An enzyme-inspired specificity in deep learning model for sleep stage classification using multi-channel PSG signals input: Separating training approach and its performance on cross-dataset validation for generalizability.

Numerous automatic sleep stage classification systems have been developed, but none have become effective assistive tools for sleep technicians due to issues with generalization. Four key factors hinder the generalization of these models are instruments, montage of recording, subject type, and scoring manual factors. This study aimed to develop a deep learning model that addresses generalization problems by integrating enzyme-inspired specificity and employing separating training approaches. Subject type and scoring manual factors were controlled, while the focus was on instruments and montage of recording factors. The proposed model consists of three sets of signal-specific models including EEG-, EOG-, and EMG-specific model. The EEG-specific models further include three sets of channel-specific models. All signal-specific and channel-specific models were established with data manipulation and weighted loss strategies, resulting in three sets of data manipulation models and class-specific models, respectively. These models were CNNs. Additionally, BiLSTM models were applied to EEG- and EOG-specific models to obtain temporal information. Finally, classification task for sleep stage was handled by 'the-last-dense' layer. The optimal sampling frequency for each physiological signal was identified and used during the training process. The proposed model was trained on MGH dataset and evaluated using both within dataset and cross-dataset. For MGH dataset, overall accuracy of 81.05 %, MF1 of 79.05 %, Kappa of 0.7408, and per-class F1-scores: W (84.98 %), N1 (58.06 %), N2 (84.82 %), N3 (79.20 %), and REM (88.17 %) can be achieved. Performances on cross-datasets are as follows: SHHS1 200 records reached 79.54 %, 70.56 %, and 0.7078; SHHS2 200 records achieved 76.77 %, 66.30 %, and 0.6632; Sleep-EDF 153 records gained 78.52 %, 72.13 %, and 0.7031; and BCI-MU (local dataset) 94 records achieved 83.57 %, 82.17 %, and 0.7769 for overall accuracy, MF1, and Kappa respectively. Additionally, the proposed model has approximately 9.3 M trainable parameters and takes around 26 s to process one PSG record. The results indicate that the proposed model demonstrates generalizability in sleep stage classification and shows potential as a feasibility tool for real-world applications. Additionally, enzyme-inspired specificity effectively addresses the challenges posed by varying montage of recording, while the identified optimal frequencies mitigate instrument-related issues.

FPJA-Net: A Lightweight End-to-End Network for Sleep Stage Prediction Based on Feature Pyramid and Joint Attention.

Sleep staging is the most crucial work before diagnosing and treating sleep disorders. Traditional manual sleep staging is time-consuming and depends on the skill of experts. Nowadays, automatic sleep staging based on deep learning attracts more and more scientific researchers. As we know, the salient waves in sleep signals contain the most important information for automatic sleep staging. However, the key information is not fully utilized in existing deep learning methods since most of them only use CNN or RNN which could not capture multi-scale features in salient waves effectively. To tackle this limitation, we propose a lightweight end-to-end network for sleep stage prediction based on feature pyramid and joint attention. The feature pyramid module is designed to effectively extract multi-scale features in salient waves, and these features are then fed to the joint attention module to closely attend to the channel and location information of the salient waves. The proposed network has much fewer parameters and significant performance improvement, which is better than the state-of-the-art results. The overall accuracy and macro F1 score on the public dataset Sleep-EDF39, Sleep-EDF153 and SHHS are 90.1%, 87.8%, 87.4%, 84.4% and 86.9%, 83.9%, respectively. Ablation experiments confirm the effectiveness of each module.

A novel deep learning model based on transformer and cross modality attention for classification of sleep stages.

