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This paper presents the implementation of deep learning methods for sleep stage detection by using three signals that can be measured in a non-invasive way: heartbeat signal, respiratory signal, and movement signal. Since signals are measurements taken during the time, the problem is seen as time-series data classification. Deep learning methods are chosen to solve the problem are convolutional neural network and long-short term memory network. Input data is structured as a time-series sequence of mentioned signals that represent 30 seconds epoch, which is a standard interval for sleep analysis. The records used belong to the overall 23 subjects, which are divided into two subsets. Records from 18 subjects were used for training the data and from 5 subjects for testing the data. For detecting four sleep stages: REM (Rapid Eye Movement), Wake, Light sleep (Stage 1 and Stage 2), and Deep sleep (Stage 3 and Stage 4), the accuracy of the model is 55%, and F1 score is 44%. For five stages: REM, Stage 1, Stage 2, Deep sleep (Stage 3 and 4), and Wake, the model gives an accuracy of 40% and F1 score of 37%.
The use of deep learning models with medical data is becoming more widespread. However, although numerous models have shown high accuracy in medical-related tasks, such as medical image recognition (e.g. radiographs), there are still many problems with seeing these models operating in a real healthcare environment. This article presents a series of basic requirements that must be taken into account when developing deep learning models for biomedical time series classification tasks, with the aim of facilitating the subsequent production of the models in healthcare. These requirements range from the correct collection of data, to the existing techniques for a correct explanation of the results obtained by the models. This is due to the fact that one of the main reasons why the use of deep learning models is not more widespread in healthcare settings is their lack of clarity when it comes to explaining decision making.
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.