Usefulness of Artificial Neural Networks in the Diagnosis and Treatment of Sleep Apnea-Hypopnea Syndrome

Sleep apnea-hypopnea syndrome (SAHS) is a chronic and highly prevalent disease considered a major health problem in industrialized countries. The gold standard diagnostic methodology is in-laboratory nocturnal polysomnography (PSG), which is complex, costly, and time consuming. In order to overcome these limitations, novel and simplified diagnostic alternatives are demanded. Sleep scientists carried out an exhaustive research during the last decades focused on the design of automated expert systems derived from artificial intelligence able to help sleep specialists in their daily practice. Among automated pattern recognition techniques, artificial neural networks (ANNs) have demonstrated to be efficient and accurate algorithms in order to implement computer-aided diagnosis systems aimed at assisting physicians in the management of SAHS. In this regard, several applications of ANNs have been developed, such as classification of patients suspected of suffering from SAHS, apnea-hypopnea index (AHI) prediction, detection and quantification of respiratory events, apneic events classification, automated sleep staging and arousal detection, alertness monitoring systems, and airflow pressure optimization in positive airway pressure (PAP) devices to fit patients’ needs. In the present research, current applications of ANNs in the framework of SAHS management are thoroughly reviewed

Automated sleep classification using the new sleep stage standards

Sleep is fundamental for physical health and good quality of life, and clinicians and researchers have long debated how best to understand it. Manual approaches to sleep classification have been in use for over 40 years, and in 2007, the American Academy of Sleep Medicine (AASM) published a new sleep scoring manual. Over the years, many attempts have been made to introduce and validate machine learning and automated classification techniques in the sleep research field, with the goals of improving consistency and reliability. This thesis explored and assessed the use of automated classification systems with the updated sleep stage definitions and scoring rules using neuro-fuzzy system (NFS) and support vector machine (SVM) methodology. For both the NFS and SVM classification techniques, the overall percent correct was approximately 65%, with sensitivity and specificity rates around 80% and 95%, respectively. The overall Kappa scores, one means for evaluating system reliability, were approximately 0.57 for both the NFS and SVM, indicating moderate agreement that is not accidental. Stage 3 sleep was detected with an 87-89% success rate. The results presented in this thesis show that the use of NFS and SVM methods for classifying sleep stages is possible using the new AASM guidelines. While the current work supports and confirms the use of these classification techniques within the research community, the results did not indicate a significant difference in the accuracy of either approach-nor a difference in one over the other. The results suggest that the important clinical stage 3 (slow wave sleep) can be accurately scored with these classifiers; however, the techniques used here would need more investigation and optimization prior to serious use in clinical applications

Sleep Stage Classification: A Deep Learning Approach

Sleep occupies significant part of human life. The diagnoses of sleep related disorders are of great importance. To record specific physical and electrical activities of the brain and body, a multi-parameter test, called polysomnography (PSG), is normally used. The visual process of sleep stage classification is time consuming, subjective and costly. To improve the accuracy and efficiency of the sleep stage classification, automatic classification algorithms were developed. In this research work, we focused on pre-processing (filtering boundaries and de-noising algorithms) and classification steps of automatic sleep stage classification. The main motivation for this work was to develop a pre-processing and classification framework to clean the input EEG signal without manipulating the original data thus enhancing the learning stage of deep learning classifiers. For pre-processing EEG signals, a lossless adaptive artefact removal method was proposed. Rather than other works that used artificial noise, we used real EEG data contaminated with EOG and EMG for evaluating the proposed method. The proposed adaptive algorithm led to a significant enhancement in the overall classification accuracy. In the classification area, we evaluated the performance of the most common sleep stage classifiers using a comprehensive set of features extracted from PSG signals. Considering the challenges and limitations of conventional methods, we proposed two deep learning-based methods for classification of sleep stages based on Stacked Sparse AutoEncoder (SSAE) and Convolutional Neural Network (CNN). The proposed methods performed more efficiently by eliminating the need for conventional feature selection and feature extraction steps respectively. Moreover, although our systems were trained with lower number of samples compared to the similar studies, they were able to achieve state of art accuracy and higher overall sensitivity

Analysis of Signal Decomposition and Stain Separation methods for biomedical applications

Nowadays, the biomedical signal processing and classification and medical image interpretation play an essential role in the detection and diagnosis of several human diseases. The problem of high variability and heterogeneity of information, which is extracted from digital data, can be addressed with signal decomposition and stain separation techniques which can be useful approaches to highlight hidden patterns or rhythms in biological signals and specific cellular structures in histological color images, respectively. This thesis work can be divided into two macro-sections. In the first part (Part I), a novel cascaded RNN model based on long short-term memory (LSTM) blocks is presented with the aim to classify sleep stages automatically. A general workflow based on single-channel EEG signals is developed to enhance the low performance in staging N1 sleep without reducing the performances in the other sleep stages (i.e. Wake, N2, N3 and REM). In the same context, several signal decomposition techniques and time-frequency representations are deployed for the analysis of EEG signals. All extracted features are analyzed by using a novel correlation-based timestep feature selection and finally the selected features are fed to a bidirectional RNN model. In the second part (Part II), a fully automated method named SCAN (Stain Color Adaptive Normalization) is proposed for the separation and normalization of staining in digital pathology. This normalization system allows to standardize digitally, automatically and in a few seconds, the color intensity of a tissue slide with respect to that of a target image, in order to improve the pathologist’s diagnosis and increase the accuracy of computer-assisted diagnosis (CAD) systems. Multiscale evaluation and multi-tissue comparison are performed for assessing the robustness of the proposed method. In addition, a stain normalization based on a novel mathematical technique, named ICD (Inverse Color Deconvolution) is developed for immunohistochemical (IHC) staining in histopathological images. In conclusion, the proposed techniques achieve satisfactory results compared to state-of-the-art methods in the same research field. The workflow proposed in this thesis work and the developed algorithms can be employed for the analysis and interpretation of other biomedical signals and for digital medical image analysis

