A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration

Matteo Cesari, Julie Anja Engelhard Christensen, Friederike Sixel-Döring, Maria‐Lucia Muntean, Brit Mollenhauer, Claudia Trenkwalder, Poul Jennum, Helge Bjarup Dissing Sørensen

Research output: Chapter in Book/Report/Conference proceedingArticle in proceedingsResearchpeer-review

Abstract

Elderly and patients with neurodegenerative diseases (NDD) often complain about sleep problems and show altered sleep structure. Automated algorithms for efficient and
specific sleep staging are needed. We propose a new algorithm using only one electroencephalographic and two electrooculographic channels to score wakefulness, rapid eye movement (REM) sleep and non-REM sleep in a cohort of elderly healthy controls (HC), patients with Parkinson’s disease (PD), isolated REM sleep behavior disorder (iRBD), considered the prodromal stage of PD, and patients with PD and RBD (PD+RBD). The proposed method scores both standard 30-s epochs (macro-staging) and 5-s mini-epochs (micro-staging), whose evaluation may help to better understand sleep microstructure. Moreover, the algorithm is interactive, as it labels the classified sleep epochs as either certain or uncertain, so that experts can manually review the uncertain ones. The algorithm performances were evaluated for macro-sleep staging, where it
achieved overall accuracies of 0.87±0.05 in 41 HC, 0.86±0.10 in 57 PD, 0.76±0.10 in 31 iRBD and 0.77±0.10 in 30 PD+RBD patients when all 30-s epochs were considered. The accuracies increased to 0.91±0.05, 0.90±0.08, 0.85±0.09, 0.88±0.08 respectively when considering only the certain ones. The epochs labeled as uncertain were 9.95±4.15%, 11.13±7.86%, 18.39±7.38% and 18.90±8.00% in HC, PD, iRBD and PD+RBD respectively. The proposed interactive micro and macro sleep staging algorithm can be used in clinics to reduce the burden of manual sleep staging in elderly and patients with NDD.
Original languageEnglish
Title of host publicationProceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society
PublisherIEEE
Publication date2019
Pages3649-52
ISBN (Print)978-1-5386-1311-5/
Publication statusPublished - 2019
Event2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society - CityCube Berlin, Berlin, Germany
Duration: 23 Jul 201927 Jul 2019
https://embc.embs.org/2019/

Conference

Conference2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society
LocationCityCube Berlin
CountryGermany
CityBerlin
Period23/07/201927/07/2019
Internet address

Cite this

Cesari, M., Christensen, J. A. E., Sixel-Döring, F., Muntean, ML., Mollenhauer, B., Trenkwalder, C., ... Sørensen, H. B. D. (2019). A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration. In Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (pp. 3649-52). IEEE.
Cesari, Matteo ; Christensen, Julie Anja Engelhard ; Sixel-Döring, Friederike ; Muntean, Maria‐Lucia ; Mollenhauer, Brit ; Trenkwalder, Claudia ; Jennum, Poul ; Sørensen, Helge Bjarup Dissing. / A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration. Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society . IEEE, 2019. pp. 3649-52
@inproceedings{5b1d2f991f1c46ebb9a903ee73825739,
title = "A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration",
abstract = "Elderly and patients with neurodegenerative diseases (NDD) often complain about sleep problems and show altered sleep structure. Automated algorithms for efficient andspecific sleep staging are needed. We propose a new algorithm using only one electroencephalographic and two electrooculographic channels to score wakefulness, rapid eye movement (REM) sleep and non-REM sleep in a cohort of elderly healthy controls (HC), patients with Parkinson’s disease (PD), isolated REM sleep behavior disorder (iRBD), considered the prodromal stage of PD, and patients with PD and RBD (PD+RBD). The proposed method scores both standard 30-s epochs (macro-staging) and 5-s mini-epochs (micro-staging), whose evaluation may help to better understand sleep microstructure. Moreover, the algorithm is interactive, as it labels the classified sleep epochs as either certain or uncertain, so that experts can manually review the uncertain ones. The algorithm performances were evaluated for macro-sleep staging, where itachieved overall accuracies of 0.87±0.05 in 41 HC, 0.86±0.10 in 57 PD, 0.76±0.10 in 31 iRBD and 0.77±0.10 in 30 PD+RBD patients when all 30-s epochs were considered. The accuracies increased to 0.91±0.05, 0.90±0.08, 0.85±0.09, 0.88±0.08 respectively when considering only the certain ones. The epochs labeled as uncertain were 9.95±4.15{\%}, 11.13±7.86{\%}, 18.39±7.38{\%} and 18.90±8.00{\%} in HC, PD, iRBD and PD+RBD respectively. The proposed interactive micro and macro sleep staging algorithm can be used in clinics to reduce the burden of manual sleep staging in elderly and patients with NDD.",
author = "Matteo Cesari and Christensen, {Julie Anja Engelhard} and Friederike Sixel-D{\"o}ring and Maria‐Lucia Muntean and Brit Mollenhauer and Claudia Trenkwalder and Poul Jennum and S{\o}rensen, {Helge Bjarup Dissing}",
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Cesari, M, Christensen, JAE, Sixel-Döring, F, Muntean, ML, Mollenhauer, B, Trenkwalder, C, Jennum, P & Sørensen, HBD 2019, A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration. in Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society . IEEE, pp. 3649-52, 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Berlin, Germany, 23/07/2019.

