Recent advancements in machine learning-based signal analysis, coupled with open data initiatives, have fuelled efforts in automatic sleep stage classification. Despite the proliferation of classification models, few have prioritised reducing model complexity, which is a crucial factor for practical applications. In this work, we introduce Multi-Scale and Attention Convolutional Neural Network (MSA-CNN), a lightweight architecture featuring as few as ~10,000 parameters. MSA-CNN leverages a novel multi-scale module employing complementary pooling to eliminate redundant filter parameters and dense convolutions. Model complexity is further reduced by separating temporal and spatial feature extraction and using cost-effective global spatial convolutions. This separation of tasks not only reduces model complexity but also mirrors the approach used by human experts in sleep stage scoring. We evaluated both small and large configurations of MSA-CNN against nine state-of-the-art baseline models across three public datasets, treating univariate and multivariate models separately. Our evaluation, based on repeated cross-validation and re-evaluation of all baseline models, demonstrated that the large MSA-CNN outperformed all baseline models on all three datasets in terms of accuracy and Cohen's kappa, despite its significantly reduced parameter count. Lastly, we explored various model variants and conducted an in-depth analysis of the key modules and techniques, providing deeper insights into the underlying mechanisms. The code for our models, baselines, and evaluation procedures is available at https://github.com/sgoerttler/MSA-CNN.
In recent years, multitudes of researches have applied deep learning to automatic sleep stage classification. Whereas actually, these works have paid less attention to the issue of cross-subject in sleep staging. At the same time, emerging neuroscience theories on inter-subject correlations can provide new insights for cross-subject analysis. This paper presents the MViTime model that have been used in sleep staging study. And we implement the inter-subject correlation theory through contrastive learning, providing a feasible solution to address the cross-subject problem in sleep stage classification. Finally, experimental results and conclusions are presented, demonstrating that the developed method has achieved state-of-the-art performance on sleep staging. The results of the ablation experiment also demonstrate the effectiveness of the cross-subject approach based on contrastive learning.
Accurate sleep stage classification is significant for sleep health assessment. In recent years, several machine-learning based sleep staging algorithms have been developed , and in particular, deep-learning based algorithms have achieved performance on par with human annotation. Despite improved performance, a limitation of most deep-learning based algorithms is their black-box behavior, which have limited their use in clinical settings. Here, we propose a cross-modal transformer, which is a transformer-based method for sleep stage classification. The proposed cross-modal transformer consists of a novel cross-modal transformer encoder architecture along with a multi-scale one-dimensional convolutional neural network for automatic representation learning. Our method outperforms the state-of-the-art methods and eliminates the black-box behavior of deep-learning models by utilizing the interpretability aspect of the attention modules. Furthermore, our method provides considerable reductions in the number of parameters and training time compared to the state-of-the-art methods. Our code is available at https://github.com/Jathurshan0330/Cross-Modal-Transformer. A demo of our work can be found at https://bit.ly/Cross_modal_transformer_demo.
Over the last few years, research in automatic sleep scoring has mainly focused on developing increasingly complex deep learning architectures. However, recently these approaches achieved only marginal improvements, often at the expense of requiring more data and more expensive training procedures. Despite all these efforts and their satisfactory performance, automatic sleep staging solutions are not widely adopted in a clinical context yet. We argue that most deep learning solutions for sleep scoring are limited in their real-world applicability as they are hard to train, deploy, and reproduce. Moreover, these solutions lack interpretability and transparency, which are often key to increase adoption rates. In this work, we revisit the problem of sleep stage classification using classical machine learning. Results show that competitive performance can be achieved with a conventional machine learning pipeline consisting of preprocessing, feature extraction, and a simple machine learning model. In particular, we analyze the performance of a linear model and a non-linear (gradient boosting) model. Our approach surpasses state-of-the-art (that uses the same data) on two public datasets: Sleep-EDF SC-20 (MF1 0.810) and Sleep-EDF ST (MF1 0.795), while achieving competitive results on Sleep-EDF SC-78 (MF1 0.775) and MASS SS3 (MF1 0.817). We show that, for the sleep stage scoring task, the expressiveness of an engineered feature vector is on par with the internally learned representations of deep learning models. This observation opens the door to clinical adoption, as a representative feature vector allows to leverage both the interpretability and successful track record of traditional machine learning models.
Sleep staging is of great importance in the diagnosis and treatment of sleep disorders. Recently, numerous data-driven deep learning models have been proposed for automatic sleep staging. They mainly train the model on a large public labeled sleep dataset and test it on a smaller one with subjects of interest. However, they usually assume that the train and test data are drawn from the same distribution, which may not hold in real-world scenarios. Unsupervised domain adaption (UDA) has been recently developed to handle this domain shift problem. However, previous UDA methods applied for sleep staging have two main limitations. First, they rely on a totally shared model for the domain alignment, which may lose the domain-specific information during feature extraction. Second, they only align the source and target distributions globally without considering the class information in the target domain, which hinders the classification performance of the model while testing. In this work, we propose a novel adversarial learning framework called ADAST to tackle the domain shift problem in the unlabeled target domain. First, we develop an unshared attention mechanism to preserve the domain-specific features in both domains. Second, we design an iterative self-training strategy to improve the classification performance on the target domain via target domain pseudo labels. We also propose dual distinct classifiers to increase the robustness and quality of the pseudo labels. The experimental results on six cross-domain scenarios validate the efficacy of our proposed framework and its advantage over state-of-the-art UDA methods. The source code is available at https://github.com/emadeldeen24/ADAST.
