# aSAGA: Automatic Sleep Analysis with Gray Areas

arXiv: https://arxiv.org/abs/2310.02032 · HTML: https://mlsanity.com/paper/2310.02032/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 47 references that are in the map.
- First posted on arXiv 3 Oct 2023.

## Builds on (most cited first, 12 of 12)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [A Review of Uncertainty Quantification in Deep Learning: Techniques, Applications and Challenges](https://mlsanity.com/paper/2011.06225/) (2020)
- [A disciplined approach to neural network hyper-parameters: Part 1 -- learning rate, batch size, momentum, and weight decay](https://mlsanity.com/paper/1803.09820/) (2018)
- [U-Time: A Fully Convolutional Network for Time Series Segmentation Applied to Sleep Staging](https://mlsanity.com/paper/1910.11162/) (2019)
- [SleepTransformer: Automatic Sleep Staging with Interpretability and Uncertainty Quantification](https://mlsanity.com/paper/2105.11043/) (2021)
- [Automatic Sleep Staging of EEG Signals: Recent Development, Challenges, and Future Directions](https://mlsanity.com/paper/2111.08446/) (2021)
- [Neural network an1alysis of sleep stages enables efficient diagnosis of narcolepsy](https://mlsanity.com/paper/1710.02094/) (2017)
- [Inter-database validation of a deep learning approach for automatic sleep scoring](https://mlsanity.com/paper/2009.10365/) (2020)
- [Dreem Open Datasets: Multi-Scored Sleep Datasets to compare Human and Automated sleep staging](https://mlsanity.com/paper/1911.03221/) (2019)
- [Towards More Accurate Automatic Sleep Staging via Deep Transfer Learning](https://mlsanity.com/paper/1907.13177/) (2019)
- [DeepSleepNet-Lite: A Simplified Automatic Sleep Stage Scoring Model with Uncertainty Estimates](https://mlsanity.com/paper/2108.10600/) (2021)
- [Automatic sleep stage classification with deep residual networks in a mixed-cohort setting](https://mlsanity.com/paper/2008.09416/) (2020)

## Built on by (most cited first, 1 of 1)

- [Bridging AI and Clinical Practice: Integrating Automated Sleep Scoring Algorithm with Uncertainty-Guided Physician Review](https://mlsanity.com/paper/2312.14996/) (2023)

## Abstract (arXiv)

State-of-the-art automatic sleep staging methods have already demonstrated comparable reliability and superior time efficiency to manual sleep staging. However, fully automatic black-box solutions are difficult to adapt into clinical workflow and the interaction between explainable automatic methods and the work of sleep technologists remains underexplored and inadequately conceptualized. Thus, we propose a human-in-the-loop concept for sleep analysis, presenting an automatic sleep staging model (aSAGA), that performs effectively with both clinical polysomnographic recordings and home sleep studies. To validate the model, extensive testing was conducted, employing a preclinical validation approach with three retrospective datasets; open-access, clinical, and research-driven. Furthermore, we validate the utilization of uncertainty mapping to identify ambiguous regions, conceptualized as gray areas, in automatic sleep analysis that warrants manual re-evaluation. The results demonstrate that the automatic sleep analysis achieved a comparable level of agreement with manual analysis across different sleep recording types. Moreover, validation of the gray area concept revealed its potential to enhance sleep staging accuracy and identify areas in the recordings where sleep technologists struggle to reach a consensus. In conclusion, this study introduces and validates a concept from explainable artificial intelligence into sleep medicine and provides the basis for integrating human-in-the-loop automatic sleep staging into clinical workflows, aiming to reduce black-box criticism and the burden associated with manual sleep staging.