Three-level Sleep Stage Classification Based on Wrist-worn Accelerometry Data Alone

Objective: The use of wearable sensor devices on daily basis to track real-time movements during wake and sleep has provided opportunities for automatic sleep quantification using such data. Existing algorithms for classifying sleep stages often require large training data and multiple input signals including heart rate and respiratory data. We aimed to examine the capability of classifying sleep stages using sensible features directly from accelerometers only with the aid of advanced recurrent neural networks. Materials and Methods: We analyzed a publicly available dataset with accelerometry data in 5s epoch length and polysomnography assessments. We developed long short-term memory (LSTM) models that take the 3-axis accelerations, angles, and temperatures from concurrent and historic observation windows to predict wake, REM and non-REM sleep. Leave-one-subject-out experiments were conducted to compare and evaluate the model performance with conventional nonsequential machine learning models using metrics such as multiclass training and testing accuracy, weighted precision, F1 score and area-under-the-curve (AUC). Results: Our sequential analysis framework outperforms traditional non-sequential models in all aspects of model evaluation metrics. We achieved an average of 65% and a maximum of 81% validation accuracy for classifying three sleep labels even with a relatively small training sample of clinical visitors. The presence of two additional derived variables, local variability and range, have shown to strongly improve the model performance. Discussion : Results indicate that it is crucial to account for deep temporal dependency and assess local variability of the features. The post-hoc analysis of individual model performances on subjects9 demographic characteristics also suggest the need of including pathological samples in the training data in order to develop robust machine learning models that are capable of capturing normal and anomaly sleep patterns in the population.