title: Sleep stage scoring using the neural network model: comparison between visual and automatic analysis in normal subjects and patients.
abstract: In this paper, we compare and analyze the results from automatic analysis and visual scoring of nocturnal sleep recordings. The validation is based on a sleep recording set of 60 subjects (33 males and 27 females), consisting of three groups: 20 normal controls subjects, 20 depressed patients and 20 insomniac patients treated with a benzodiazepine. The inter-expert variability estimated from these 60 recordings (61,949 epochs) indicated an average agreement rate of 87.5% between two experts on the basis of 30-second epochs. The automatic scoring system, compared in the same way with one expert, achieved an average agreement rate of 82.3%, without expert supervision. By adding expert supervision for ambiguous and unknown epochs, detected by computation of an uncertainty index and unknown rejection, the automatic/expert agreement grew from 82.3% to 90%, with supervision over only 20% of the night. Bearing in mind the composition and the size of the test sample, the automated sleep staging system achieved a satisfactory performance level and may be considered a useful alternative to visual sleep stage scoring for large-scale investigations of human sleep.
authors.affiliation: Institute for Research in Neurosciences and Psychiatry, Centre Hospitalier, Rouffach, France.
authors.forename: N
authors.initials: N
authors.lastname: Schaltenbrand
authors.forename: R
authors.initials: R
authors.lastname: Lengelle
authors.forename: M
authors.initials: M
authors.lastname: Toussaint
authors.forename: R
authors.initials: R
authors.lastname: Luthringer
authors.forename: G
authors.initials: G
authors.lastname: Carelli
authors.forename: A
authors.initials: A
authors.lastname: Jacqmin
authors.forename: E
authors.initials: E
authors.lastname: Lainey
authors.forename: A
authors.initials: A
authors.lastname: Muzet
authors.forename: J P
authors.initials: JP
authors.lastname: Macher
mesh_terms: D000328:Adult; D000368:Aged; D001569:Benzodiazepines / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004569:Electroencephalography; D001330:Electronic Data Processing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D015588:Observer Variation; D017286:Polysomnography; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D012894:Sleep Stages; D012895:Sleep, REM
chemical_list: D001569:Benzodiazepines