The classification of sleep stages is crucial for gaining insights into an individual's sleep patterns and identifying potential health issues. Employing several important physiological channels in different views, each providing a distinct perspective on sleep patterns, can have a great impact on the efficiency of the classification models. In the context of neural networks and deep learning models, transformers are very effective, especially when dealing with time series data, and have shown remarkable compatibility with sequential data analysis as physiological channels. On the other hand, cross-modality attention by integrating information from multiple views of the data enables to capture relationships among different modalities, allowing models to selectively focus on relevant information from each modality. In this paper, we introduce a novel deep-learning model based on transformer encoder-decoder and cross-modal attention for sleep stage classification. The proposed model processes information from various physiological channels with different modalities using the Sleep Heart Health Study Dataset (SHHS) data and leverages transformer encoders for feature extraction and cross-modal attention for effective integration to feed into the transformer decoder. The combination of these elements increased the accuracy of the model up to 91.33% in classifying five classes of sleep stages. Empirical evaluations demonstrated the model's superior performance compared to standalone approaches and other state-of-the-art techniques, showcasing the potential of combining transformer and cross-modal attention for improved sleep stage classification.

SleepBoost: a multi-level tree-based ensemble model for automatic sleep stage classification.

Neurodegenerative diseases often exhibit a strong link with sleep disruption, highlighting the importance of effective sleep stage monitoring. In this light, automatic sleep stage classification (ASSC) plays a pivotal role, now more streamlined than ever due to the advancements in deep learning (DL). However, the opaque nature of DL models can be a barrier in their clinical adoption, due to trust concerns among medical practitioners. To bridge this gap, we introduce SleepBoost, a transparent multi-level tree-based ensemble model specifically designed for ASSC. Our approach includes a crafted feature engineering block (FEB) that extracts 41 time and frequency domain features, out of which 23 are selected based on their high mutual information score (> 0.23). Uniquely, SleepBoost integrates three fundamental linear models into a cohesive multi-level tree structure, further enhanced by a novel reward-based adaptive weight allocation mechanism. Tested on the Sleep-EDF-20 dataset, SleepBoost demonstrates superior performance with an accuracy of 86.3%, F1-score of 80.9%, and Cohen kappa score of 0.807, outperforming leading DL models in ASSC. An ablation study underscores the critical role of our selective feature extraction in enhancing model accuracy and interpretability, crucial for clinical settings. This innovative approach not only offers a more transparent alternative to traditional DL models but also extends potential implications for monitoring and understanding sleep patterns in the context of neurodegenerative disorders. The open-source availability of SleepBoost's implementation at https://github.com/akibzaman/SleepBoost can further facilitate its accessibility and potential for widespread clinical adoption.

Reliable automatic sleep stage classification based on hybrid intelligence.

Sleep staging is a vital aspect of sleep assessment, serving as a critical tool for evaluating the quality of sleep and identifying sleep disorders. Manual sleep staging is a laborious process, while automatic sleep staging is seldom utilized in clinical practice due to issues related to the inadequate accuracy and interpretability of classification results in automatic sleep staging models. In this work, a hybrid intelligent model is presented for automatic sleep staging, which integrates data intelligence and knowledge intelligence, to attain a balance between accuracy, interpretability, and generalizability in the sleep stage classification. Specifically, it is built on any combination of typical electroencephalography (EEG) and electrooculography (EOG) channels, including a temporal fully convolutional network based on the U-Net architecture and a multi-task feature mapping structure. The experimental results show that, compared to current interpretable automatic sleep staging models, our model achieves a Macro-F1 score of 0.804 on the ISRUC dataset and 0.780 on the Sleep-EDFx dataset. Moreover, we use knowledge intelligence to address issues of excessive jumps and unreasonable sleep stage transitions in the coarse sleep graphs obtained by the model. We also explore the different ways knowledge intelligence affects coarse sleep graphs by combining different sleep graph correction methods. Our research can offer convenient support for sleep physicians, indicating its significant potential in improving the efficiency of clinical sleep staging.

[Multi-modal physiological time-frequency feature extraction network for accurate sleep stage classification].

