Evidence map›Paper›PMID 41384756›Full record

ArticleSleep2026

Optimizing automated sleep stage scoring of 5-s mini-epochs: a transfer learning study.

Louise Frøstrup Follin, Julie Anja Engelhard Christensen, Janita Vevelstad, Hilde T Juvodden, Rannveig Viste, Berit Hjelde Hansen, Mathias Perslev, Tobias Kaufmann, Alexander Neergaard Zahid, Stine Knudsen-Heier

Abstract read
In one paragraph

Article in Sleep, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Louise Frøstrup FollinDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.
Julie Anja Engelhard ChristensenDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.ORCID 0000-0003-4225-3359
Janita VevelstadDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.
Hilde T JuvoddenDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.ORCID 0000-0001-6796-7177
Rannveig VisteDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.
Berit Hjelde HansenDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.
Mathias PerslevDanish Center for Sleep Medicine, Rigshospitalet, Copenhagen, Denmark.
Tobias KaufmannCentre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Alexander Neergaard ZahidDepartment of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark.ORCID 0000-0001-6881-9766
Stine Knudsen-HeierDepartment of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Oslo, Norway.ORCID 0000-0003-1946-1125

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesConventional sleep staging relies on 30-s epochs, potentially concealing transient sleep stage intrusion and reducing precision. Building on our previous study of mini-epochs, we investigated whether U-Sleep, an existing automatic deep learning-based sleep staging model with high performance in epochs, could be optimized to similar performance level in 5-s mini-epoch scoring, thereby enabling more detailed sleep characterization.

methodsWe created a dataset of 48 000 human-scored 5-s mini-epochs from 100 polysomnographies. We compared mini-epochs to human-scored epochs before U-Sleep was optimized using transfer learning and evaluated on a test set. Model performance was assessed using F1-scores, confusion matrices, stage distributions and transition rates comparing scorings of the original U-Sleep before, and the optimized U-Sleep after transfer learning to human-scored mini-epochs.

resultsCompared to human-scored epochs, human-scored mini-epochs captured significantly more transitions (1.70/min vs. 0.21/min, p < .001), and significantly more wake (8.4 per cent vs. 5.4 per cent), N1 (7.2 per cent vs. 5.4 per cent), and N2 (51.8 per cent vs. 40.9 per cent), less N3 (15.4 per cent vs. 25.2 per cent), and REM sleep (16.7 per cent vs. 23.0 per cent) (all p < .001). Optimizing U-Sleep improved its performance significantly from F1 = 0.74 to F1 = 0.81 (p < .05) and gave increased transition rates in the test set (original U-Sleep: 1.06/min, optimized U-Sleep: 1.34/min, human-scored mini-epochs: 1.70/min). Stage distributions did not differ between optimized U-Sleep's scorings and human-scored mini-epochs.

conclusionAfter optimization, U-Sleep performance in mini-epochs matched the high performance levels previously reported in both human and automated 30-s epoch scoring. This demonstrates the feasibility of precise, automated high-resolution sleep staging. Future work should include external validation and application to full-night recordings. Statement of Significance Conventional 30-s epochs limit temporal resolution in sleep staging and may conceal transient intrusions of wake or sleep stages. However, no validated methods are available for high-resolution scoring. In this study, we trained and validated the state-of-the-art deep learning model U-Sleep for accurate automatic 5-s mini-epoch scoring using a large dataset of human-scored mini-epochs. The optimized model achieved a high performance, matching levels from previously reported automatic and human epoch scoring. Compared to epoch scoring, mini-epochs captured significantly more stage transitions, supporting their ability to uncover sleep dynamics that are otherwise lost. Our findings show the potential of high-resolution sleep staging for more detailed characterization of sleep architecture and demonstrate the feasibility of precise, automatic mini-epoch scoring.

Indexed as

Deep LearningPolysomnographySleep StagesAdultFemaleHumansMaleMiddle Agedartificial intelligenceautomatic sleep classificationmini-epochspolysomnographysleep stagingU-sleep

Identifiers

PMID41384756
PMCPMC13089430

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.