Neural network analysis of sleep stages enables efficient diagnosis of narcolepsy.

Journal: Nature communications
Published Date: Dec 6, 2018

Abstract

Analysis of sleep for the diagnosis of sleep disorders such as Type-1 Narcolepsy (T1N) currently requires visual inspection of polysomnography records by trained scoring technicians. Here, we used neural networks in approximately 3,000 normal and abnormal sleep recordings to automate sleep stage scoring, producing a hypnodensity graph-a probability distribution conveying more information than classical hypnograms. Accuracy of sleep stage scoring was validated in 70 subjects assessed by six scorers. The best model performed better than any individual scorer (87% versus consensus). It also reliably scores sleep down to 5 s instead of 30 s scoring epochs. A T1N marker based on unusual sleep stage overlaps achieved a specificity of 96% and a sensitivity of 91%, validated in independent datasets. Addition of HLA-DQB1*06:02 typing increased specificity to 99%. Our method can reduce time spent in sleep clinics and automates T1N diagnosis. It also opens the possibility of diagnosing T1N using home sleep studies.

Authors

  • Jens B Stephansen
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Alexander N Olesen
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Mads Olsen
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Aditya Ambati
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Eileen B Leary
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Hyatt E Moore
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Oscar Carrillo
    Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Ling Lin
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Fang Han
    Department of Respiratory Medicine and Intensive Care Unit.Peking University People's Hospital, Beijing 100044, China; Email: hanfangl@hotmail.com.
  • Han Yan
    Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, 100044, China.
  • Yun L Sun
    Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, 100044, China.
  • Yves Dauvilliers
    Centre de Reference Nationale Maladies Rares, Narcolepsie et Hypersomnie Idiopathique, Service Neurologie, Hôpital Gui-de-Chauliac, INSERM U1061, Montpellier, France.
  • Sabine Scholz
    Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, 34295, France.
  • Lucie Barateau
    Centre de Reference Nationale Maladies Rares, Narcolepsie et Hypersomnie Idiopathique, Service Neurologie, Hôpital Gui-de-Chauliac, INSERM U1061, Montpellier, France.
  • Birgit Högl
    Neurology Department, Sleep Disorders Clinic, Medical University of Innsbruck, Innsbruck, Austria.
  • Ambra Stefani
    Department of Neurology, Innsbruck Medical University, Innsbruck, 6020, Austria.
  • Seung Chul Hong
    Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea, Seoul, 16247, Korea.
  • Tae Won Kim
    AI‧Future Strategy Center, National Information Society Agency of Korea, Daegu, Korea.
  • Fabio Pizza
    Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
  • Giuseppe Plazzi
    Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
  • Stefano Vandi
    Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, 40123, Italy.
  • Elena Antelmi
    Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
  • Dimitri Perrin
    School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, 4001, Australia.
  • Samuel T Kuna
    Department of Medicine and Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, 19104, PA, USA.
  • Paula K Schweitzer
    Sleep Medicine and Research Center, St. Luke's Hospital, Chesterfield, 63017, MO, USA.
  • Clete Kushida
    Center for Sleep Science and Medicine, Stanford University, Stanford, 94304, CA, USA.
  • Paul E Peppard
    Department of Preventive medicine, U Madison Wisconsin Madison, Wisconsin, USA.
  • Helge B D Sorensen
  • Poul Jennum
    Danish Center for Sleep Medicine, Rigshospitalet, Glostrup, 2600, Denmark.
  • Emmanuel Mignot
    Center for Sleep Sciences and Medicine, Stanford School of Medicine, Palo Alto, CA, USA.

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