Sleep stage classification is essential for clinical disease diagnosis and sleep quality assessment. Most of the existing methods for sleep stage classification are based on single-channel or single-modal signal, and extract features using a single-branch, deep convolutional network, which not only hinders the capture of the diversity features related to sleep and increase the computational cost, but also has a certain impact on the accuracy of sleep stage classification. To solve this problem, this paper proposes an end-to-end multi-modal physiological time-frequency feature extraction network (MTFF-Net) for accurate sleep stage classification. First, multi-modal physiological signal containing electroencephalogram (EEG), electrocardiogram (ECG), electrooculogram (EOG) and electromyogram (EMG) are converted into two-dimensional time-frequency images containing time-frequency features by using short time Fourier transform (STFT). Then, the time-frequency feature extraction network combining multi-scale EEG compact convolution network (Ms-EEGNet) and bidirectional gated recurrent units (Bi-GRU) network is used to obtain multi-scale spectral features related to sleep feature waveforms and time series features related to sleep stage transition. According to the American Academy of Sleep Medicine (AASM) EEG sleep stage classification criterion, the model achieved 84.3% accuracy in the five-classification task on the third subgroup of the Institute of Systems and Robotics of the University of Coimbra Sleep Dataset (ISRUC-S3), with 83.1% macro F1 score value and 79.8% Cohen's Kappa coefficient. The experimental results show that the proposed model achieves higher classification accuracy and promotes the application of deep learning algorithms in assisting clinical decision-making.

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.

MixSleepNet: A Multi-Type Convolution Combined Sleep Stage Classification Model.

BACKGROUND AND OBJECTIVE: Sleep staging is an essential step for sleep disorder diagnosis, which is time-intensive and laborious for experts to perform this work manually. Automatic sleep stage classification methods not only alleviate experts from these demanding tasks but also enhance the accuracy and efficiency of the classification process. METHODS: A novel multi-channel biosignal-based model constructed by the combination of a 3D convolutional operation and a graph convolutional operation is proposed for the automated sleep stages using various physiological signals. Both the 3D convolution and graph convolution can aggregate information from neighboring brain areas, which helps to learn intrinsic connections from the biosignals. Electroencephalogram (EEG), electromyogram (EMG), electrooculogram (EOG) and electrocardiogram (ECG) signals are employed to extract time domain and frequency domain features. Subsequently, these signals are input to the 3D convolutional and graph convolutional branches, respectively. The 3D convolution branch can explore the correlations between multi-channel signals and multi-band waves in each channel in the time series, while the graph convolution branch can explore the connections between each channel and each frequency band. In this work, we have developed the proposed multi-channel convolution combined sleep stage classification model (MixSleepNet) using ISRUC datasets (Subgroup 3 and 50 random samples from Subgroup 1). RESULTS: Based on the first expert's label, our generated MixSleepNet yielded an accuracy, F1-score and Cohen kappa scores of 0.830, 0.821 and 0.782, respectively for ISRUC-S3. It obtained accuracy, F1-score and Cohen kappa scores of 0.812, 0.786, and 0.756, respectively for the ISRUC-S1 dataset. In accordance with the evaluations conducted by the second expert, the comprehensive accuracies, F1-scores, and Cohen kappa coefficients for the ISRUC-S3 and ISRUC-S1 datasets are determined to be 0.837, 0.820, 0.789, and 0.829, 0.791, 0.775, respectively. CONCLUSION: The results of the performance metrics by the proposed method are much better than those from all the compared models. Additional experiments were carried out on the ISRUC-S3 sub-dataset to evaluate the contributions of each module towards the classification performance.

Machine Learning-Derived Active Sleep as an Early Predictor of White Matter Development in Preterm Infants.

White matter dysmaturation is commonly seen in preterm infants admitted to the neonatal intensive care unit (NICU). Animal research has shown that active sleep is essential for early brain plasticity. This study aimed to determine the potential of active sleep as an early predictor for subsequent white matter development in preterm infants. Using heart and respiratory rates routinely monitored in the NICU, we developed a machine learning-based automated sleep stage classifier in a cohort of 25 preterm infants (12 females). The automated classifier was subsequently applied to a study cohort of 58 preterm infants (31 females) to extract active sleep percentage over 5-7 consecutive days during 29-32 weeks of postmenstrual age. Each of the 58 infants underwent high-quality T2-weighted magnetic resonance brain imaging at term-equivalent age, which was used to measure the total white matter volume. The association between active sleep percentage and white matter volume was examined using a multiple linear regression model adjusted for potential confounders. Using the automated classifier with a superior sleep classification performance [mean area under the receiver operating characteristic curve (AUROC) = 0.87, 95% CI 0.83-0.92], we found that a higher active sleep percentage during the preterm period was significantly associated with an increased white matter volume at term-equivalent age [ß = 0.31, 95% CI 0.09-0.53, false discovery rate (FDR)-adjusted p-value = 0.021]. Our results extend the positive association between active sleep and early brain development found in animal research to human preterm infants and emphasize the potential benefit of sleep preservation in the NICU setting.

