Automated Polysomnography Analysis for Detection of Non-Apneic and Non-Hypopneic Arousals using Feature Engineering and a Bidirectional LSTM Network

Objective: The aim of this study is to develop an automated classification algorithm for polysomnography (PSG) recordings to detect non-apneic and non-hypopneic arousals. Our particular focus is on detecting the respiratory effort-related arousals (RERAs) which are very subtle respiratory events that do not meet the criteria for apnea or hypopnea, and are more challenging to detect. Methods: The proposed algorithm is based on a bidirectional long short-term memory (BiLSTM) classifier and 465 multi-domain features, extracted from multimodal clinical time series. The features consist of a set of physiology-inspired features (n = 75), obtained by multiple steps of feature selection and expert analysis, and a set of physiology-agnostic features (n = 390), derived from scattering transform. Results: The proposed algorithm is validated on the 2018 PhysioNet challenge dataset. The overall performance in terms of the area under the precision-recall curve (AUPRC) is 0.50 on the hidden test dataset. This result is tied for the second-best score during the follow-up and official phases of the 2018 PhysioNet challenge. Conclusions: The results demonstrate that it is possible to automatically detect subtle non-apneic/non-hypopneic arousal events from PSG recordings. Significance: Automatic detection of subtle respiratory events such as RERAs together with other non-apneic/non-hypopneic arousals will allow detailed annotations of large PSG databases. This contributes to a better retrospective analysis of sleep data, which may also improve the quality of treatment.