Automated Detection of Sleep Stages Using Energy-Localized Orthogonal Wavelet Filter Banks

Evaluating sleep-stage classification: how age and early-late sleep affects classification performance

Sleep stage classification is a common method used by experts to monitor the quantity and quality of sleep in humans, but it is a time-consuming and labour-intensive task with high inter- and intra-observer variability. Using wavelets for feature extraction and random forest for classification, an automatic sleep-stage classification method was sought and assessed. The age of the subjects, as well as the moment of sleep (early-night and late-night), were confronted to the performance of the classifier. From this study, we observed that these variables do affect the automatic model performance, improving the classification of some sleep stages and worsening others.

A novel automated robust dual-channel EEG-based sleep scoring system using optimal half-band pair linear-phase biorthogonal wavelet filter bank

Nowadays, the hectic work life of people has led to sleep deprivation. This may further result in sleep-related disorders and adverse physiological conditions. Therefore, sleep study has become an active research area. Sleep scoring is crucial for detecting sleep-related disorders like sleep apnea, insomnia, narcolepsy, periodic leg movement (PLM), and restless leg syndrome (RLS). Sleep is conventionally monitored in a sleep laboratory using polysomnography (PSG) which is the recording of various physiological signals. The traditional sleep stage scoring (SSG) done by professional sleep scorers is a tedious, strenuous, and time-consuming process as it is manual. Hence, developing a machine-learning model for automatic SSG is essential. In this study, we propose an automated SSG approach based on the biorthogonal wavelet filter bank's (BWFB) novel least squares (LS) design. We have utilized a huge Wisconsin sleep cohort (WSC) database in this study. The proposed study is a pioneering work on automatic sleep stage classification using the WSC database, which includes good sleepers and patients suffering from various sleep-related disorders, including apnea, insomnia, hypertension, diabetes, and asthma. To investigate the generalization of the proposed system, we evaluated the proposed model with the following publicly available databases: cyclic alternating pattern (CAP), sleep EDF, ISRUC, MIT-BIH, and the sleep apnea database from St. Vincent's University. This study uses only two unipolar EEG channels, namely O1-M2 and C3-M2, for the scoring. The Hjorth parameters (HP) are extracted from the wavelet subbands (SBS) that are obtained from the optimal BWFB. To classify sleep stages, the HP features are fed to several supervised machine learning classifiers. 12 different datasets have been created to develop a robust model. A total of 12 classification tasks (CT) have been conducted employing various classification algorithms. Our developed model achieved the best accuracy of 83.2% and Cohen's Kappa of 0.7345 to reliably distinguish five sleep stages, using an ensemble bagged tree classifier with 10-fold cross-validation using WSC data. We also observed that our system is either better or competitive with existing state-of-art systems when we tested with the above-mentioned five databases other than WSC. This method yielded promising results using only two EEG channels using a huge WSC database. Our approach is simple and hence, the developed model can be installed in home-based clinical systems and wearable devices for sleep scoring.

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.

Pulse oximetrySpO2signal for automated identification of sleep apnea: a review and future trends

Sleep apnea (SA) is characterized by intermittent episodes of apnea or hypopnea paused or reduced breathing, respectively each lasting at least ten seconds that occur during sleep. SA has an estimated global prevalence of 200 million and is associated with medical comorbidity, and sufferers are also more likely to sustain traffic- and work-related injury due to daytime somnolence. SA is amenable to treatment if detected early. Polysomnography (PSG) involving multi-channel signal acquisition is the reference standard for diagnosing SA but is onerous and costly. For home-based detection of SA, single-channelSpO₂signal acquisition using portable pulse oximeters is feasible. Machine (ML) and deep learning (DL) models have been developed for automated classification of SA versus no SA usingSpO₂signals alone. In this work, we review studies published between 2012 and 2022 on the use of ML and DL forSpO₂signal-based diagnosis of SA. A literature search based on PRISMA recommendations yielded 297 publications, of which 31 were selected after considering the inclusion and exclusion criteria. There were 20 ML and 11 DL models; their methods, differences, results, merits, and limitations were discussed. Many studies reported encouraging performance, which indicates the utility ofSpO₂signals in wearable devices for home-based SA detection.