Automated Sleep Stage Classification in Home Environments: An Evaluation of Seven Deep Neural Network Architectures.

Sleep is an essential human physiological need that has garnered increasing scientific attention due to the burgeoning prevalence of sleep-related disorders and their impact on public health. Among contemporary challenges, the demand for authentic sleep monitoring outside the confines of specialized laboratories, ideally within the home environment, has arisen. Addressing this, we explore the development of pragmatic approaches that facilitate implementation within domestic settings. Such approaches necessitate the deployment of streamlined, computationally efficient automated classifiers. In pursuit of a sleep stage classifier tailored for home use, this study rigorously assessed seven conventional neural network architectures prominent in deep learning (LeNet, ResNet, VGG, MLP, LSTM-CNN, LSTM, BLSTM). Leveraging sleep recordings from a cohort of 20 subjects, we elucidate that LeNet, VGG, and ResNet exhibit superior performance compared to recent advancements reported in the literature. Furthermore, a comprehensive architectural analysis was conducted, illuminating the strengths and limitations of each in the context of home-based sleep monitoring. Our findings distinctly identify LeNet as the most-amenable architecture for this purpose, with LSTM and BLSTM demonstrating relatively lesser compatibility. Ultimately, this research substantiates the feasibility of automating sleep stage classification employing lightweight neural networks, thereby accommodating scenarios with constrained computational resources. This advancement aims at revolutionizing the field of sleep monitoring, making it more accessible and reliable for individuals in their homes.

Multi-task learning for arousal and sleep stage detection using fully convolutional networks.

Objective.Sleep is a critical physiological process that plays a vital role in maintaining physical and mental health. Accurate detection of arousals and sleep stages is essential for the diagnosis of sleep disorders, as frequent and excessive occurrences of arousals disrupt sleep stage patterns and lead to poor sleep quality, negatively impacting physical and mental health. Polysomnography is a traditional method for arousal and sleep stage detection that is time-consuming and prone to high variability among experts.Approach. In this paper, we propose a novel multi-task learning approach for arousal and sleep stage detection using fully convolutional neural networks. Our model, FullSleepNet, accepts a full-night single-channel EEG signal as input and produces segmentation masks for arousal and sleep stage labels. FullSleepNet comprises four modules: a convolutional module to extract local features, a recurrent module to capture long-range dependencies, an attention mechanism to focus on relevant parts of the input, and a segmentation module to output final predictions.Main results.By unifying the two interrelated tasks as segmentation problems and employing a multi-task learning approach, FullSleepNet achieves state-of-the-art performance for arousal detection with an area under the precision-recall curve of 0.70 on Sleep Heart Health Study and Multi-Ethnic Study of Atherosclerosis datasets. For sleep stage classification, FullSleepNet obtains comparable performance on both datasets, achieving an accuracy of 0.88 and an F1-score of 0.80 on the former and an accuracy of 0.83 and an F1-score of 0.76 on the latter.Significance. Our results demonstrate that FullSleepNet offers improved practicality, efficiency, and accuracy for the detection of arousal and classification of sleep stages using raw EEG signals as input.

Optimizing sleep staging on multimodal time series: Leveraging borderline synthetic minority oversampling technique and supervised convolutional contrastive learning.