Automatic Sleep Stages Classification

In this thesis, we first develop an efficient automated classification algorithm for sleep stages identification. Polysomnography recordings (PSGs) from twenty subjects were used in this study and features were extracted from the time{frequency representation of the electroencephalography (EEG) signal. The classification of the extracted features was done using random forest classifier. The performance of the new approach is tested by evaluating the accuracy of each sleep stages and total accuracy. The results shows improvement in all five sleep stages compared to previous works. Then, we present a simulation decision algorithm for switching between sleep interventions. This method improves the percentage of average amount of sleep in each stage. The results shows that sleep efficiency can be maximized by switching between intervention chains

A review of automated sleep stage scoring based on physiological signals for the new millennia

Background and Objective: Sleep is an important part of our life. That importance is highlighted by the multitude of health problems which result from sleep disorders. Detecting these sleep disorders requires an accurate interpretation of physiological signals. Prerequisite for this interpretation is an understanding of the way in which sleep stage changes manifest themselves in the signal waveform. With that understanding it is possible to build automated sleep stage scoring systems. Apart from their practical relevance for automating sleep disorder diagnosis, these systems provide a good indication of the amount of sleep stage related information communicated by a specific physiological signal. Methods: This article provides a comprehensive review of automated sleep stage scoring systems, which were created since the year 2000. The systems were developed for Electrocardiogram (ECG), Electroencephalogram (EEG), Electrooculogram (EOG), and a combination of signals. Results: Our review shows that all of these signals contain information for sleep stage scoring. Conclusions: The result is important, because it allows us to shift our research focus away from information extraction methods to systemic improvements, such as patient comfort, redundancy, safety and cost

CES-513 Stages for Developing Control Systems using EMG and EEG Signals: A survey

Bio-signals such as EMG (Electromyography), EEG (Electroencephalography), EOG (Electrooculogram), ECG (Electrocardiogram) have been deployed recently to develop control systems for improving the quality of life of disabled and elderly people. This technical report aims to review the current deployment of these state of the art control systems and explain some challenge issues. In particular, the stages for developing EMG and EEG based control systems are categorized, namely data acquisition, data segmentation, feature extraction, classification, and controller. Some related Bio-control applications are outlined. Finally a brief conclusion is summarized.

Detecting Slow Wave Sleep Using a Single EEG Signal Channel

Background: In addition to the cost and complexity of processing multiple signal channels, manual sleep staging is also tedious, time consuming, and error-prone. The aim of this paper is to propose an automatic slow wave sleep (SWS) detection method that uses only one channel of the electroencephalography (EEG) signal. New Method: The proposed approach distinguishes itself from previous automatic sleep staging methods by using three specially designed feature groups. The first feature group characterizes the waveform pattern of the EEG signal. The remaining two feature groups are developed to resolve the difficulties caused by interpersonal EEG signal differences. Results and comparison with existing methods: The proposed approach was tested with 1,003 subjects, and the SWS detection results show kappa coefficient at 0.66, an accuracy level of 0.973, a sensitivity score of 0.644 and a positive predictive value of 0.709. By excluding sleep apnea patients and persons whose age is older than 55, the SWS detection results improved to kappa coefficient, 0.76; accuracy, 0.963; sensitivity, 0.758; and positive predictive value, 0.812. Conclusions: With newly developed signal features, this study proposed and tested a single-channel EEG-based SWS detection method. The effectiveness of the proposed approach was demonstrated by applying it to detect the SWS of 1003 subjects. Our test results show that a low SWS ratio and sleep apnea can degrade the performance of SWS detection. The results also show that a large and accurately staged sleep dataset is of great importance when developing automatic sleep staging methods

Low-complexity algorithms for automatic detection of sleep stages and events for use in wearable EEG systems

Objective: Diagnosis of sleep disorders is an expensive procedure that requires performing a sleep study, known as polysomnography (PSG), in a controlled environment. This study monitors the neural, eye and muscle activity of a patient using electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) signals which are then scored in to different sleep stages. Home PSG is often cited as an alternative of clinical PSG to make it more accessible, however it still requires patients to use a cumbersome system with multiple recording channels that need to be precisely placed. This thesis proposes a wearable sleep staging system using a single channel of EEG. For realisation of such a system, this thesis presents novel features for REM sleep detection from EEG (normally detected using EMG/EOG), a low-complexity automatic sleep staging algorithm using a single EEG channel and its complete integrated circuit implementation. Methods: The difference between Spectral Edge Frequencies (SEF) at 95% and 50% in the 8-16 Hz frequency band is shown to have high discriminatory ability for detecting REM sleep stages. This feature, together with other spectral features from single-channel EEG are used with a set of decision trees controlled by a state machine for classification. The hardware for the complete algorithm is designed using low-power techniques and implemented on chip using 0.18μm process node technology. Results: The use of SEF features from one channel of EEG resulted in 83% of REM sleep epochs being correctly detected. The automatic sleep staging algorithm, based on contextually aware decision trees, resulted in an accuracy of up to 79% on a large dataset. Its hardware implementation, which is also the very first complete circuit level implementation of any sleep staging algorithm, resulted in an accuracy of 98.7% with great potential for use in fully wearable sleep systems.Open Acces