Fully-automated sleep staging: multicenter validation of a generalizable deep neural network for Parkinson's disease and isolated REM sleep behavior disorder

Jesper Strøm; Casper Skjærbæk; Natasha Becker Bertelsen; Steffen Torpe Simonsen; Niels Okkels; David Bertram; Sinah Röttgen; Konstantin Kufer; Kaare B. Mikkelsen; Marit Otto; Poul Jørgen Jennum; Per Borghammer; Michael Sommerauer; Preben Kidmose

arXiv · 2602.09793

Fully-automated sleep staging: multicenter validation of a generalizable deep neural network for Parkinson's disease and isolated REM sleep behavior disorder

Jesper Strøm·Casper Skjærbæk·Natasha Becker Bertelsen·Steffen Torpe Simonsen·Niels Okkels·David Bertram·Sinah Röttgen·Konstantin Kufer·Kaare B. Mikkelsen·Marit Otto·Poul Jørgen Jennum·Per Borghammer·Michael Sommerauer·Preben Kidmose

View original source ↗Read source document ↗Export metadata ↓

Abstract

Isolated REM sleep behavior disorder (iRBD) is a key prodromal marker of Parkinson's disease (PD), and video-polysomnography (vPSG) remains the diagnostic gold standard. However, manual sleep staging is particularly challenging in neurodegenerative diseases due to EEG abnormalities and fragmented sleep, making PSG assessments a bottleneck for deploying new RBD screening technologies at scale. We adapted U-Sleep, a deep neural network, for generalizable sleep staging in PD and iRBD. A pretrained U-Sleep model, based on a large, multisite non-neurodegenerative dataset (PUB; 19,236 PSGs across 12 sites), was fine-tuned on research datasets from two centers (Lundbeck Foundation Parkinson's Disease Research Center (PACE) and the Cologne-Bonn Cohort (CBC); 112 PD, 138 iRBD, 89 age-matched controls. The resulting model was evaluated on an independent dataset from the Danish Center for Sleep Medicine (DCSM; 81 PD, 36 iRBD, 87 sleep-clinic controls). A subset of PSGs with low agreement between the human rater and the model (Cohen's $κ$ < 0.6) was re-scored by a second blinded human rater to identify sources of disagreement. Finally, we applied confidence-based thresholds to optimize REM sleep staging. The pretrained model achieved mean $κ$ = 0.81 in PUB, but $κ$ = 0.66 when applied directly to PACE/CBC. By fine-tuning the model, we developed a generalized model with $κ$ = 0.74 on PACE/CBC (p < 0.001 vs. the pretrained model). In DCSM, mean and median $κ$ increased from 0.60 to 0.64 (p < 0.001) and 0.64 to 0.69 (p < 0.001), respectively. In the interrater study, PSGs with low agreement between the model and the initial scorer showed similarly low agreement between human scorers. Applying a confidence threshold increased the proportion of correctly identified REM sleep epochs from 85% to 95.5%, while preserving sufficient (> 5 min) REM sleep for 95% of subjects.

Explore related subjects

cs.LG q-bio.QM

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Jesper Strøm, Casper Skjærbæk, Natasha Becker Bertelsen, Steffen Torpe Simonsen, Niels Okkels, David Bertram, Sinah Röttgen, Konstantin Kufer, Kaare B. Mikkelsen, Marit Otto, Poul Jørgen Jennum, Per Borghammer, Michael Sommerauer, Preben Kidmose. 2026-02-11. Fully-automated sleep staging: multicenter validation of a generalizable deep neural network for Parkinson's disease and isolated REM sleep behavior disorder. https://arxiv.org/abs/2602.09793

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Label Propagation for Physics-Informed Neural Networks and Physics-Informed Gaussian Processes

We present a series of empirical results of the application of semi-supervised label propagation techniques in training physics-informed machine learning methods. This includes self-training of physics-informed neural networks and physics-informed Gaussian processes in isolation, and the integration of the two via co-training, therefore establishing a hybrid between these two main classes of physics-informed machine learning. We demonstrate via extensive numerical experiments how these methods can ameliorate the issue of propagating information from boundaries into the physical domain, including information from initial conditions in the case of solving stiff time-dependent partial differential equations, which is known to be a common failure mode of physics-informed machine learning.

cs.LG↗

arXiv2026

Multi-Armed Bernoulli Bandits via Minimax Single-Arm Stopping

We develop an index policy for finite-horizon Bernoulli multi-armed bandits from minimax solutions to single-arm bandit (SAB) problems. Each SAB problem involves choosing between an unknown Bernoulli arm and a known reward. We show that minimizing worst-case regret of SAB problems over all non-anticipative policies admits an exact semi-infinite linear programming formulation. The resulting stopping policies offer a natural way to compare arms: the higher the known reward against which a policy continues sampling, the more promising the unknown arm. We turn this intuition into indices based on cumulative continuation probabilities, with a monotone adjustment and a reward-shortfall cap. By relating index errors to the regret of single-arm stopping policies, we establish a distribution-free regret bound of $4.45\sqrt{KT}+10.75K$ for $K$ arms and horizon $T$. This bound matches the minimax-optimal regret order established in the literature. The guarantee extends to rewards supported on $[0,1]$ through Bernoulli randomization. We also provide a finite-grid implementation with quantified approximation loss. In numerical experiments, the SAB-based index policy achieves lower worst-case regret than every tested benchmark policy across all evaluated numbers of arms and horizons, while closely matching the grid-based MAB minimax policy in the two-arm setting.

cs.LG↗

arXiv2026

Autonomous Model Lifecycle Management for Digital Twin-Based Manufacturing Control

Manufacturing AI systems must autonomously adapt to continuous distributional shift from raw-material variability, ambient changes, and equipment aging, under strict safeguard and operator-trust requirements where model failures risk physical damage. This paper presents a closed-loop Cyber-Physical System (CPS) for autonomous model lifecycle management in automotive manufacturing, deployed since 2023. The system manages product-specialized model pairs: a sequence-to-sequence physics model (LPP) serving as a digital twin, and a deep Reinforcement Learning (RL) control policy (LCP) trained against it. Per retraining cycle, multiple model variants spanning architecture families and RL algorithms compete; only the best-scoring candidate advances. A Conductor orchestrator autonomously manages plant-wide model inventories with dependency-aware retraining and Proportional-Integral-Derivative (PID) fallback. Reflecting the principle of Human-Centric Intelligence, the LCP composite score embeds an operator-trust gate penalizing policies deviating from established practice; without it, 23% of policies are rejected by operators despite passing accuracy thresholds. Across multiple facilities, LCP-controlled processes achieve process stability improvements of 28-45% over uncontrolled baselines with zero safety incidents.

cs.LG↗