Automated classification of neonatal sleep states using EEG

•Neonatal EEG and its sleep state characteristics change across development.•The combination of EEG features allows sleep state classification across preterm development.•The classifier allows the generation of a sleep state probability index for long term monitoring.

ObjectiveTo develop a method for automated neonatal sleep state classification based on EEG that can be applied over a wide range of age.MethodsWe collected 231 EEG recordings from 67 infants between 24 and 45 weeks of postmenstrual age. Ten minute epochs of 8 channel polysomnography (N = 323) from active and quiet sleep were used as a training dataset. We extracted a set of 57 EEG features from the time, frequency, and spatial domains. A greedy algorithm was used to define a reduced feature set to be used in a support vector machine classifier.ResultsPerformance tests showed that our algorithm was able to classify quiet and active sleep epochs with 85% accuracy, 83% sensitivity, and 87% specificity. The performance was not substantially lowered by reducing the epoch length or EEG channel number. The classifier output was used to construct a novel trend, the sleep state probability index, that improves the visualisation of brain state fluctuations.ConclusionsA robust EEG-based sleep state classifier was developed. It performs consistently well across a large span of postmenstrual ages.SignificanceThis method enables the visualisation of sleep state in preterm infants which can assist clinical management in the neonatal intensive care unit.