An Automated Wavelet-Based Sleep Scoring Model Using EEG, EMG, and EOG Signals with More Than 8000 Subjects

Human life necessitates high-quality sleep. However, humans suffer from a lower quality of life because of sleep disorders. The identification of sleep stages is necessary to predict the quality of sleep. Manual sleep-stage scoring is frequently conducted through sleep experts’ visually evaluations of a patient’s neurophysiological data, gathered in sleep laboratories. Manually scoring sleep is a tough, time-intensive, tiresome, and highly subjective activity. Hence, the need of creating automatic sleep-stage classification has risen due to the limitations imposed by manual sleep-stage scoring methods. In this study, a novel machine learning model is developed using dual-channel unipolar electroencephalogram (EEG), chin electromyogram (EMG), and dual-channel electrooculgram (EOG) signals. Using an optimum orthogonal filter bank, sub-bands are obtained by decomposing 30 s epochs of signals. Tsallis entropies are then calculated from the coefficients of these sub-bands. Then, these features are fed an ensemble bagged tree (EBT) classifier for automated sleep classification. We developed our automated sleep classification model using the Sleep Heart Health Study (SHHS) database, which contains two parts, SHHS-1 and SHHS-2, containing more than 8455 subjects with more than 75,000 h of recordings. The proposed model separated three classes if sleep: rapid eye movement (REM), non-REM, and wake, with a classification accuracy of 90.70% and 91.80% using the SHHS-1 and SHHS-2 datasets, respectively. For the five-class problem, the model produces a classification accuracy of 84.3% and 86.3%, corresponding to the SHHS-1 and SHHS-2 databases, respectively, to classify wake, N1, N2, N3, and REM sleep stages. The model acquired Cohen’s kappa (κ) coefficients as 0.838 with SHHS-1 and 0.86 with SHHS-2 for the three-class classification problem. Similarly, the model achieved Cohen’s κ of 0.7746 for SHHS-1 and 0.8007 for SHHS-2 in five-class classification tasks. The model proposed in this study has achieved better performance than the best existing methods. Moreover, the model that has been proposed has been developed to classify sleep stages for both good sleepers as well as patients suffering from sleep disorders. Thus, the proposed wavelet Tsallis entropy-based model is robust and accurate and may help clinicians to comprehend and interpret sleep stages efficiently.

SleepContextNet: A temporal context network for automatic sleep staging based single-channel EEG

BACKGROUND AND OBJECTIVE

Single-channel EEG is the most popular choice of sensing modality in sleep staging studies, because it widely conforms to the sleep staging guidelines. The current deep learning method using single-channel EEG signals for sleep staging mainly extracts the features of its surrounding epochs to obtain the short-term temporal context information of EEG epochs, and ignore the influence of the long-term temporal context information on sleep staging. However, the long-term context information includes sleep stage transition rules in a sleep cycle, which can further improve the performance of sleep staging. The aim of this research is to develop a temporal context network to capture the long-term context between EEG sleep stages.

METHODS

In this paper, we design a sleep staging network named SleepContextNet for sleep stage sequence. SleepContextNet can extract and utilize the long-term temporal context between consecutive EEG epochs, and combine it with the short-term context. we utilize Convolutional Neural Network(CNN) layers for learning representative features from each sleep stage and the representation features sequence learned are fed into a Recurrent Neural Network(RNN) layer for learning long-term and short-term context information among sleep stage in chronological order. In addition, we design a data augmentation algorithm for EEG to retain the long-term context information without changing the number of samples.

