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The scoring of sleep stages is one of the essential tasks in sleep analysis. Since a manual procedure requires considerable human and financial resources, and incorporates some subjectivity, an automated approach could result in several advantages. There have been many developments in this area, and in order to provide a comprehensive overview, it is essential to review relevant recent works and summarise the characteristics of the approaches, which is the main aim of this article. To achieve it, we examined articles published between 2018 and 2022 that dealt with the automated scoring of sleep stages. In the final selection for in-depth analysis, 125 articles were included after reviewing a total of 515 publications. The results revealed that automatic scoring demonstrates good quality (with Cohen's kappa up to over 0.80 and accuracy up to over 90%) in analysing EEG/EEG + EOG + EMG signals. At the same time, it should be noted that there has been no breakthrough in the quality of results using these signals in recent years. Systems involving other signals that could potentially be acquired more conveniently for the user (e.g. respiratory, cardiac or movement signals) remain more challenging in the implementation with a high level of reliability but have considerable innovation capability. In general, automatic sleep stage scoring has excellent potential to assist medical professionals while providing an objective assessment.
Healthy sleep is one of the prerequisites for a good human body and brain condition, including general well-being. Unfortunately, there are several sleep disorders that can negatively affect this. One of the most common is sleep apnoea, in which breathing is impaired. Studies have shown that this disorder often remains undiagnosed. To avoid this, developing a system that can be widely used in a home environment to detect apnoea and monitor the changes once therapy has been initiated is essential. The conceptualisation of such a system is the main aim of this research. After a thorough analysis of the available literature and state of the art in this area of knowledge, a concept of the system was created, which includes the following main components: data acquisition (including two parts), storage of the data, apnoea detection algorithm, user and device management, data visualisation. The modules are interchangeable, and interfaces have been defined for data transfer, most of which operate using the MQTT protocol. System diagrams and detailed component descriptions, including signal requirements and visualisation mockups, have also been developed. The system's design includes the necessary concepts for the implementation and can be realised in a prototype in the next phase.
The development of automatic solutions for the detection of physiological events of interest is booming. Improvements in the collection and storage of large amounts of healthcare data allow access to these data faster and more efficiently. This fact means that the development of artificial intelligence models for the detection and monitoring of a large number of pathologies is becoming increasingly common in the medical field. In particular, developing deep learning models for detecting obstructive apnea (OSA) events is at the forefront. Numerous scientific studies focus on the architecture of the models and the results that these models can provide in terms of OSA classification and Apnea-Hypopnea-Index (AHI) calculation. However, little focus is put on other aspects of great relevance that are crucial for the training and performance of the models. Among these aspects can be found the set of physiological signals used and the preprocessing tasks prior to model training. This paper covers the essential requirements that must be considered before training the deep learning model for obstructive sleep apnea detection, in addition to covering solutions that currently exist in the scientific literature by analyzing the preprocessing tasks prior to training.
The massive use of patient data for the training of artificial intelligence algorithms is common nowadays in medicine. In this scientific work, a statistical analysis of one of the most used datasets for the training of artificial intelligence models for the detection of sleep disorders is performed: sleep health heart study 2. This study focuses on determining whether the gender and age of the patients have a relevant influence to consider working with differentiated datasets based on these variables for the training of artificial intelligence models.
Background: Polysomnography (PSG) is the gold standard for detecting obstructive sleep apnea (OSA). However, this technique has many disadvantages when using it outside the hospital or for daily use. Portable monitors (PMs) aim to streamline the OSA detection process through deep learning (DL).
Materials and methods: We studied how to detect OSA events and calculate the apnea-hypopnea index (AHI) by using deep learning models that aim to be implemented on PMs. Several deep learning models are presented after being trained on polysomnography data from the National Sleep Research Resource (NSRR) repository. The best hyperparameters for the DL architecture are presented. In addition, emphasis is focused on model explainability techniques, concretely on Gradient-weighted Class Activation Mapping (Grad-CAM).
Results: The results for the best DL model are presented and analyzed. The interpretability of the DL model is also analyzed by studying the regions of the signals that are most relevant for the model to make the decision. The model that yields the best result is a one-dimensional convolutional neural network (1D-CNN) with 84.3% accuracy.
Conclusion: The use of PMs using machine learning techniques for detecting OSA events still has a long way to go. However, our method for developing explainable DL models demonstrates that PMs appear to be a promising alternative to PSG in the future for the detection of obstructive apnea events and the automatic calculation of AHI.