Sleep is an important research area in nutritional medicine that plays a crucial role in human physical and mental health restoration. It can influence diet, metabolism, and hormone regulation, which can affect overall health and well-being. As an essential tool in the sleep study, the sleep stage classification provides a parsing of sleep architecture and a comprehensive understanding of sleep patterns to identify sleep disorders and facilitate the formulation of targeted sleep interventions. However, the class imbalance issue is typically salient in sleep datasets, which severely affects classification performances. To address this issue and to extract optimal multimodal features of EEG, EOG, and EMG that can improve the accuracy of sleep stage classification, a Borderline Synthetic Minority Oversampling Technique (B-SMOTE)-Based Supervised Convolutional Contrastive Learning (BST-SCCL) is proposed, which can avoid the risk of data mismatch between various sleep knowledge domains (varying health conditions and annotation rules) and strengthening learning characteristics of the N1 stage from the pair-wise segments comparison strategy. The lightweight residual network architecture with a novel truncated cross-entropy loss function is designed to accommodate multimodal time series and boost the training speed and performance stability. The proposed model has been validated on four well-known public sleep datasets (Sleep-EDF-20, Sleep-EDF-78, ISRUC-1, and ISRUC-3) and its superior performance (overall accuracy of 91.31-92.34%, MF1 of 88.21-90.08%, and Cohen's Kappa coefficient k of 0.87-0.89) has further demonstrated its effectiveness. It shows the great potential of contrastive learning for cross-domain knowledge interaction in precision medicine.

An evolutionary model for sleep quality analytics using fuzzy system.

Electroencephalography (EEG) is a neuro signal reflecting brain activity. These signals provide information about brain activity, eye movements, and muscle tone, which can be used to determine the sleep stage. Categorizing sleep stages can be done manually by visually. Alternatively, automated algorithms can be developed using machine learning techniques to classify sleep stages based on signal features and patterns. This paper aims to automatically classify sleep stages based on extracted patterns from EEG signals. A fuzzy min-max neural network is proposed and implemented for sleep stage classification and clustering. The paper concludes that the fuzzy min-max neural network outperforms other tested methods in sleep stage classification. The models implemented in the study include K-Nearest Neighbor (KNN), Random Forest, Decision Tree, XGBoost, AdaBoost, Linear Discriminant Analysis (LDA), Quadratic Discriminant Analysis (QDA), Convolutional Neural Network (CNN), and the fuzzy min-max classifier. The results indicate that the fuzzy classifier achieves the highest accuracy of 86%, followed by the CNN model with 81%. Among the machine learning algorithms, Random Forest with an accuracy of 55.46%, followed by XGBoost with 53.18%, surpassing the other algorithms used in the experiment. AdaBoost and Gaussian Naive Bayes both achieve an accuracy of 45.10%. Decision Tree, KNN, LDA, and QDA yield accuracies of 37.66%, 16.46%, 28.57%, and 29.5% respectively. These findings demonstrate the efficiency of the fuzzy min-max neural network and the superiority of the fuzzy classifier and CNN models in sleep stage classification, indicating their potential for accurate automated sleep stage analysis.

Evaluation of consensus sleep stage scoring of dysregulated sleep in Parkinson's disease.

OBJECTIVE: Sleep dysregulation in Parkinson's disease (PD) has been hypothesized to occur, in part, from dysfunction in the basal ganglia-cortical circuit. Assessment of this relationship requires accurate sleep stage determination, a known challenge in this clinical population. Our objective was to optimize the consensus on the sleep staging process and reduce interrater variability in a cohort of advanced PD subjects. METHODS: Fifteen PD subjects were enrolled from three sites in a clinical trial that involved recordings from subthalamic nucleus (STN) deep brain stimulation (DBS) leads (NCT04620551). Video polysomnography (vPSG) data for a total of 45 nights were analyzed. Four experienced scorers independently scored data on initial review. Epochs with less than 75% consensus were flagged for secondary review. In secondary review of discordant epochs, two of the original scorers re-assessed epochs, from which the final consensus stage was derived. RESULTS: Sleep stage classification agreement averaged 83.10% across all sleep stages on initial scoring (IS), and on secondary consensus scoring (CS) review, agreement reached 96.58%. Greatest disagreement was noted in determination of awake epochs (33.6% of discordant epochs) and non-rapid-eye-movement stage 2 (N2) epochs (31.8% of discordant epochs). Scoring discrepancy was resolved with direct measurement of cortical frequency and amplitudes, physiologic context of the epoch, and video review. CONCLUSION: Our method of multi-level initial and then secondary consensus review scoring resulted in consensus scoring agreement superior to conventional standards. This work features a custom-engineered vPSG software and review platform for integration of consensus sleep stage scoring in a multi-site clinical trial.

