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      A machine learning model for multi-night actigraphic detection of chronic insomnia: development and validation of a pre-screening tool

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          Abstract

          We propose a novel machine learning-based method for analysing multi-night actigraphy signals to objectively classify and differentiate nocturnal awakenings in individuals with chronic insomnia (CI) and their cohabiting healthy partners. We analysed nocturnal actigraphy signals from 40 cohabiting couples with one partner seeking treatment for insomnia. We extracted 12 time-domain dynamic and nonlinear features from the actigraphy signals to classify nocturnal awakenings in healthy individuals and those with CI. These features were then used to train two machine learning classifiers, random forest (RF) and support vector machine (SVM). An optimization algorithm that incorporated the predicted quality of each night for each individual was used to classify individuals into CI or healthy sleepers. Using the proposed actigraphic signal analysis technique, coupled with a rigorous leave-one-out validation approach, we achieved a classification accuracy of 80% (sensitivity: 76%, specificity: 82%) in classifying CI individuals and their healthy bed partners. The RF classifier (accuracy: 80%) showed a better performance than SVM (accuracy: 75%). Our approach to analysing the multi-night nocturnal actigraphy recordings provides a new method for screening individuals with CI, using wrist-actigraphy devices, facilitating home monitoring.

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          Most cited references51

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          Support-vector networks

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            Sleep drives metabolite clearance from the adult brain.

            The conservation of sleep across all animal species suggests that sleep serves a vital function. We here report that sleep has a critical function in ensuring metabolic homeostasis. Using real-time assessments of tetramethylammonium diffusion and two-photon imaging in live mice, we show that natural sleep or anesthesia are associated with a 60% increase in the interstitial space, resulting in a striking increase in convective exchange of cerebrospinal fluid with interstitial fluid. In turn, convective fluxes of interstitial fluid increased the rate of β-amyloid clearance during sleep. Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.
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              The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response.

              Although insomnia is a prevalent complaint with significant morbidity, it often remains unrecognized and untreated. Brief and valid instruments are needed both for screening and outcome assessment. This study examined psychometric indices of the Insomnia Severity Index (ISI) to detect cases of insomnia in a population-based sample and to evaluate treatment response in a clinical sample. Participants were 959 individuals selected from the community for an epidemiological study of insomnia (Community sample) and 183 individuals evaluated for insomnia treatment and 62 controls without insomnia (Clinical sample). They completed the ISI and several measures of sleep quality, fatigue, psychological symptoms, and quality of life; those in the Clinical sample also completed sleep diaries, polysomnography, and interviews to validate their insomnia/good sleep status and assess treatment response. In addition to standard psychometric indices of reliability and validity, item response theory analyses were computed to examine ISI item response patterns. Receiver operating curves were used to derive optimal cutoff scores for case identification and to quantify the minimally important changes in relation to global improvement ratings obtained by an independent assessor. ISI internal consistency was excellent for both samples (Cronbach α of 0.90 and 0.91). Item response analyses revealed adequate discriminatory capacity for 5 of the 7 items. Convergent validity was supported by significant correlations between total ISI score and measures of fatigue, quality of life, anxiety, and depression. A cutoff score of 10 was optimal (86.1% sensitivity and 87.7% specificity) for detecting insomnia cases in the community sample. In the clinical sample, a change score of -8.4 points (95% CI: -7.1, -9.4) was associated with moderate improvement as rated by an independent assessor after treatment. These findings provide further evidence that the ISI is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.
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                Author and article information

                Contributors
                Journal
                R Soc Open Sci
                RSOS
                royopensci
                Royal Society Open Science
                The Royal Society
                2054-5703
                June 16, 2021
                June 2021
                : 8
                : 6
                : 202264
                Affiliations
                [ 1 ]School of Information Technology, Deakin University, , Geelong, Victoria 3125, Australia
                [ 2 ]Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, , Melbourne, Australia
                [ 3 ]Department of Psychology, Northumbria University, , Newcastle upon Tyne, UK
                Author information
                http://orcid.org/0000-0002-0931-0916
                Article
                rsos202264
                10.1098/rsos.202264
                8206690
                34150313
                53a6648f-acab-4633-8378-8b1de4b11ef2
                © 2021 The Authors.

                Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.

                History
                : December 18, 2020
                : May 21, 2021
                Categories
                1008
                1001
                1003
                119
                18
                50
                Computer Science and Artificial Intelligence
                Research Articles

                actigraphy,sleep,chronic insomnia,multi-night recordings,dynamical features,machine learning

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