Learning decent representations from unlabeled time-series data with temporal dynamics is a very challenging task. In this paper, we propose an unsupervised Time-Series representation learning framework via Temporal and Contextual Contrasting (TS-TCC), to learn time-series representation from unlabeled data. First, the raw time-series data are transformed into two different yet correlated views by using weak and strong augmentations. Second, we propose a novel temporal contrasting module to learn robust temporal representations by designing a tough cross-view prediction task. Last, to further learn discriminative representations, we propose a contextual contrasting module built upon the contexts from the temporal contrasting module. It attempts to maximize the similarity among different contexts of the same sample while minimizing similarity among contexts of different samples. Experiments have been carried out on three real-world time-series datasets. The results manifest that training a linear classifier on top of the features learned by our proposed TS-TCC performs comparably with the supervised training. Additionally, our proposed TS-TCC shows high efficiency in few-labeled data and transfer learning scenarios. The code is publicly available at https://github.com/emadeldeen24/TS-TCC.
Sleep disorder diagnosis relies on the analysis of polysomnography (PSG) records. As a preliminary step of this examination, sleep stages are systematically determined. In practice, sleep stage classification relies on the visual inspection of 30-second epochs of polysomnography signals. Numerous automatic approaches have been developed to replace this tedious and expensive task. Although these methods demonstrated better performance than human sleep experts on specific datasets, they remain largely unused in sleep clinics. The main reason is that each sleep clinic uses a specific PSG montage that most automatic approaches cannot handle out-of-the-box. Moreover, even when the PSG montage is compatible, publications have shown that automatic approaches perform poorly on unseen data with different demographics. To address these issues, we introduce RobustSleepNet, a deep learning model for automatic sleep stage classification able to handle arbitrary PSG montages. We trained and evaluated this model in a leave-one-out-dataset fashion on a large corpus of 8 heterogeneous sleep staging datasets to make it robust to demographic changes. When evaluated on an unseen dataset, RobustSleepNet reaches 97% of the F1 of a model explicitly trained on this dataset. Hence, RobustSleepNet unlocks the possibility to perform high-quality out-of-the-box automatic sleep staging with any clinical setup. We further show that finetuning RobustSleepNet, using a part of the unseen dataset, increases the F1 by 2% when compared to a model trained specifically for this dataset. Therefore, finetuning might be used to reach a state-of-the-art level of performance on a specific population.
Study Objectives: Sleep stage scoring is performed manually by sleep experts and is prone to subjective interpretation of scoring rules with low intra- and interscorer reliability. Many automatic systems rely on few small-scale databases for developing models, and generalizability to new datasets is thus unknown. We investigated a novel deep neural network to assess the generalizability of several large-scale cohorts. Methods: A deep neural network model was developed using 15684 polysomnography studies from five different cohorts. We applied four different scenarios: 1) impact of varying time-scales in the model; 2) performance of a single cohort on other cohorts of smaller, greater or equal size relative to the performance of other cohorts on a single cohort; 3) varying the fraction of mixed-cohort training data compared to using single-origin data; and 4) comparing models trained on combinations of data from 2, 3, and 4 cohorts. Results: Overall classification accuracy improved with increasing fractions of training data (0.25$\%$: 0.782 $\pm$ 0.097, 95$\%$ CI [0.777-0.787]; 100$\%$: 0.869 $\pm$ 0.064, 95$\%$ CI [0.864-0.872]), and with increasing number of data sources (2: 0.788 $\pm$ 0.102, 95$\%$ CI [0.787-0.790]; 3: 0.808 $\pm$ 0.092, 95$\%$ CI [0.807-0.810]; 4: 0.821 $\pm$ 0.085, 95$\%$ CI [0.819-0.823]). Different cohorts show varying levels of generalization to other cohorts. Conclusions: Automatic sleep stage scoring systems based on deep learning algorithms should consider as much data as possible from as many sources available to ensure proper generalization. Public datasets for benchmarking should be made available for future research.
