PEI-LIN LEEHuang, Y.-H.Y.-H.HuangLin, P.-C.P.-C.LinChiao, Y.-A.Y.-A.ChiaoHou, J.-W.J.-W.HouLiu, H.-W.H.-W.LiuHuang, Y.-L.Y.-L.HuangLiu, Y.-T.Y.-T.LiuTZI-DAR CHIUEH2020-07-202020-07-20201915509389https://www.scopus.com/inward/record.uri?eid=2-s2.0-85073049775&doi=10.5664%2fjcsm.7964&partnerID=40&md5=3fa465d467177f6be10925e3242ce054https://scholars.lib.ntu.edu.tw/handle/123456789/510174Study Objectives: Reliable sleep staging is difficult to obtain from home sleep testing for diagnosis of obstructive sleep apnea (OSA), especially when it is self-applied. Hence, the current study aimed to develop a single frontal electroencephalography-based automatic sleep staging system (ASSS). Methods: The ASSS system was developed on a clinical dataset, with a high percentage of participants with OSA. The F4-M1 signal extracted from 62 participants (62.9% having OSA) was used to build a four-stage classifier. Performance of the ASSS was tested in a holdout set of 58 patients (60.3% having OSA) with epoch-by-epoch and whole-night agreement for sleep staging compared with expert scoring of polysomnography. Results: Mean all-stage percentage agreement was 75.52% (95% confidence interval, 72.90 to 78.13) (kappa 0.62; 95% confidence interval, 0.58 to 0.65), with mean percentage agreement for wake, light sleep, deep sleep (DS), and rapid eye movement of 78.04%, 70.97%, 83.65%, and 75.00%, respectively. The whole-night agreement was good-excellent (intraclass correlation coefficient, 0.74 to 0.88) for sleep onset latency, wake after sleep onset, total sleep time, and sleep efficiency. Compared to the non-OSA subset, the OSA subset had lower agreement for DS. Conclusions: Our results indicate that a single-channel F4-M1 based ASSS was sufficient for sleep staging in a population with a high percentage of participants with OSA. © 2019 American Academy of Sleep Medicine. All rights reserved.Automatic sleep staging; Deep sleep; Electroencephalography obstructive sleep apnea; Light sleep; Polysomnographyadult; Article; automatic sleep staging system; automation; controlled study; electroencephalography; female; human; major clinical study; male; middle aged; night sleep; polysomnography; REM sleep; scoring system; sleep disordered breathing; sleep latency; sleep stage; sleep time; slow wave sleep; stage 1 sleep; stage 2 sleep; staging; electroencephalography; pathophysiology; physiology; procedures; reproducibility; sleep disordered breathing; sleep stage; Taiwan; Electroencephalography; Female; Humans; Male; Middle Aged; Polysomnography; Reproducibility of Results; Sleep Apnea, Obstructive; Sleep Stages; Taiwanjournal article10.5664/jcsm.7964315029512-s2.0-85073049775