RESULTS

We evaluate the performance of our proposed network using four public datasets, the 2013 version of Sleep-EDF (SEDF), the 2018 version of Sleep-EDF Expanded (SEDFX), Sleep Heart Health Study (SHHS) and the CAP Sleep Database. The experimental results demonstrate that SleepContextNet outperforms state-of-the-art techniques in terms of different evaluation metrics by capturing long-term and short-term temporal context information. On average, accuracy of 84.8% in SEDF, 82.7% in SEDFX, 86.4% in SHHS and 78.8% in CAP are obtained under subject-independent cross validation.

CONCLUSIONS

The network extracts the long-term and short-term temporal context information of sleep stages from the sequence features, which utilizes the temporal dependencies among the EEG epochs effectively and improves the accuracy of sleep stages. The sleep staging method based on forward temporal context information is suitable for real-time family sleep monitoring system.

Automated identification of sleep disorders using wavelet-based features extracted from electrooculogram and electromyogram signals

Sleep is imperative for a healthy life as it rejuvenates memory, cognitive performance, cell repair and eliminates waste from the muscles. Sleep-related disorders such as insomnia, narcolepsy, sleep-disordered breathing (SDB), periodic leg movement (PLM), and bruxism lead to hormonal imbalance, slower reaction time, memory problems, depression, and headaches. This adversity of sleep disorder gained the attention of many sleep researchers. To examine the reasons for sleep disorders, it is imperative to monitor and analyze the sleep of the affected patients. The conventional method of monitoring sleep and identifying the sleep disorders using polysomnographic (PSG) recording is a complicated and cumbersome task in which multiple physiological signals with multiple modalities are recorded for a long (overnight) duration. The PSG recordings are carried out in sophisticated sleep laboratories and cannot be considered suitable for real-time sleep monitoring. Thus, a simple and patient-convenient system is highly desirable to monitor and analyze the quality of sleep. We proposed an automatic detection of sleep disorders using single modal electrooculogram (EOG) and electromyogram (EMG) signals. We have used a new maximally flat multiplier-less biorthogonal filter bank for obtaining discrete wavelet transform of the signals. We computed Hjorth parameters (HOP) such as activity, mobility, and complexity from the wavelet sub-bands. Highly discriminative HOP features are fed to different machine learning classifiers to develop the model. Our results show that the developed system can classify insomnia, narcolepsy, NFLE, PLM, and REM behaviour disorder (RBD) against normal healthy subjects with an accuracy of 99.7%, 97.6%, 97.5%, 97.5%, and 98.3%, respectively using combined features from EOG and EMG signal. The proposed model has yielded an accuracy of 94.3% in classifying six classes using an ensemble bagged trees classifier (EBTC) with a 10-fold cross-validation technique. Hence, EOG and EMG-based proposed methods can be deployed in a portable home-based environment to identify the type of sleep disorders automatically.

Automated Detection of Hypertension Using Continuous Wavelet Transform and a Deep Neural Network with Ballistocardiography Signals

Managing hypertension (HPT) remains a significant challenge for humanity. Despite advancements in blood pressure (BP)-measuring systems and the accessibility of effective and safe anti-hypertensive medicines, HPT is a major public health concern. Headaches, dizziness and fainting are common symptoms of HPT. In HPT patients, normalcy may be observed at one instant and abnormality may prevail during a long duration of 24 h ambulatory BP. This may cause difficulty in identifying patients with HPT, and hence there is a possibility that individuals may be untreated or administered insufficiently. Most importantly, uncontrolled HPT can lead to severe complications (stroke, heart attack, kidney disease, and heart failure), mainly ignoring the signs in nascent stages. HPT in the beginning stages may not present distinct symptoms and may be difficult to diagnose from standard physiological signals. Hence, ballistocardiography (BCG) signal was used in this study to detect HPT automatically. The processed signals from BCG were converted into scalogram images using a continuous wavelet transform (CWT) and were then fed into a 2-D convolutional neural network model (2D-CNN). The model was trained to learn and recognize BCG patterns of healthy controls (HC) and HPT classes. Our proposed model obtained a high classification accuracy of 86.14% with a ten-fold cross-validation (CV) strategy. Hence, this is the first use of a 2D-CNN model (deep-learning algorithm) to detect HPT employing BCG signals.

