YASA automated sleep staging performance across seven nights of normal sleep and sleep restriction

Abstract Study objectives This study aimed to compare YASA’s automated sleep staging to manual staging in the context of a multi-night experimental sleep restriction protocol. Methods Seventy-five adults (58% female; 57% nonwhite) participated in up to seven nights of laboratory-based polysomnography measurements. The study involved one adaptation night, followed by three nights of normal sleep (9 h time in bed) and three nights of sleep restriction (5.5 h time in bed). Condition order was counterbalanced. Manual sleep staging was performed by a registered polysomnographic technician. Sleep data were exported and processed using Python 3.12, MNE 1.8.0, and YASA 0.6.5 for automated sleep staging. Results Across 483 valid sleep nights, there was 82.9% overall agreement between YASA scoring and manual scoring. Stage-specific agreement was 40.3% (N1), 85.1% (N2), 86.9% (N3), and 78.7% (REM). Agreement was higher during normal sleep nights than sleep restriction nights, particularly for wake, N1, and REM sleep classifications. Conclusions YASA-based staging exhibited good overall agreement with manual scoring during normal sleep nights. However, caution is needed when interpreting N1 estimates, as well as in interpreting data during short sleep nights. Brief summary Current knowledge/study rationale Sleep stage scoring is typically conducted manually by at least one experienced technician, but this process is laborious and subject to biases. This study investigated whether a machine-learning-based open tool—YASA—could automatically stage polysomnography data with acceptable accuracy. Study impact Across 430,813 epochs, YASA showed acceptable accuracy in sleep staging, making it an efficient tool for the sleep community. However, caution is still needed for some applications, such as interpreting YASA’s N1 estimates as well as data from short sleep nights.