A model-based monitor of human sleep stages.

Stochastic models are proposed for sleep and for the sleep related electroencephalogram (EEG), electrooculogram (EOG), and electromyogram (EMG). The evolution of sleep through its various stages is described as a Markov chain. The EEG is modelled using Wiener processes. The EOG and EMG are modelled as combinations of Poisson point processes and Gaussian processes, respectively. The EEG models contain a feedback structure that is based on physiological data. The maximum likelihood sleep stage monitor, that uses the sleep-related observations, has been derived and implemented. The agreement between automatic and human stage classifications of six sleep recordings was 70.6%, which was 4.5% worse than the average agreement between six human classifiers. Monitoring of simulated sleep suggests that the difficulty in separating wakefulness from stage 1 is due to poor modelling. If one ignores this difference, which, from a diagnostic point of view is fairly unimportant, the above mentioned agreement reaches 81.8%, which is 0.5% better than the corresponding average human vs human agreement.