A method for the automatic analysis of the sleep macrostructure in continuum

Sleep staging is one of the most important tasks within the context of sleep studies. For more than 40 years the gold standard to the characterization of patient’s sleep macrostructure has been based on set of rules proposed by Rechtschaffen and Kales and recently modified by the American Academy of Sleep Medicine. Nevertheless the resulting map of sleep, the so-called hypnogram, has several limitations such as its low temporal resolution and the unnatural characterization of sleep through the assignment of discrete sleep states. This study reports an automatic method for the characterization of the structure of the sleep. The main intention is to overcome limitations of epoch-based sleep staging by obtaining a more continuous evolution of the sleep of the patient. The method is based on the use of fuzzy inference in order to avoid binary decisions, provide soft transitions and enable concurrent characterization of the different states. It is proven, in addition, how the new proposed continuous representation can still be used to generate the classical epoch-based hypnogram.

► A new method for the automatic analysis of the sleep state in continuum is explored.
► The objective is to overcome limitations of classical epoch-based staging methods.
► Binary decisions are avoided and more analysis resolution is achieved.
► Fuzzy inference is used to allow concurrent characterization of the sleep states.
► Validation (33 patients) shows agreement similar to human intrascorer variability.