A Deep Learning-based Algorithm for Detection of Cortical Arousal During Sleep.

STUDY OBJECTIVE The frequency of cortical arousals is an indicator of sleep quality. Additionally, cortical arousals are used to identify hypopneic events. However, it is inconvenient to record electroencephalogram (EEG) data during home sleep testing. Fortunately, most cortical arousal events are associated with autonomic nervous system activity that could be observed on an electrocardiography (ECG) signal. ECG data have lower noise and are easier to record at home than EEG. In this study, we developed a deep learning-based cortical arousal detection (DeepCAD) algorithm that uses a single-lead ECG to detect arousal during sleep. METHODS This study included 1547 polysomnography records that met study inclusion criteria and were selected from the Multi-Ethnic Study of Atherosclerosis (MESA) database. We developed an end-to-end deep learning model consisting of convolutional neural networks and recurrent neural networks which: (1) accepted varying length physiological data; (2) directly extracted features from the raw ECG signal; (3) captured long-range dependencies in the physiological data; and (4) produced arousal probability in one second resolution. RESULTS We evaluated the model on a test set (n=311). The model achieved a gross area under precision-recall curve score of 0.62 and a gross area under receiver operating characteristic curve score of 0.93. CONCLUSION This study demonstrated the end-to-end deep learning approach with a single-lead ECG has the potential to be used to accurately detect arousals in home sleep tests.