用生理约束提升睡眠分期准确性,让结果更符合真实睡眠规律。
StageGuard: Physiologically Constrained Sleep Staging
- 给任意睡眠分期模型加生理先验,约束异常过渡和片段化。
- 减少90%以上异常过渡,碎片化指数降低56%-62%。
- 适合关注睡眠结构统计量的临床与科研人员。
自动化睡眠分期广泛用于大规模研究中提取睡眠结构指标,如总睡眠时间、快速眼动潜伏期、睡眠效率及片段持续时间。深度学习模型虽在分段级别达到接近专家一致性的准确率,但常生成违反生理规律的睡眠图谱,如罕见过渡(如直接从清醒到快速眼动期)或过度碎片化序列,此类偏差会扭曲下游睡眠指标,即使整体准确率高亦然。本文提出StageGuard,一种即插即用、不依赖骨干网络的结构化推理框架,通过(1)可微软过渡惩罚项在训练中抑制罕见过渡,(2)带时长增强状态空间的半马尔可夫解码器,在推理时联合施加过渡惩罚与最小片段时长约束。不同于硬性禁止方法,当发射证据强烈时仍允许罕见过渡,保留病理事件信息。StageGuard强制分期输出满足已知生理先验,而非生成式建模。我们使用过渡违规率(TVR)和碎片化指数(FI)量化有效性差距,结果表明:在六个骨干网络与四个数据集上,StageGuard将TVR降至生理可接受水平,使FI降低56%-62%,同时保持或略微提升分类准确率。关键在于,更强的约束满足带来衍生睡眠结构指标误差降低59%-79%,更准确恢复专家定义亚组差异(如阻塞性睡眠呼吸暂停严重程度、年龄)的方向与效应大小,优于无约束基线。
原文摘要 · Abstract (English)
Automated sleep staging is increasingly used in large-scale studies to derive sleep-architecture endpoints: total sleep time, REM latency, sleep efficiency, and bout-duration statistics. Deep learning models achieve epoch-level accuracy approaching inter-rater agreement, yet often produce hypnograms that violate physiological invariants, such as rare transitions (e.g., direct Wake -> REM) or excessively fragmented sequences. Such violations can bias downstream sleep metrics, regardless of overall accuracy. We propose StageGuard, a plug-and-play, backbone-agnostic structured-inference framework that wraps any neural sleep-staging backbone with physiology-informed priors. StageGuard combines (1) a differentiable soft transition penalty that discourages physiologically rare transitions during training, and (2) a semi-Markov constrained decoder with a duration-augmented state space that jointly enforces transition penalties and minimum bout durations at inference. Unlike hard-prohibition methods, it admits rare transitions when emission evidence is overwhelming, leaving informative pathological events recoverable rather than blocked. StageGuard constrains staging outputs to satisfy known physiological priors rather than modeling sleep generatively. We quantify the validity gap using transition-violation rate (TVR) and fragmentation index (FI) and demonstrate that, across six backbones and four datasets, StageGuard reduces TVR to physiologically plausible levels and lowers FI by 56-62%, while maintaining or slightly improving classification accuracy. Crucially, improved constraint satisfaction translates into 59-79% lower error on derived sleep-architecture statistics not directly optimized by the method, and recovers the direction and effect size of expert-defined subgroup differences (OSA severity, age) more faithfully than the unconstrained baseline.
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