Domain Adversarial Convolutional Neural Network Improves the Accuracy and Generalizability of Wearable Sleep Assessment Technology.

Wearable accelerometers are widely used as an ecologically valid and scalable solution for long-term at-home sleep monitoring in both clinical research and care. In this study, we applied a deep learning domain adversarial convolutional neural network (DACNN) model to this task and demonstrated that this new model outperformed existing sleep algorithms in classifying sleep-wake and estimating sleep outcomes based on wrist-worn accelerometry. This model generalized well to another dataset based on different wearable devices and activity counts, achieving an accuracy of 80.1% (sensitivity 84% and specificity 58%). Compared to commonly used sleep algorithms, this model resulted in the smallest error in wake after sleep onset (MAE of 48.7, Cole-Kripke of 86.2, Sadeh of 108.2, z-angle of 57.5) and sleep efficiency (MAE of 11.8, Cole-Kripke of 18.4, Sadeh of 23.3, z-angle of 9.3) outcomes. Despite being around for many years, accelerometer-alone devices continue to be useful due to their low cost, long battery life, and ease of use. Improving the accuracy and generalizability of sleep algorithms for accelerometer wrist devices is of utmost importance. We here demonstrated that domain adversarial convolutional neural networks can improve the overall accuracy, especially the specificity, of sleep-wake classification using wrist-worn accelerometer data, substantiating its use as a scalable and valid approach for sleep outcome assessment in real life.