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This research addresses the performance gap in wearable sleep staging by proposing a novel label expansion pipeline that leverages Hidden Semi-Markov Models to resolve temporal mismatches between coarse clinical epochs and rapid cardiovascular signal shifts. By converting standard 30-second labels into second-level annotations, the method significantly improves accuracy across diverse model architectures without requiring invasive EEG data. This work represents a meaningful advancement in applying machine learning techniques to optimize non-invasive health monitoring systems using photoplethysmography signals.
Rethinking PPG-based Sleep Staging: Datasets, Metrics, and Benchmarks
arXiv:2608.00943v1 Announce Type: cross Abstract: Automated sleep staging assigns discrete stage labels to successive time epochs throughout an overnight recording; conventionally each window spans at least 30 seconds, reflecting the minimum temporal resolution of the clinical scoring standard. Wearable photoplethysmography (PPG) has attracted sustained interest as an ambulatory alternative to laboratory-based polysomnography, which relies on electroencephalography (EEG) and other recording modalities that are impractical outside clinical environments. Yet PPG-based staging trails EEG-based methods by a substantial margin, and we argue this gap largely reflects a mismatch between signal and task. Within a stable stage, PPG's inter-stage feature differences are more subtle than those in EEG; yet at stage boundaries, PPG's principal cardiovascular features, heart rate variability and pulse morphology, shift sharply within seconds. The conventional practice of assigning one label to each 30-second epoch therefore suppresses feature that is concentrated near boundaries. We address this gap in two steps. First, we develop a label expansion pipeline based on Hidden Semi-Markov Models that converts coarse epoch labels into sec-level annotations. To assess whether these expanded labels are reliable enough for downstream supervision, we validate them on a separate expert-reviewed dataset and through an auxiliary sleep-wake task whose labels are independent of the expansion pipeline. Second, we use the resulting sec-level supervision on MESA to improve conventional four-class epoch-level staging across four architecturally diverse baselines by 3.7--5.7\,pp in accuracy against the original epoch labels, with supplementary zero-shot evaluation on CFS showing that the transfer benefit persists under cohort and annotation-protocol shift.
Abstract:Automated sleep staging assigns discrete stage labels to successive time epochs throughout an overnight recording; conventionally each window spans at least 30 seconds, reflecting the minimum temporal resolution of the clinical scoring standard. Wearable photoplethysmography (PPG) has attracted sustained interest as an ambulatory alternative to laboratory-based polysomnography, which relies on electroencephalography (EEG) and other recording modalities that are impractical outside clinical environments. Yet PPG-based staging trails EEG-based methods by a substantial margin, and we argue this gap largely reflects a mismatch between signal and task. Within a stable stage, PPG's inter-stage feature differences are more subtle than those in EEG; yet at stage boundaries, PPG's principal cardiovascular features, heart rate variability and pulse morphology, shift sharply within seconds. The conventional practice of assigning one label to each 30-second epoch therefore suppresses feature that is concentrated near boundaries. We address this gap in two steps. First, we develop a label expansion pipeline based on Hidden Semi-Markov Models that converts coarse epoch labels into sec-level annotations. To assess whether these expanded labels are reliable enough for downstream supervision, we validate them on a separate expert-reviewed dataset and through an auxiliary sleep-wake task whose labels are independent of the expansion pipeline. Second, we use the resulting sec-level supervision on MESA to improve conventional four-class epoch-level staging across four architecturally diverse baselines by 3.7--5.7\,pp in accuracy against the original epoch labels, with supplementary zero-shot evaluation on CFS showing that the transfer benefit persists under cohort and annotation-protocol shift.
Human-Computer Interaction (cs.HC); Machine Learning (cs.LG)
arXiv:2608.00943 [cs.HC]
(or arXiv:2608.00943v1 [cs.HC] for this version)
https://doi.org/10.48550/arXiv.2608.00943 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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