STDP-based adaptive graph convolutional networks for automatic sleep staging.

Automatic sleep staging is important for improving diagnosis and treatment, and machine learning with neuroscience explainability of sleep staging is shown to be a suitable method to solve this problem. In this paper, an explainable model for automatic sleep staging is proposed. Inspired by the Spike-Timing-Dependent Plasticity (STDP), an adaptive Graph Convolutional Network (GCN) is established to extract features from the Polysomnography (PSG) signal, named STDP-GCN. In detail, the channel of the PSG signal can be regarded as a neuron, the synapse strength between neurons can be constructed by the STDP mechanism, and the connection between different channels of the PSG signal constitutes a graph structure. After utilizing GCN to extract spatial features, temporal convolution is used to extract transition rules between sleep stages, and a fully connected neural network is used for classification. To enhance the strength of the model and minimize the effect of individual physiological signal discrepancies on classification accuracy, STDP-GCN utilizes domain adversarial training. Experiments demonstrate that the performance of STDP-GCN is comparable to the current state-of-the-art models.

Sleep Stage Classification in Children Using Self-Attention and Gaussian Noise Data Augmentation.

The analysis of sleep stages for children plays an important role in early diagnosis and treatment. This paper introduces our sleep stage classification method addressing the following two challenges: the first is the data imbalance problem, i.e., the highly skewed class distribution with underrepresented minority classes. For this, a Gaussian Noise Data Augmentation (GNDA) algorithm was applied to polysomnography recordings to seek the balance of data sizes for different sleep stages. The second challenge is the difficulty in identifying a minority class of sleep stages, given their short sleep duration and similarities to other stages in terms of EEG characteristics. To overcome this, we developed a DeConvolution- and Self-Attention-based Model (DCSAM) which can inverse the feature map of a hidden layer to the input space to extract local features and extract the correlations between all possible pairs of features to distinguish sleep stages. The results on our dataset show that DCSAM based on GNDA obtains an accuracy of 90.26% and a macro F1-score of 86.51% which are higher than those of our previous method. We also tested DCSAM on a well-known public dataset-Sleep-EDFX-to prove whether it is applicable to sleep data from adults. It achieves a comparable performance to state-of-the-art methods, especially accuracies of 91.77%, 92.54%, 94.73%, and 95.30% for six-stage, five-stage, four-stage, and three-stage classification, respectively. These results imply that our DCSAM based on GNDA has a great potential to offer performance improvements in various medical domains by considering the data imbalance problems and correlations among features in time series data.

Novel methods for elucidating modality importance in multimodal electrophysiology classifiers.

Introduction: Multimodal classification is increasingly common in electrophysiology studies. Many studies use deep learning classifiers with raw time-series data, which makes explainability difficult, and has resulted in relatively few studies applying explainability methods. This is concerning because explainability is vital to the development and implementation of clinical classifiers. As such, new multimodal explainability methods are needed. Methods: In this study, we train a convolutional neural network for automated sleep stage classification with electroencephalogram (EEG), electrooculogram, and electromyogram data. We then present a global explainability approach that is uniquely adapted for electrophysiology analysis and compare it to an existing approach. We present the first two local multimodal explainability approaches. We look for subject-level differences in the local explanations that are obscured by global methods and look for relationships between the explanations and clinical and demographic variables in a novel analysis. Results: We find a high level of agreement between methods. We find that EEG is globally the most important modality for most sleep stages and that subject-level differences in importance arise in local explanations that are not captured in global explanations. We further show that sex, followed by medication and age, had significant effects upon the patterns learned by the classifier. Discussion: Our novel methods enhance explainability for the growing field of multimodal electrophysiology classification, provide avenues for the advancement of personalized medicine, yield unique insights into the effects of demographic and clinical variables upon classifiers, and help pave the way for the implementation of multimodal electrophysiology clinical classifiers.

