Beyond K-complex binary scoring during sleep: probabilistic classification using deep learning

Study objectives: K-complexes (KCs) are a recognized electroencephalography marker of sensory processing and a defining feature of sleep stage 2. KC frequency and morphology may also be reflective of sleep quality, aging, and a range of sleep and sensory processing deficits. However, manual scoring of K-complexes is impractical, time-consuming, and thus costly and currently not well-standardized. Although automated KC detection methods have been developed, performance and uptake remain limited.

Methods: The proposed algorithm is based on a deep neural network and Gaussian process, which gives the input waveform a probability of being a KC ranging from 0% to 100%. The algorithm was trained on half a million synthetic KCs derived from manually scored sleep stage 2 KCs from the Montreal Archive of Sleep Study containing 19 healthy young participants. Algorithm performance was subsequently assessed on 700 independent recordings from the Cleveland Family Study using sleep stages 2 and 3 data.

Results: The developed algorithm showed an F1 score (a measure of binary classification accuracy) of 0.78 and thus outperforms currently available KC scoring algorithms with F1 = 0.2-0.6. The probabilistic approach also captured expected variability in KC shape and amplitude within individuals and across age groups.

Conclusions: An automated probabilistic KC classification is well suited and effective for systematic KC detection for a more in-depth exploration of potential relationships between KCs during sleep and clinical outcomes such as health impacts and daytime symptomatology.