Sleep is essential for maintaining human health and quality of life. Analyzing physiological signals during sleep is critical in assessing sleep quality and diagnosing sleep disorders. However, manual diagnoses by clinicians are time-intensive and subjective. Despite advances in deep learning that have enhanced automation, these approaches remain heavily dependent on large-scale labeled datasets. This study introduces SynthSleepNet, a multimodal hybrid self-supervised learning framework designed for analyzing polysomnography (PSG) data. SynthSleepNet effectively integrates masked prediction and contrastive learning to leverage complementary features across multiple modalities, including electroencephalogram (EEG), electrooculography (EOG), electromyography (EMG), and electrocardiogram (ECG). This approach enables the model to learn highly expressive representations of PSG data. Furthermore, a temporal context module based on Mamba was developed to efficiently capture contextual information across signals. SynthSleepNet achieved superior performance compared to state-of-the-art methods across three downstream tasks: sleep-stage classification, apnea detection, and hypopnea detection, with accuracies of 89.89%, 99.75%, and 89.60%, respectively. The model demonstrated robust performance in a semi-supervised learning environment with limited labels, achieving accuracies of 87.98%, 99.37%, and 77.52% in the same tasks. These results underscore the potential of the model as a foundational tool for the comprehensive analysis of PSG data. SynthSleepNet demonstrates comprehensively superior performance across multiple downstream tasks compared to other methodologies, making it expected to set a new standard for sleep disorder monitoring and diagnostic systems.
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 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.
Much attention has been given to automatic sleep staging algorithms in past years, but the detection of discrete events in sleep studies is also crucial for precise characterization of sleep patterns and possible diagnosis of sleep disorders. We propose here a deep learning model for automatic detection and annotation of arousals and leg movements. Both of these are commonly seen during normal sleep, while an excessive amount of either is linked to disrupted sleep patterns, excessive daytime sleepiness impacting quality of life, and various sleep disorders. Our model was trained on 1,485 subjects and tested on 1,000 separate recordings of sleep. We tested two different experimental setups and found optimal arousal detection was attained by including a recurrent neural network module in our default model with a dynamic default event window (F1 = 0.75), while optimal leg movement detection was attained using a static event window (F1 = 0.65). Our work show promise while still allowing for improvements. Specifically, future research will explore the proposed model as a general-purpose sleep analysis model.