arXiv:2606.18506cs.LGeess.SP2026-06中稿 · the 2nd Workshop o…

用因果发现方法构建睡眠恢复评分,比传统指标更贴近患者感受。

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

论文配图:Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health
图 1 · 摘自论文原文
  • 基于多模态睡眠数据,用因果图识别五类生理因素。
  • 新评分与主观恢复感相关性是传统AHI的3.4倍。
  • 适合临床研究与可穿戴健康设备的睡眠评估应用。

客观睡眠评估依赖多导睡眠图(PSG),但临床效果常由患者自评结果(如困倦、疲劳)反映。现有指标如呼吸暂停低通气指数(AHI)难以揭示功能恢复背后的多领域生理机制。本文提出一种可解释的因果发现引导框架,从多模态PSG数据中推导分层睡眠恢复评分(SRS)。在两个大型队列(MESA:n=1540;MrOS:n=825)中,采用有向无环图(DAG)学习识别涵盖呼吸负荷、缺氧负担、睡眠碎片化、睡眠结构和自主神经调节的候选生理驱动因素。尽管源自临床PSG,这些维度自然映射到可穿戴设备(如心电、血氧、睡眠分期)日益普及的连网健康技术。为保持机制合理性,引入两阶段筛选流程,结合生理学约束与受限大模型辅助审计,识别并移除结构混杂因素及构造重叠变量。跨队列分析显示,这五个维度均反复关联恢复,所获SRS与感知恢复的契合度最高达AHI的3.4倍。该工作通过可解释、抗偏倚、领域结构化的框架,将多模态睡眠生理与以患者为中心的结果相连接,为临床睡眠研究与新兴智能连网健康场景中的恢复建模提供实用基础。

原文摘要 · Abstract (English)

Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery-guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: \(n=1{,}540\); MrOS: \(n=825\)), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to \(3.4\times\) stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain-structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

睡眠评估因果发现可解释模型连网健康

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