SleepExplain: Explainable Non-Rapid Eye Movement and Rapid Eye Movement Sleep Stage Classification from EEG Signal

Automated sleep staging is commonly approached as a supervised machine learning problem, with deep learning methods dominating recent research. While machine learning models achieve near-human level agreement with human-scored reference sleep stages, their decisions are typically opaque and not designed to follow clinical scoring rules. We propose a transparent alternative: a deterministic, rule-based sleep staging method that explicitly operationalizes the American Academy of Sleep Medicine's (AASM) scoring logic as executable code, coupled with epoch-level natural-language justifications derived from an explanation trace. We evaluate the approach on 50 polysomnography recordings with a 10-scorer majority-vote consensus as reference. Across all recordings, the method agreed with the majority-vote reference in 60.5% of epochs ($κ=0.42$), with substantially higher agreement on a dataset used during development (77.1%, $κ=0.61$). Agreement with the reference was highest for sleep stage N2 (recall 83.5%) and moderate for sleep stage R (recall 68.7%), while Wake and N1 recall were low. Despite lower agreement with the reference than contemporary deep learning models, the method provides deterministic decisions and natural language explanations aligned with AASM scoring rules, making it a complementary tool for auditing, debugging, and governing deep learning-based sleep staging.

Sleep stage classification is important for the diagnosis and management of sleep disorders, yet most automatic staging studies evaluate models against a single reference hypnogram despite known inter-scorer variability. This study investigates whether multi-scored datasets can be used to construct more reliable reference labels from the collective behavior of multiple experts. We use the publicly available DOD-H and DOD-O datasets. EEG (C3-M2) and chin EMG signals were segmented into 30-s epochs, and 30 features were extracted from each modality, yielding 60 features for EEG+EMG. We propose a learning-based hypnogram (LBH) that models the stage-specific behavior of each scorer using confusion matrices derived from machine-learning models. After column normalization, these matrices estimate the probability of each true sleep stage given each scorer's label; probabilities are aggregated across scorers to assign the final label for each epoch. LBH was evaluated with random forest, support vector machine, and multilayer perceptron classifiers under EEG-only and EEG+EMG settings, and compared with the dataset hypnogram (DH) and best-scorer hypnogram (BSH). LBH consistently improved overall performance. The best results were obtained with random forest and EEG+EMG, reaching 86.07% accuracy, 85.46% precision, and 85.29% F1-score on DOD-H, and 86.04% accuracy, 85.21% precision, and 84.70% F1-score on DOD-O. These findings suggest that personalized scorer modeling can improve reference hypnogram construction without discarding information from individual experts.

Accurate classification of sleep stages is crucial for diagnosing sleep disorders and automating this process can significantly enhance clinical assessments. This study aims to explore the use of a self-supervised model (more specifically, an adapted version of mulEEG) combined with a Linear SVM classifier to improve sleep stage classification. \textbf{Methods:} The mulEEG model, which learns electroencephalogram signal representations in a self-supervised manner, was simplified here by replacing ResNet-50 with 1D-convolutions used as time series encoder by a ResNet-18 backbone. Two other adaptations were conducted: the first one evaluated different configurations of the model and data volume for training, while the second tested the effectiveness of time series features, spectrogram features, and their concatenation as inputs to a Linear SVM classifier. \textbf{Results:} The results showed that reducing the volume of data offered a better cost-benefit ratio compared to simplifying the model. Using the concatenated features with ResNet-18 also outperformed the linear evaluations of the original mulEEG model, achieving higher classification performance. \textbf{Conclusions:} Simplifying the mulEEG model to extract features and pairing it with a robust classifier leads to more efficient and accurate sleep stage classification. This approach holds promise for improving clinical sleep assessments and can be extended to other biological signal classification tasks.