Automated sleep stage and event detection algorithms using quality-controlled polysomnography annotations.

Study Objectives To develop machine learning models for sleep stage classification, arousal detection, and respiratory event detection from overnight polysomnography, and to evaluate their performance relative to expert scorers. Methods Overnight polysomnography recordings were obtained from healthy...

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Publicado en:Sleep Advances Vol. 7; no. 2; pp. 1 - 18
Autores principales: Kaneda, Michiru, Ogaki, Sho, Nohara, Tomoyuki, Fujita, Syuhei, Osako, Naoshi, Yagi, Tomoko, Tomita, Yasuhiro, Ogata, Takanori
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA 2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2026
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      pub: Oxford University Press / USA
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        10.1093/sleepadvances/zpag054
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        atl: Automated sleep stage and event detection algorithms using quality-controlled polysomnography annotations.
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        au:
          Kaneda, Michiru
          Ogaki, Sho
          Nohara, Tomoyuki
          Fujita, Syuhei
          Osako, Naoshi
          Yagi, Tomoko
          Tomita, Yasuhiro
          Ogata, Takanori
        affil: ACCELStars, Inc.,  Tokyo, Japan
      sug:
        subj:
          Automation
          Sleep Stages Classification
          Arousal Evaluation
          Detection Algorithms
          Polysomnography
          Machine Learning Algorithms
          Classification Algorithms
          Sleep Apnea Syndromes Diagnosis
          Sensitivity and Specificity Evaluation
          Prediction Models
          Diagnosis, Computer Assisted
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Consensus
          Funding Source
          Comparative Studies
          Interrater Reliability
          Decision Trees
          kappa Statistic
          Questionnaires
          Sleep Apnea Syndromes
          Electroencephalography
          Electromyography
          Electrooculography
          Descriptive Statistics
          Machine Learning
          Decision Support Systems, Clinical
          Validation Studies
          Precision
          Sleep Apnea, Central Diagnosis
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Study Objectives To develop machine learning models for sleep stage classification, arousal detection, and respiratory event detection from overnight polysomnography, and to evaluate their performance relative to expert scorers. Methods Overnight polysomnography recordings were obtained from healthy participants and participants referred for suspected sleep-disordered breathing. Four certified scorers completed calibration sessions and generated reference annotations for sleep stages, arousals, and respiratory events. A subset of recordings was independently annotated by all scorers to support consensus analyses, enabling direct comparison between model outputs and human inter-scorer agreement. Gradient-boosted decision tree models were trained using hand-crafted features derived from standard physiological signals. Results Sleep stage classification achieved an accuracy of 0.840, a Cohen's kappa of 0.791, and an F1-score of 0.841, with limits of agreement for total sleep time of approximately ±0.5 h. Arousal detection achieved an F1-score of 0.733, with limits of agreement for the arousal index of approximately ±15 events/h. Respiratory event detection achieved an F1-score of 0.818, with limits of agreement for the apnea–hypopnea index also within approximately ±15 events/h. In consensus analyses, model performance was comparable to human inter-scorer agreement for sleep stages and arousals, while remaining below human inter-scorer agreement for respiratory events, despite high absolute performance relative to prior studies. Conclusions The proposed models achieved performance approaching human-level agreement across major sleep scoring tasks. These findings indicate that high consistency in expert annotations is a key factor underlying robust model performance and support the use of quality-controlled annotations for developing reliable automated sleep analysis systems. Statement of Significance Manual scoring of overnight sleep studies remains a major bottleneck in sleep medicine, limiting efficiency, consistency, and large-scale research. This study demonstrates that interpretable automated analysis can achieve performance approaching human-level agreement for core sleep scoring tasks when reference annotations are highly consistent. By directly comparing model outputs with calibrated inter-scorer agreement, the results show that annotation quality is a key determinant of attainable accuracy, rather than model complexity alone. Such systems may provide stable and reproducible reference outputs that support clinical decision-making, scorer training, and standardization across centers. Important remaining challenges include validation across institutions and populations, robustness to real-world signal artifacts, and extension to clinically meaningful subtypes of respiratory events.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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