Identifying bio-signals based-sleep stages requires time-consuming and tedious labor of skilled clinicians. Deep learning approaches have been introduced in order to challenge the automatic sleep stage classification conundrum. However, the difficulties can be posed in replacing the clinicians with the automatic system due to the differences in many aspects found in individual bio-signals, causing the inconsistency in the performance of the model on every incoming individual. Thus, we aim to explore the feasibility of using a novel approach, capable of assisting the clinicians and lessening the workload. We propose the transfer learning framework, entitled MetaSleepLearner, based on Model Agnostic Meta-Learning (MAML), in order to transfer the acquired sleep staging knowledge from a large dataset to new individual subjects. The framework was demonstrated to require the labelling of only a few sleep epochs by the clinicians and allow the remainder to be handled by the system. Layer-wise Relevance Propagation (LRP) was also applied to understand the learning course of our approach. In all acquired datasets, in comparison to the conventional approach, MetaSleepLearner achieved a range of 5.4\% to 17.7\% improvement with statistical difference in the mean of both approaches. The illustration of the model interpretation after the adaptation to each subject also confirmed that the performance was directed towards reasonable learning. MetaSleepLearner outperformed the conventional approaches as a result from the fine-tuning using the recordings of both healthy subjects and patients. This is the first work that investigated a non-conventional pre-training method, MAML, resulting in a possibility for human-machine collaboration in sleep stage classification and easing the burden of the clinicians in labelling the sleep stages through only several epochs rather than an entire recording.
Sleep stage classification constitutes an important element of sleep disorder diagnosis. It relies on the visual inspection of polysomnography records by trained sleep technologists. Automated approaches have been designed to alleviate this resource-intensive task. However, such approaches are usually compared to a single human scorer annotation despite an inter-rater agreement of about 85 % only. The present study introduces two publicly-available datasets, DOD-H including 25 healthy volunteers and DOD-O including 55 patients suffering from obstructive sleep apnea (OSA). Both datasets have been scored by 5 sleep technologists from different sleep centers. We developed a framework to compare automated approaches to a consensus of multiple human scorers. Using this framework, we benchmarked and compared the main literature approaches. We also developed and benchmarked a new deep learning method, SimpleSleepNet, inspired by current state-of-the-art. We demonstrated that many methods can reach human-level performance on both datasets. SimpleSleepNet achieved an F1 of 89.9 % vs 86.8 % on average for human scorers on DOD-H, and an F1 of 88.3 % vs 84.8 % on DOD-O. Our study highlights that using state-of-the-art automated sleep staging outperforms human scorers performance for healthy volunteers and patients suffering from OSA. Consideration could be made to use automated approaches in the clinical setting.
Background: Despite recent significant progress in the development of automatic sleep staging methods, building a good model still remains a big challenge for sleep studies with a small cohort due to the data-variability and data-inefficiency issues. This work presents a deep transfer learning approach to overcome these issues and enable transferring knowledge from a large dataset to a small cohort for automatic sleep staging. Methods: We start from a generic end-to-end deep learning framework for sequence-to-sequence sleep staging and derive two networks as the means for transfer learning. The networks are first trained in the source domain (i.e. the large database). The pretrained networks are then finetuned in the target domain (i.e. the small cohort) to complete knowledge transfer. We employ the Montreal Archive of Sleep Studies (MASS) database consisting of 200 subjects as the source domain and study deep transfer learning on three different target domains: the Sleep Cassette subset and the Sleep Telemetry subset of the Sleep-EDF Expanded database, and the Surrey-cEEGrid database. The target domains are purposely adopted to cover different degrees of data mismatch to the source domains. Results: Our experimental results show significant performance improvement on automatic sleep staging on the target domains achieved with the proposed deep transfer learning approach. Conclusions: These results suggest the efficacy of the proposed approach in addressing the above-mentioned data-variability and data-inefficiency issues. Significance: As a consequence, it would enable one to improve the quality of automatic sleep staging models when the amount of data is relatively small. The source code and the pretrained models are available at http://github.com/pquochuy/sleep_transfer_learning.
Correctly identifying sleep stages is important in diagnosing and treating sleep disorders. This work proposes a joint classification-and-prediction framework based on CNNs for automatic sleep staging, and, subsequently, introduces a simple yet efficient CNN architecture to power the framework. Given a single input epoch, the novel framework jointly determines its label (classification) and its neighboring epochs' labels (prediction) in the contextual output. While the proposed framework is orthogonal to the widely adopted classification schemes, which take one or multiple epochs as contextual inputs and produce a single classification decision on the target epoch, we demonstrate its advantages in several ways. First, it leverages the dependency among consecutive sleep epochs while surpassing the problems experienced with the common classification schemes. Second, even with a single model, the framework has the capacity to produce multiple decisions, which are essential in obtaining a good performance as in ensemble-of-models methods, with very little induced computational overhead. Probabilistic aggregation techniques are then proposed to leverage the availability of multiple decisions. We conducted experiments on two public datasets: Sleep-EDF Expanded with 20 subjects, and Montreal Archive of Sleep Studies dataset with 200 subjects. The proposed framework yields an overall classification accuracy of 82.3% and 83.6%, respectively. We also show that the proposed framework not only is superior to the baselines based on the common classification schemes but also outperforms existing deep-learning approaches. To our knowledge, this is the first work going beyond the standard single-output classification to consider multitask neural networks for automatic sleep staging. This framework provides avenues for further studies of different neural-network architectures for automatic sleep staging.