Towards Interpretable Sleep Stage Classification Using Cross-Modal Transformers

Accurate sleep stage classification is significant for sleep health assessment. In recent years, several machine-learning based sleep staging algorithms have been developed, and in particular, deep-learning based algorithms have achieved performance on par with human annotation. Despite the improved performance, a limitation of most deep-learning based algorithms is their black-box behavior, which has limited their use in clinical settings. Here, we propose a cross-modal transformer, which is a transformer-based method for sleep stage classification. The proposed cross-modal transformer consists of a novel cross-modal transformer encoder architecture along with a multi-scale one-dimensional convolutional neural network for automatic representation learning. Our method outperforms the state-of-the-art methods and eliminates the black-box behavior of deep-learning models by utilizing the interpretability aspect of the attention modules. Furthermore, our method provides considerable reductions in the number of parameters and training time compared to the state-of-the-art methods. Our code is available at https://github.com/Jathurshan0330/Cross-Modal-Transformer.

[1]  Syed Waqas Zamir,et al.  Transformers in Medical Imaging: A Survey , 2022, Medical Image Anal..

[2]  Junwen Pan,et al.  Transformer for Polyp Detection , 2021, ArXiv.

[3]  F. Faraci,et al.  DeepSleepNet-Lite: A Simplified Automatic Sleep Stage Scoring Model With Uncertainty Estimates , 2021, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[4]  Hyang-Woon Lee,et al.  Transferring Structured Knowledge in Unsupervised Domain Adaptation of a Sleep Staging Network , 2021, IEEE Journal of Biomedical and Health Informatics.

[5]  Maarten De Vos,et al.  SleepTransformer: Automatic Sleep Staging With Interpretability and Uncertainty Quantification , 2021, IEEE Transactions on Biomedical Engineering.

[6]  Julien Mairal,et al.  Emerging Properties in Self-Supervised Vision Transformers , 2021, 2021 IEEE/CVF International Conference on Computer Vision (ICCV).

[7]  Cuntai Guan,et al.  An Attention-Based Deep Learning Approach for Sleep Stage Classification With Single-Channel EEG , 2021, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[8]  Eric C. Frey,et al.  ViT-V-Net: Vision Transformer for Unsupervised Volumetric Medical Image Registration , 2021, ArXiv.

[9]  Kaare B. Mikkelsen,et al.  Light-weight sleep monitoring: electrode distance matters more than placement for automatic scoring , 2021, 2104.04567.

[10]  U. Rajendra Acharya,et al.  Automated Detection of Sleep Stages Using Deep Learning Techniques: A Systematic Review of the Last Decade (2010–2020) , 2020, Applied Sciences.

[11]  S. Gelly,et al.  An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale , 2020, ICLR.

[12]  Maarten De Vos,et al.  XSleepNet: Multi-View Sequential Model for Automatic Sleep Staging , 2020, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[13]  Akara Supratak,et al.  TinySleepNet: An Efficient Deep Learning Model for Sleep Stage Scoring based on Raw Single-Channel EEG , 2020, 2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[14]  Feng Yu,et al.  Convolution- and Attention-Based Neural Network for Automated Sleep Stage Classification , 2020, International journal of environmental research and public health.

[15]  Chen Chen,et al.  A Hierarchical Neural Network for Sleep Stage Classification Based on Comprehensive Feature Learning and Multi-Flow Sequence Learning , 2020, IEEE Journal of Biomedical and Health Informatics.

[16]  Wei Chen,et al.  MetaSleepLearner: A Pilot Study on Fast Adaptation of Bio-Signals-Based Sleep Stage Classifier to New Individual Subject Using Meta-Learning , 2020, IEEE Journal of Biomedical and Health Informatics.

[17]  Geoffrey E. Hinton,et al.  A Simple Framework for Contrastive Learning of Visual Representations , 2020, ICML.

[18]  Ziyao Xu,et al.  Automated multi-model deep neural network for sleep stage scoring with unfiltered clinical data , 2020, Sleep and Breathing.

