The Staging of Sleep Apneics' Sleep: A Comparison of Computerized Analysis with Human Scoring

Abstract

Computerized sleep staging is maintained to be a possible replacement for human scoring of sleep and is expected to reduce substantially the sleep technologists' time and efforts in scoring sleep into stages and practically to provide paperless polysomnography. So far various computer algorithms have been developed and automatic sleep analyzing systems have been tested mainly on normal human subjects and are alleged to be substantially reliable. However, it still remains to be answered how capable the systems are of reliably diagnosing sleep disordered subjects. The author attempted to review the function of a major automatic sleep analyzer (Oxford Medilog SAC 847 system) in comparison with expert human scoring. In eleven sleep apneic patients, one full night record of nocturnal polysomnography was compared between automatic analysis and human scoring on sleep stages epoch by epoch and on overall sleep architecture including various sleep parameters. The automatic analysis produced fewer stages 1 and REM, and more stage wake. The automatic stager's major difficulty was found to be with identifying wake and REM stages correctly. In conclusion, the present state of sophistication in automatic sleep analysis remains to be tested further in clinical sleep medicine.