Automated Characterization of Cyclic Alternating Pattern Using Wavelet-Based Features and Ensemble Learning Techniques with EEG Signals

Sleep is highly essential for maintaining metabolism of the body and mental balance for increased productivity and concentration. Often, sleep is analyzed using macrostructure sleep stages which alone cannot provide information about the functional structure and stability of sleep. The cyclic alternating pattern (CAP) is a physiological recurring electroencephalogram (EEG) activity occurring in the brain during sleep and captures microstructure of the sleep and can be used to identify sleep instability. The CAP can also be associated with various sleep-related pathologies, and can be useful in identifying various sleep disorders. Conventionally, sleep is analyzed using polysomnogram (PSG) in various sleep laboratories by trained physicians and medical practitioners. However, PSG-based manual sleep analysis by trained medical practitioners is onerous, tedious and unfavourable for patients. Hence, a computerized, simple and patient convenient system is highly desirable for monitoring and analysis of sleep. In this study, we have proposed a system for automated identification of CAP phase-A and phase-B. To accomplish the task, we have utilized the openly accessible CAP sleep database. The study is performed using two single-channel EEG modalities and their combination. The model is developed using EEG signals of healthy subjects as well as patients suffering from six different sleep disorders namely nocturnal frontal lobe epilepsy (NFLE), sleep-disordered breathing (SDB), narcolepsy, periodic leg movement disorder (PLM), insomnia and rapid eye movement behavior disorder (RBD) subjects. An optimal orthogonal wavelet filter bank is used to perform the wavelet decomposition and subsequently, entropy and Hjorth parameters are extracted from the decomposed coefficients. The extracted features have been applied to different machine learning algorithms. The best performance is obtained using ensemble of bagged tress (EBagT) classifier. The proposed method has obtained the average classification accuracy of 84%, 83%, 81%, 78%, 77%, 76% and 72% for NFLE, healthy, SDB, narcolepsy, PLM, insomnia and RBD subjects, respectively in discriminating phases A and B using a balanced database. Our developed model yielded an average accuracy of 78% when all 77 subjects including healthy and sleep disordered patients are considered. Our proposed system can assist the sleep specialists in an automated and efficient analysis of sleep using sleep microstructure.

Automated Identification of Sleep Disorder Types Using Triplet Half-Band Filter and Ensemble Machine Learning Techniques with EEG Signals

A sleep disorder is a medical condition that affects an individual’s regular sleeping pattern and routine, hence negatively affecting the individual’s health. The traditional procedures of identifying sleep disorders by clinicians involve questionnaires and polysomnography (PSG), which are subjective, time-consuming, and inconvenient. Hence, an automated sleep disorder identification is required to overcome these limitations. In the proposed study, we have proposed a method using electroencephalogram (EEG) signals for the automated identification of six sleep disorders, namely insomnia, nocturnal frontal lobe epilepsy (NFLE), narcolepsy, rapid eye movement behavior disorder (RBD), periodic leg movement disorder (PLM), and sleep-disordered breathing (SDB). To the best of our belief, this is one of the first studies ever undertaken to identify sleep disorders using EEG signals employing cyclic alternating pattern (CAP) sleep database. After sleep-scoring EEG epochs, we have created eight different data subsets of EEG epochs to develop the proposed model. A novel optimal triplet half-band filter bank (THFB) is used to obtain the subbands of EEG signals. We have extracted Hjorth parameters from subbands of EEG epochs. The selected features are fed to various supervised machine learning algorithms for the automated classification of sleep disorders. Our proposed system has obtained the highest accuracy of 99.2%, 98.2%, 96.2%, 98.3%, 98.8%, and 98.8% for insomnia, narcolepsy, NFLE, PLM, RBD, and SDB classes against normal healthy subjects, respectively, applying ensemble boosted trees classifier. As a result, we have attained the highest accuracy of 91.3% to identify the type of sleep disorder. The proposed method is simple, fast, efficient, and may reduce the challenges faced by medical practitioners during the diagnosis of various sleep disorders accurately in less time at sleep clinics and homes.

