Evidence map›Paper›PMID 41550037›Full record

ArticleJournal of sleep research2026

The Potential of Ensemble-Based Automated Sleep Staging on Single-Channel EEG Signal From a Wearable Device.

Federico Salfi, Domenico Corigliano, Giulia Amicucci, Samantha Mombelli, Aurora D'Atri, John Axelsson, Michele Ferrara

Abstract read
In one paragraph

Article in Journal of sleep research, 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

7 authors.

Federico SalfiDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0003-1961-286X
Domenico CoriglianoDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0002-6033-5406
Giulia AmicucciDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0001-9975-6497
Samantha MombelliCenter for Advanced Research in Sleep Medicine, Centre intégré Universitaire de santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montréal, Canada.ORCID https://orcid.org/0000-0002-5406-8620
Aurora D'AtriDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0003-3650-0683
John AxelssonDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0003-3932-7310
Michele FerraraDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0003-2304-7576

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Machine-learning-based sleep staging models have achieved expert-level performance on standard polysomnographic (PSG) data. However, their application to EEG recorded by wearable devices remains limited by non-conventional referencing montage and the lack of benchmarking against PSG. Here, we tested whether an ensemble of state-of-the-art staging algorithms can reliably classify sleep from a customised configuration of the ZMax headband, adapted to record a fronto-mastoid EEG channel. Thirty-five nights of simultaneous ZMax and PSG recordings were acquired in a home setting, yielding 250.02 h of data from 10 healthy participants. PSG data were scored according to AASM criteria by two independent experts, with discrepancies resolved to obtain a consensus hypnogram. ZMax signal was processed using four machine-learning algorithms (YASA, U-Sleep, SleepTransformer, DeepResNet), whose predictions were combined into a final ensemble scoring through soft voting. Quantitative/qualitative analyses of NREM slow waves and spindles evaluated the preservation of microstructural features across recording systems. The ensemble scoring achieved almost perfect agreement with human consensus staging (night-level mean ± SD; accuracy = 88.83% ± 2.84%, Cohen's κ = 84.10% ± 4.52%, and Matthews Correlation Coefficient = 84.54% ± 4.23%). It showed excellent classification efficiency for REM (F1-score = 93.99%), N3 (89.53%), N2 (87.93%), and wakefulness (86.37%), with lower performance for N1 (53.20%). Microstructural comparisons confirmed strong correspondence between ZMax and PSG signals. These findings support the deployment of an ensemble scoring approach based on state-of-the-art sleep staging algorithms on ultra-minimal EEG setups. This paradigm advances the integration of data from modern wearable technologies into traditional PSG-based sleep research, overcoming longstanding barriers to ecological, large-scale sleep monitoring.

Indexed as

ElectroencephalographyMachine LearningSignal Processing, Computer-AssistedSleep StagesWearable Electronic DevicesAdultAlgorithmsEnsemble LearningFemaleHumansMalePolysomnographyYoung Adultco‐recordingmachine‐learningmicrostructural analysisportable EEGsleep stagingZMax headband

Identifiers

PMID41550037
PMCPMC13357711

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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.