Deep Learning Application to Clinical Decision Support System in Sleep Stage Classification

Recently, deep learning for automated sleep stage classification has been introduced with promising results. However, as many challenges impede their routine application, automatic sleep scoring algorithms are not widely used. Typically, polysomnography (PSG) uses multiple channels for higher accuracy; however, the disadvantages include a requirement for a patient to stay one or more nights in the lab wearing uncomfortable sensors and wires. To avoid the inconvenience caused by the multiple channels, we aimed to develop a deep learning model for use in clinical decision support systems (CDSSs) and combined convolutional neural networks and a transformer for the supervised learning of three classes of sleep stages only with single-channel EEG data (C4-M1). The data for training, validation, and test were derived from 1590, 341, and 343 polysomnography recordings, respectively. The developed model yielded an overall accuracy of 91.4%, comparable with that of human experts. Based on the severity of obstructive sleep apnea, the model's accuracy was 94.3%, 91.9%, 91.9%, and 90.6% in normal, mild, moderate, and severe cases, respectively. Our deep learning model enables accurate and rapid delineation of three-class sleep staging and could be useful as a CDSS for application in real-world clinical practice.