Automated Detection of Hypertension Using Physiological Signals: A Review

Arterial hypertension (HT) is a chronic condition of elevated blood pressure (BP), which may cause increased incidence of cardiovascular disease, stroke, kidney failure and mortality. If the HT is diagnosed early, effective treatment can control the BP and avert adverse outcomes. Physiological signals like electrocardiography (ECG), photoplethysmography (PPG), heart rate variability (HRV), and ballistocardiography (BCG) can be used to monitor health status but are not directly correlated with BP measurements. The manual detection of HT using these physiological signals is time consuming and prone to human errors. Hence, many computer-aided diagnosis systems have been developed. This paper is a systematic review of studies conducted on the automated detection of HT using ECG, HRV, PPG and BCG signals. In this review, we have identified 23 studies out of 250 screened papers, which fulfilled our eligibility criteria. Details of the study methods, physiological signal studied, database used, various nonlinear techniques employed, feature extraction, and diagnostic performance parameters are discussed. The machine learning and deep learning based methods based on ECG and HRV signals have yielded the best performance and can be used for the development of computer-aided diagnosis of HT. This work provides insights that may be useful for the development of wearable for continuous cuffless remote monitoring of BP based on ECG and HRV signals.

Automatic Sleep-Stage Scoring in Healthy and Sleep Disorder Patients Using Optimal Wavelet Filter Bank Technique with EEG Signals

Sleep stage classification plays a pivotal role in effective diagnosis and treatment of sleep related disorders. Traditionally, sleep scoring is done manually by trained sleep scorers. The analysis of electroencephalogram (EEG) signals recorded during sleep by clinicians is tedious, time-consuming and prone to human errors. Therefore, it is clinically important to score sleep stages using machine learning techniques to get accurate diagnosis. Several studies have been proposed for automated detection of sleep stages. However, these studies have employed only healthy normal subjects (good sleepers). The proposed study focuses on the automated sleep-stage scoring of subjects suffering from seven different kind of sleep disorders such as insomnia, bruxism, narcolepsy, nocturnal frontal lobe epilepsy (NFLE), periodic leg movement (PLM), rapid eye movement (REM) behavioural disorder and sleep-disordered breathing as well as normal subjects. The open source physionet's cyclic alternating pattern (CAP) sleep database is used for this study. The EEG epochs are decomposed into sub-bands using a new class of optimized wavelet filters. Two EEG channels, namely F4-C4 and C4-A1, combined are used for this work as they can provide more insights into the changes in EEG signals during sleep. The norm features are computed from six sub-bands coefficients of optimal wavelet filter bank and fed to various supervised machine learning classifiers. We have obtained the highest classification performance using an ensemble of bagged tree (EBT) classifier with 10-fold cross validation. The CAP database comprising of 80 subjects is divided into ten different subsets and then ten different sleep-stage scoring tasks are performed. Since, the CAP database is unbalanced with different duration of sleep stages, the balanced dataset also has been created using over-sampling and under-sampling techniques. The highest average accuracy of 85.3% and Cohen's Kappa coefficient of 0.786 and accuracy of 92.8% and Cohen's Kappa coefficient of 0.915 are obtained for unbalanced and balanced databases, respectively. The proposed method can reliably classify the sleep stages using single or dual channel EEG epochs of 30 s duration instead of using multimodal polysomnography (PSG) which are generally used for sleep-stage scoring. Our developed automated system is ready to be tested with more sleep EEG data and can be employed in various sleep laboratories to evaluate the quality of sleep in various sleep disorder patients and normal subjects.