[19]  Jianming Liang,et al.  UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation , 2019, IEEE Transactions on Medical Imaging.

[20]  Chenglu Sun,et al.  A hierarchical sequential neural network with feature fusion for sleep staging based on EOG and RR signals , 2019, Journal of neural engineering.

[21]  Maarten De Vos,et al.  Towards More Accurate Automatic Sleep Staging via Deep Transfer Learning , 2019, IEEE Transactions on Biomedical Engineering.

[22]  U. Rajendra Acharya,et al.  SleepEEGNet: Automated sleep stage scoring with sequence to sequence deep learning approach , 2019, PloS one.

[23]  U Rajendra Acharya,et al.  A Deep Learning Model for Automated Sleep Stages Classification Using PSG Signals , 2019, International journal of environmental research and public health.

[24]  Mihaela van der Schaar,et al.  What is Interpretable? Using Machine Learning to Design Interpretable Decision-Support Systems , 2018, ArXiv.

[25]  Mohammed Imamul Hassan Bhuiyan,et al.  Sleep stage classification using single-channel EOG , 2018, Comput. Biol. Medicine.

[26]  Oliver Y. Chén,et al.  SeqSleepNet: End-to-End Hierarchical Recurrent Neural Network for Sequence-to-Sequence Automatic Sleep Staging , 2018, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[27]  Jun Fu,et al.  Dual Attention Network for Scene Segmentation , 2018, 2019 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[28]  Jingdong Wang,et al.  OCNet: Object Context Network for Scene Parsing , 2018, ArXiv.

[29]  Maarten De Vos,et al.  Automatic Sleep Stage Classification Using Single-Channel EEG: Learning Sequential Features with Attention-Based Recurrent Neural Networks , 2018, 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[30]  Oliver Y. Chén,et al.  Joint Classification and Prediction CNN Framework for Automatic Sleep Stage Classification , 2018, IEEE Transactions on Biomedical Engineering.

[31]  Dimitri Perrin,et al.  Neural network analysis of sleep stages enables efficient diagnosis of narcolepsy , 2017, Nature Communications.

[32]  Lukasz Kaiser,et al.  Attention is All you Need , 2017, NIPS.

[33]  Chao Wu,et al.  DeepSleepNet: A Model for Automatic Sleep Stage Scoring Based on Raw Single-Channel EEG , 2017, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[34]  Hao Dong,et al.  Mixed Neural Network Approach for Temporal Sleep Stage Classification , 2016, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[35]  Mohammed Imamul Hassan Bhuiyan,et al.  Computer-aided sleep staging using Complete Ensemble Empirical Mode Decomposition with Adaptive Noise and bootstrap aggregating , 2016, Biomed. Signal Process. Control..

[36]  P. Matthews,et al.  Automatic Sleep Stage Scoring Using Time-Frequency Analysis and Stacked Sparse Autoencoders , 2015, Annals of Biomedical Engineering.

[37]  Jimmy Ba,et al.  Adam: A Method for Stochastic Optimization , 2014, ICLR.

[38]  Aeilko H. Zwinderman,et al.  Analysis of a sleep-dependent neuronal feedback loop: the slow-wave microcontinuity of the EEG , 2000, IEEE Transactions on Biomedical Engineering.

[39]  Jeffrey M. Hausdorff,et al.  Physionet: Components of a New Research Resource for Complex Physiologic Signals". Circu-lation Vol , 2000 .

[40]  Ming-Wei Chang,et al.  BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding , 2019, NAACL.

[41]  Alec Radford,et al.  Improving Language Understanding by Generative Pre-Training , 2018 .

[42]  Mohammed Imamul Hassan Bhuiyan,et al.  Automatic sleep scoring using statistical features in the EMD domain and ensemble methods , 2016 .

[43]  Amy Loutfi,et al.  Sleep Stage Classification Using Unsupervised Feature Learning , 2012, Adv. Artif. Neural Syst..

[44]  A. Chesson,et al.  The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Techinical Specifications , 2007 .