A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration. / Cesari, Matteo; Christensen, Julie Anja Engelhard; Sixel-Döring, Friederike; Muntean, Maria‐Lucia ; Mollenhauer, Brit ; Trenkwalder, Claudia; Jennum, Poul; Sørensen, Helge Bjarup Dissing.

Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society . IEEE, 2019. p. 3649-52.

Research output: Chapter in Book/Report/Conference proceedingArticle in proceedingsResearchpeer-review

TY - GEN

T1 - A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration

AU - Cesari, Matteo

AU - Christensen, Julie Anja Engelhard

AU - Sixel-Döring, Friederike

AU - Muntean, Maria‐Lucia

AU - Mollenhauer, Brit

AU - Trenkwalder, Claudia

AU - Jennum, Poul

AU - Sørensen, Helge Bjarup Dissing

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N2 - Elderly and patients with neurodegenerative diseases (NDD) often complain about sleep problems and show altered sleep structure. Automated algorithms for efficient andspecific sleep staging are needed. We propose a new algorithm using only one electroencephalographic and two electrooculographic channels to score wakefulness, rapid eye movement (REM) sleep and non-REM sleep in a cohort of elderly healthy controls (HC), patients with Parkinson’s disease (PD), isolated REM sleep behavior disorder (iRBD), considered the prodromal stage of PD, and patients with PD and RBD (PD+RBD). The proposed method scores both standard 30-s epochs (macro-staging) and 5-s mini-epochs (micro-staging), whose evaluation may help to better understand sleep microstructure. Moreover, the algorithm is interactive, as it labels the classified sleep epochs as either certain or uncertain, so that experts can manually review the uncertain ones. The algorithm performances were evaluated for macro-sleep staging, where itachieved overall accuracies of 0.87±0.05 in 41 HC, 0.86±0.10 in 57 PD, 0.76±0.10 in 31 iRBD and 0.77±0.10 in 30 PD+RBD patients when all 30-s epochs were considered. The accuracies increased to 0.91±0.05, 0.90±0.08, 0.85±0.09, 0.88±0.08 respectively when considering only the certain ones. The epochs labeled as uncertain were 9.95±4.15%, 11.13±7.86%, 18.39±7.38% and 18.90±8.00% in HC, PD, iRBD and PD+RBD respectively. The proposed interactive micro and macro sleep staging algorithm can be used in clinics to reduce the burden of manual sleep staging in elderly and patients with NDD.

AB - Elderly and patients with neurodegenerative diseases (NDD) often complain about sleep problems and show altered sleep structure. Automated algorithms for efficient andspecific sleep staging are needed. We propose a new algorithm using only one electroencephalographic and two electrooculographic channels to score wakefulness, rapid eye movement (REM) sleep and non-REM sleep in a cohort of elderly healthy controls (HC), patients with Parkinson’s disease (PD), isolated REM sleep behavior disorder (iRBD), considered the prodromal stage of PD, and patients with PD and RBD (PD+RBD). The proposed method scores both standard 30-s epochs (macro-staging) and 5-s mini-epochs (micro-staging), whose evaluation may help to better understand sleep microstructure. Moreover, the algorithm is interactive, as it labels the classified sleep epochs as either certain or uncertain, so that experts can manually review the uncertain ones. The algorithm performances were evaluated for macro-sleep staging, where itachieved overall accuracies of 0.87±0.05 in 41 HC, 0.86±0.10 in 57 PD, 0.76±0.10 in 31 iRBD and 0.77±0.10 in 30 PD+RBD patients when all 30-s epochs were considered. The accuracies increased to 0.91±0.05, 0.90±0.08, 0.85±0.09, 0.88±0.08 respectively when considering only the certain ones. The epochs labeled as uncertain were 9.95±4.15%, 11.13±7.86%, 18.39±7.38% and 18.90±8.00% in HC, PD, iRBD and PD+RBD respectively. The proposed interactive micro and macro sleep staging algorithm can be used in clinics to reduce the burden of manual sleep staging in elderly and patients with NDD.

M3 - Article in proceedings

SN - 978-1-5386-1311-5/

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BT - Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Cesari M, Christensen JAE, Sixel-Döring F, Muntean ML, Mollenhauer B, Trenkwalder C et al. A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration. In Proceedings of 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society . IEEE. 2019. p. 3649-52