Deep learning-based sleep stage classification with cardiorespiratory and body movement activities in individuals with suspected sleep disorders

Deep learning methods have gained significant attention in sleep science. This study aimed to assess the performance of a deep learning-based sleep stage classification model constructed using fewer physiological parameters derived from cardiorespiratory and body movement data. Overnight polysomnography (PSG) data from 123 participants (age: 19–82 years) with suspected sleep disorders were analyzed. Multivariate time series data, including heart rate, respiratory rate, cardiorespiratory coupling, and body movement frequency, were input into a bidirectional long short-term memory (biLSTM) network model to train and predict five-class sleep stages. The trained model's performance was evaluated using balanced accuracy, Cohen's κ coefficient, and F1 scores on an epoch-per-epoch basis and compared with the ground truth using the leave-one-out cross-validation scheme. The model achieved an accuracy of 71.2 ± 5.8%, Cohen's κ of 0.425 ± 0.115, and an F1 score of 0.650 ± 0.083 across all sleep stages, and all metrics were negatively correlated with the apnea–hypopnea index, as well as age, but positively correlated with sleep efficiency. Moreover, the model performance varied for each sleep stage, with the highest F1 score observed for N2 and the lowest for N3. Regression and Bland–Altman analyses between sleep parameters of interest derived from deep learning and PSG showed substantial correlations (r = 0.33–0.60) with low bias. The findings demonstrate the efficacy of the biLSTM deep learning model in accurately classifying sleep stages and in estimating sleep parameters for sleep structure analysis using a reduced set of physiological parameters. The current model without using EEG information may expand the application of unobtrusive in-home monitoring to clinically assess the prevalence of sleep disorders outside of a sleep laboratory.