The Sleep Well Baby project: an automated real-time sleep-wake state prediction algorithm in preterm infants
Sentner, Thom; Wang, Xiaowan; de Groot, Eline R; van Schaijk, Lieke; Tataranno, Maria Luisa; Vijlbrief, Daniel C; Benders, Manon J N L; Bartels, Richard; Dudink, Jeroen
(2022) Sleep, volume 45, issue 10, pp. 1 - 11
(Article)
Abstract
STUDY OBJECTIVES: Sleep is an important driver of early brain development. However, sleep is often disturbed in preterm infants admitted to the neonatal intensive care unit (NICU). We aimed to develop an automated algorithm based on routinely measured vital parameters to classify sleep-wake states of preterm infants in real-time at
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the bedside. METHODS: In this study, sleep-wake state observations were obtained in 1-minute epochs using a behavioral scale developed in-house while vital signs were recorded simultaneously. Three types of vital parameter data, namely, heart rate, respiratory rate, and oxygen saturation, were collected at a low-frequency sampling rate of 0.4 Hz. A supervised machine learning workflow was used to train a classifier to predict sleep-wake states. Independent training (n = 37) and validation datasets were validation n = 9) datasets were used. Finally, a setup was designed for real-time implementation at the bedside. RESULTS: The macro-averaged area-under-the-receiver-operator-characteristic (AUROC) of the automated sleep staging algorithm ranged between 0.69 and 0.82 for the training data, and 0.61 and 0.78 for the validation data. The algorithm provided the most accurate prediction for wake states (AUROC = 0.80). These findings were well validated on an independent sample (AUROC = 0.77). CONCLUSIONS: With this study, to the best of our knowledge, a reliable, nonobtrusive, and real-time sleep staging algorithm was developed for the first time for preterm infants. Deploying this algorithm in the NICU environment may assist and adapt bedside clinical work based on infants' sleep-wake states, potentially promoting the early brain development and well-being of preterm infants.
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Keywords: Algorithm, Algorithms, Hospitalization, Humans, Infant, Infant, Newborn, Infant, Premature/physiology, Intensive Care Units, Neonatal, NICU, Sleep/physiology, automated sleep staging, brain, machine learning, neonatal intensive care, preterm, sleep, Journal Article
ISSN: 0161-8105
Publisher: Oxford University Press
Note: Funding Information: This work was supported by the European Commission, Horizon 2020 Marie Skłodowska-Curie Actions [Grant agreement number: EU H2020 MSCA-ITN-2018-#813483, INtegrating Functional Assessment measures for Neonatal Safeguard (INFANS)]. Publisher Copyright: © 2022 Sleep Research Society.
(Peer reviewed)