Automated detection of schizophrenia using optimal wavelet-based l 1 norm features extracted from single-channel EEG

Schizophrenia (SZ) is a mental disorder, which affects the ability of human thinking, memory, and way of living. Manual screening of SZ patients is tedious, laborious and prone to human errors. Hence, we developed a computer-aided diagnosis (CAD) system to diagnose SZ patients accurately using single-channel electroencephalogram (EEG) signals. The EEG signals are nonlinear and non-stationary. Hence, we have used wavelet-based features to capture the hidden non-stationary nature present in the signal. First, the EEG signals are subjected to the the wavelet decomposition through six iterations, which yields seven sub-bands. The l 1 norm is computed for each sub-band. The extracted norm features are disseminated to various classification algorithms. We have obtained the highest accuracy of 99.21% and 97.2% using K-nearest neighbor classifiers with ten-fold and leave-one-subject-out cross-validations. The developed single-channel EEG wavelet-based CAD model can help the clinicians to confirm the outcome of their manual screening and obtain an accurate diagnosis.

An automatic EEG-based sleep staging system with introducing NAoSP and NAoGP as new metrics for sleep staging systems

Different biological signals are recorded in sleep labs during sleep for the diagnosis and treatment of human sleep problems. Classification of sleep stages with electroencephalography (EEG) is preferred to other biological signals due to its advantages such as providing clinical information, cost-effectiveness, comfort, and ease of use. The evaluation of EEG signals taken during sleep by clinicians is a tiring, time-consuming, and error-prone method. Therefore, it is clinically mandatory to determine sleep stages by using software-supported systems. Like all classification problems, the accuracy rate is used to compare the performance of studies in this domain, but this metric can be accurate when the number of observations is equal in classes. However, since there is not an equal number of observations in sleep stages, this metric is insufficient in the evaluation of such systems. For this purpose, in recent years, Cohen's kappa coefficient and even the sensitivity of NREM1 have been used for comparing the performance of these systems. Still, none of them examine the system from all dimensions. Therefore, in this study, two new metrics based on the polygon area metric, called the normalized area of sensitivity polygon and normalized area of the general polygon, are proposed for the performance evaluation of sleep staging systems. In addition, a new sleep staging system is introduced using the applications offered by the MATLAB program. The existing systems discussed in the literature were examined with the proposed metrics, and the best systems were compared with the proposed sleep staging system. According to the results, the proposed system excels in comparison with the most advanced machine learning methods. The single-channel method introduced based on the proposed metrics can be used for robust and reliable sleep stage classification from all dimensions required for real-time applications.

An Automatic Sleep Stage Classification Algorithm Using Improved Model Based Essence Features

The automatic sleep stage classification technique can facilitate the diagnosis of sleep disorders and release the medical expert from labor-consumption work. In this paper, novel improved model based essence features (IMBEFs) were proposed combining locality energy (LE) and dual state space models (DSSMs) for automatic sleep stage detection on single-channel electroencephalograph (EEG) signals. Firstly, each EEG epoch is decomposed into low-level sub-bands (LSBs) and high-level sub-bands (HSBs) by wavelet packet decomposition (WPD), separately. Then, the DSSMs are estimated by the LSBs and the LE calculation is carried out on HSBs. Thirdly, the IMBEFs extracted from the DSSM and LE are fed into the appropriate classifier for sleep stage classification. The performance of the proposed method was evaluated on three public sleep databases. The experimental results show that under the Rechtschaffen's and Kale's (R&K) standard, the sleep stage classification accuracies of six classes on the Sleep EDF database and the Dreams Subjects database are 92.04% and 78.92%, respectively. Under the American Academy of Sleep Medicine (AASM) standard, the classification accuracies of five classes in the Dreams Subjects database and the ISRUC database reached 79.90% and 81.65%. The proposed method can be used for reliable sleep stage classification with high accuracy compared with state-of-the-art methods.