Mamba-based Deep Learning Approaches for Sleep Staging on a Wireless Multimodal Wearable System without Electroencephalography

Study Objectives: We investigate using Mamba-based deep learning approaches for sleep staging on signals from ANNE One (Sibel Health, Evanston, IL), a minimally intrusive dual-sensor wireless wearable system measuring chest electrocardiography (ECG), triaxial accelerometry, and temperature, as well as finger photoplethysmography (PPG) and temperature. Methods: We obtained wearable sensor recordings from 360 adults undergoing concurrent clinical polysomnography (PSG) at a tertiary care sleep lab. PSG recordings were scored according to AASM criteria. PSG and wearable sensor data were automatically aligned using their ECG channels with manual confirmation by visual inspection. We trained Mamba-based models with both convolutional-recurrent neural network (CRNN) and the recurrent neural network (RNN) architectures on these recordings. Ensembling of model variants with similar architectures was performed. Results: Our best approach, after ensembling, attains a 3-class (wake, NREM, REM) balanced accuracy of 83.50%, F1 score of 84.16%, Cohen's $\kappa$ of 72.68%, and a MCC score of 72.84%; a 4-class (wake, N1/N2, N3, REM) balanced accuracy of 74.64%, F1 score of 74.56%, Cohen's $\kappa$ of 61.63%, and MCC score of 62.04%; a 5-class (wake, N1, N2, N3, REM) balanced accuracy of 64.30%, F1 score of 66.97%, Cohen's $\kappa$ of 53.23%, MCC score of 54.38%. Conclusions: Deep learning models can infer major sleep stages from a wearable system without electroencephalography (EEG) and can be successfully applied to data from adults attending a tertiary care sleep clinic.