Transformer-Based Sleep Stage Classification Enhanced by Clinical Information

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Hauptverfasser: Chung, Woosuk, Hong, Seokwoo, Lee, Wonhyeok, Bae, Sangyoon
Format: Preprint
Veröffentlicht: 2025
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author Chung, Woosuk
Hong, Seokwoo
Lee, Wonhyeok
Bae, Sangyoon
author_facet Chung, Woosuk
Hong, Seokwoo
Lee, Wonhyeok
Bae, Sangyoon
contents Manual sleep staging from polysomnography (PSG) is labor-intensive and prone to inter-scorer variability. While recent deep learning models have advanced automated staging, most rely solely on raw PSG signals and neglect contextual cues used by human experts. We propose a two-stage architecture that combines a Transformer-based per-epoch encoder with a 1D CNN aggregator, and systematically investigates the effect of incorporating explicit context: subject-level clinical metadata (age, sex, BMI) and per-epoch expert event annotations (apneas, desaturations, arousals, periodic breathing). Using the Sleep Heart Health Study (SHHS) cohort (n=8,357), we demonstrate that contextual fusion substantially improves staging accuracy. Compared to a PSG-only baseline (macro-F1 0.7745, micro-F1 0.8774), our final model achieves macro-F1 0.8031 and micro-F1 0.9051, with event annotations contributing the largest gains. Notably, feature fusion outperforms multi-task alternatives that predict the same auxiliary labels. These results highlight that augmenting learned representations with clinically meaningful features enhances both performance and interpretability, without modifying the PSG montage or requiring additional sensors. Our findings support a practical and scalable path toward context-aware, expert-aligned sleep staging systems.
format Preprint
id arxiv_https___arxiv_org_abs_2511_08864
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Transformer-Based Sleep Stage Classification Enhanced by Clinical Information
Chung, Woosuk
Hong, Seokwoo
Lee, Wonhyeok
Bae, Sangyoon
Machine Learning
Artificial Intelligence
Manual sleep staging from polysomnography (PSG) is labor-intensive and prone to inter-scorer variability. While recent deep learning models have advanced automated staging, most rely solely on raw PSG signals and neglect contextual cues used by human experts. We propose a two-stage architecture that combines a Transformer-based per-epoch encoder with a 1D CNN aggregator, and systematically investigates the effect of incorporating explicit context: subject-level clinical metadata (age, sex, BMI) and per-epoch expert event annotations (apneas, desaturations, arousals, periodic breathing). Using the Sleep Heart Health Study (SHHS) cohort (n=8,357), we demonstrate that contextual fusion substantially improves staging accuracy. Compared to a PSG-only baseline (macro-F1 0.7745, micro-F1 0.8774), our final model achieves macro-F1 0.8031 and micro-F1 0.9051, with event annotations contributing the largest gains. Notably, feature fusion outperforms multi-task alternatives that predict the same auxiliary labels. These results highlight that augmenting learned representations with clinically meaningful features enhances both performance and interpretability, without modifying the PSG montage or requiring additional sensors. Our findings support a practical and scalable path toward context-aware, expert-aligned sleep staging systems.
title Transformer-Based Sleep Stage Classification Enhanced by Clinical Information
topic Machine Learning
Artificial Intelligence
url https://arxiv.org/abs/2511.08864