa is 0.725 on a large, diverse dataset of 5 to 90-year-old subjects. Comparisons with a comprehensive meta-analysis of between-human inter-rater agreement confirm the non-inferior performance of our model. Finally, we developed a novel loss function to align the training objective with Cohen's kappa. Our method offers an inexpensive, automated, and convenient alternative for sleep stage classification-further enhanced by a real-time scoring option. Cardiosomnography, or a sleep study conducted with ECG only, could take expert-level sleep studies outside the confines of clinics and laboratories and into realistic settings. This advancement democratizes access to high-quality sleep studies, considerably enhancing the field of sleep medicine and neuroscience. It makes less-expensive, higher-quality studies accessible to a broader community, enabling improved sleep research and more personalized, accessible sleep-related healthcare interventions.

Using a quadratic parameter sinusoid model to characterize the structure of EEG sleep spindles

Sleep spindles are essentially non-stationary signals that display time and frequency-varying characteristics within their envelope, which makes it difficult to accurately identify its instantaneous frequency and amplitude. To allow a better parameterization of the structure of spindle, we propose modeling spindles using a Quadratic Parameter Sinusoid (QPS). The QPS is well suited to model spindle activity as it utilizes a quadratic representation to capture the inherent duration and frequency variations within spindles. The effectiveness of our proposed model and estimation technique was quantitatively evaluated in parameter determination experiments using simulated spindle-like signals and real spindles in the presence of background EEG. We used the QPS parameters to predict the energy and frequency of spindles with a mean accuracy of 92.34 and 97.73% respectively. We also show that the QPS parameters provide a quantification of the amplitude and frequency variations occurring within sleep spindles that can be observed visually and related to their characteristic "waxing and waning" shape. We analyze the variations in the parameters values to present how they can be used to understand the inter- and intra-participant variations in spindle structure. Finally, we present a comparison of the QPS parameters of spindles and non-spindles, which shows a substantial difference in parameter values between the two classes.

Automated detection of rapid eye movements in children

We present an automated multiple-step tool to identify Rapid Eye Movements (REMs) in the polysomnogram, based on modeling expert criteria. It begins by identifying the polysomnogram segments compatible with REMs presence. On these segments, high-energy REMs are identified. Then, vicinity zones around those REMs are defined, and lesser-energy REMs are sought in these vicinities. This strategy has the advantage that it can detect lesser-energy REMs without increasing much the false positive detections. Signal processing, feature extraction, and fuzzy logic tools are used to achieve the goal. The tool was trained and validated on a database consisting of 20 all-night polysomnogram recordings (160 hr) of healthy ten-year-old children. Preliminary results on the validation set show 85.5% sensitivity and a false positive rate of 16.2%. Our tool works on complete polysomnogram recordings, without the need of preprocessing, prior knowledge of the hypnogram, or noise-free segments selection.