Validation of the influence of biosignals on performance of machine learning algorithms for sleep stage classification.

Background: Sleep stage identification is critical in multiple areas (e.g. medicine or psychology) to diagnose sleep-related disorders. Previous studies have reported that the performance of machine learning algorithms can be changed depending on the biosignals and feature-extraction processes in sleep stage classification. Methods: To compare as many conditions as possible, 414 experimental conditions were applied, considering the combination of different biosignals, biosignal length, and window length. Five biosignals in polysomnography (i.e. electrocardiogram (ECG), electroencephalogram (EEG), electromyogram (EMG), electrooculogram left, and electrooculogram right) were used to identify optimal signal combinations for classification. In addition, three different signal-length conditions and six different window-length conditions were applied. The validity of each condition was examined via classification performance from the XGBoost classifiers trained using 10-fold cross-validation. Furthermore, results considering feature importance were examined to validate the experimental results in terms of model explanation. Results: The combination of EEG + EMG + ECG with a 40 s window and 120 s signal length resulted in the best classification performance (precision: 0.853, recall: 0.855, F1-score: 0.853, and accuracy: 0.853). Compared to other conditions and feature importance results, EEG signals showed a relatively higher importance for classification in the present study. Conclusion: We determined the optimal biosignal and window conditions for the feature-extraction process in machine learning algorithm-based sleep stage classification. Our experimental results inform researchers in the future conduct of related studies. To generalize our results, more diverse methodologies and conditions should be applied in future studies.

A temporal multi-scale hybrid attention network for sleep stage classification.

Sleep is crucial for human health. Automatic sleep stage classification based on polysomnogram (PSG) is meaningful for the diagnosis of sleep disorders, which has attracted extensive attention in recent years. Most existing methods could not fully consider the different transitions of sleep stages and fit the visual inspection of sleep experts simultaneously. To this end, we propose a temporal multi-scale hybrid attention network, namely TMHAN, to automatically achieve sleep staging. The temporal multi-scale mechanism incorporates short-term abrupt and long-term periodic transitions of the successive PSG epochs. Furthermore, the hybrid attention mechanism includes 1-D local attention, 2-D global attention, and 2-D contextual sparse multi-head self-attention for three kinds of sequence-level representations. The concatenated representation is subsequently fed into a softmax layer to train an end-to-end model. Experimental results on two benchmark sleep datasets show that TMHAN obtains the best performance compared with several baselines, demonstrating the effectiveness of our model. In general, our work not only provides good classification performance, but also fits the actual sleep staging processes, which makes contribution for the combination of deep learning and sleep medicine.

Multi-scored sleep databases: how to exploit the multiple-labels in automated sleep scoring.

STUDY OBJECTIVES: Inter-scorer variability in scoring polysomnograms is a well-known problem. Most of the existing automated sleep scoring systems are trained using labels annotated by a single-scorer, whose subjective evaluation is transferred to the model. When annotations from two or more scorers are available, the scoring models are usually trained on the scorer consensus. The averaged scorer's subjectivity is transferred into the model, losing information about the internal variability among different scorers. In this study, we aim to insert the multiple-knowledge of the different physicians into the training procedure. The goal is to optimize a model training, exploiting the full information that can be extracted from the consensus of a group of scorers. METHODS: We train two lightweight deep learning-based models on three different multi-scored databases. We exploit the label smoothing technique together with a soft-consensus (LSSC) distribution to insert the multiple-knowledge in the training procedure of the model. We introduce the averaged cosine similarity metric (ACS) to quantify the similarity between the hypnodensity-graph generated by the models with-LSSC and the hypnodensity-graph generated by the scorer consensus. RESULTS: The performance of the models improves on all the databases when we train the models with our LSSC. We found an increase in ACS (up to 6.4%) between the hypnodensity-graph generated by the models trained with-LSSC and the hypnodensity-graph generated by the consensus. CONCLUSION: Our approach definitely enables a model to better adapt to the consensus of the group of scorers. Future work will focus on further investigations on different scoring architectures and hopefully large-scale-heterogeneous multi-scored datasets.