Variability of sleep stage scoring in late midlife and early old age.
aging
automatic scoring
electroencephalography
inter-expert variability
Journal
Journal of sleep research
ISSN: 1365-2869
Titre abrégé: J Sleep Res
Pays: England
ID NLM: 9214441
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
20
05
2021
accepted:
30
05
2021
pubmed:
26
6
2021
medline:
1
2
2022
entrez:
25
6
2021
Statut:
ppublish
Résumé
Sleep stage scoring can lead to important inter-expert variability. Although likely, whether this issue is amplified in older populations, which show alterations of sleep electrophysiology, has not been thoroughly assessed. Algorithms for automatic sleep stage scoring may appear ideal to eliminate inter-expert variability. Yet, variability between human experts and algorithm sleep stage scoring in healthy older individuals has not been investigated. Here, we aimed to compare stage scoring of older individuals and hypothesized that variability, whether between experts or considering the algorithm, would be higher than usually reported in the literature. Twenty cognitively normal and healthy late midlife individuals' (61 ± 5 years; 10 women) night-time sleep recordings were scored by two experts from different research centres and one algorithm. We computed agreements for the entire night (percentage and Cohen's κ) and each sleep stage. Whole-night pairwise agreements were relatively low and ranged from 67% to 78% (κ, 0.54-0.67). Sensitivity across pairs of scorers proved lowest for stages N1 (8.2%-63.4%) and N3 (44.8%-99.3%). Significant differences between experts and/or algorithm were found for total sleep time, sleep efficiency, time spent in N1/N2/N3 and wake after sleep onset (p ≤ 0.005), but not for sleep onset latency, rapid eye movement (REM) and slow-wave sleep (SWS) duration (N2 + N3). Our results confirm high inter-expert variability in healthy aging. Consensus appears good for REM and SWS, considered as a whole. It seems more difficult for N3, potentially because human raters adapt their interpretation according to overall changes in sleep characteristics. Although the algorithm does not substantially reduce variability, it would favour time-efficient standardization.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13424Subventions
Organisme : H2020 European Research Council
ID : GA 757763
Organisme : CIHR
ID : 190750
Pays : Canada
Organisme : Fonds National de la Recherche Scientifique
ID : T.0242.19
Organisme : Actions de Recherche Concertées
ID : 17/27-09
Organisme : CIHR
ID : 190750
Pays : Canada
Informations de copyright
© 2021 European Sleep Research Society.
Références
Achermann, P., Dijk, D.J., Brunner, D.P., & Borbély, A.A. (1993). A model of human sleep homeostasis based on EEG slow-wave activity: Quantitative comparison of data and simulations. Brain Research Bulletin, 31, 97-113. https://doi.org/10.1016/0361-9230(93)90016-5
Altman, D.G. (1997). Practical statistics for medical research. CRC press.
Basner, M., Griefahn, B., & Penzel, T. (2008). Inter-rater agreement in sleep stage classification between centers with different backgrounds. Somnologie, 12, 75-84. https://doi.org/10.1007/s11818-008-0327-y
Berry, R.B., Brooks, R., Gamaldo, C., Harding, S., Lloyd, R., Quan, S., Troester, M., & Vaughn, B. (2017). The AASM Manual for the Scoring of Sleep and Associated Events. American Academy of Sleep Medicine.
Berthomier, C., Drouot, X., Herman-Stoïca, M., Berthomier, P., Prado, J., Bokar-Thire, D., Benoit, O., Mattout, J., & d'Ortho, M.P. (2007). Automatic analysis of single-channel sleep EEG: Validation in healthy individuals. Sleep, 30, 1587-1595. https://doi.org/10.1093/sleep/30.11.1587
Berthomier, C., Muto, V., Schmidt, C., Vandewalle, G., Jaspar, M., Devillers, J., Gaggioni, G., Chellappa, S.L., Meyer, C., Phillips, C., Salmon, E., Berthomier, P., Prado, J., Benoit, O., Bouet, R., Brandewinder, M., Mattout, J., & Maquet, P. (2020). Exploring scoring methods for research studies: Accuracy and variability of visual and automated sleep scoring. Journal of sleep research, 29(5), e12994.
Březinová, V. (1975). The number and duration of the episodes of the various EEG stages of sleep in young and older people. Electroencephalography and Clinical Neurophysiology, 39, 273-278. https://doi.org/10.1016/0013-4694(75)90149-2
Cajochen, C., Münch, M., Knoblauch, V., Blatter, K., & Wirz-Justice, A. (2006). Age-related changes in the circadian and homeostatic regulation of human sleep. Chronobiology International, 23, 461-474. https://doi.org/10.1080/07420520500545813
Carrier, J., Viens, I., Poirier, G., Robillard, R., Lafortune, M., Vandewalle, G., … Filipini, D. (2011). Sleep slow wave changes during the middle years of life. European Journal of Neuroscience, 33, 758-766. https://doi.org/10.1111/j.1460-9568.2010.07543.x
Cohen, J. (1960). A Coefficient of Agreement for Nominal Scales. Educational and Psychological Measurement, 20(1), 37-46.
Cuffin, N. (1993). Effects of local variations in skull and scalp thickness on EEG's and MEG's. IEEE Transactions on Biomedical Engineering, 40(1), 42-48.
Danker-Hopfe, H., Anderer, P., Zeitlhofer, J., Boeck, M., Dorn, H., Gruber, G., Heller, E., Loretz, E., Moser, D., Parapatics, S., Saletu, B., Schmidt, A., & Dorffner, G. (2009). Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard. Journal of Sleep Research, 18, 74-84. https://doi.org/10.1111/j.1365-2869.2008.00700.x
Danker-Hopfe, H., Kunz, D., Gruber, G., Klösch, G., Lorenzo, J.L., Himanen, S.L., Kemp, B., Penzel, T., Röschke, J., Dorn, H., Schlögl, A., Trenker, E., & Dorffner, G. (2004). Interrater reliability between scorers from eight European sleep laboratories in subjects with different sleep disorders. Journal of Sleep Research, 13, 63-69. https://doi.org/10.1046/j.1365-2869.2003.00375.x
Do Kim, Y., Kurachi, M., Horita, M., Matsuura, K., & Kamikawa, Y. (2007). Agreement in visual scoring of sleep stages among laboratories in Japan. International Journal of Phytoremediation, 20, 135-136. https://doi.org/10.1111/j.1365-2869.1992.tb00011.x
Dube, J., Lafortune, M., Bedetti, C., Bouchard, M., Gagnon, J.F., Doyon, J., Evans, A., Lina, J.M., & Carrier, J. (2015). Cortical thinning explains changes in sleep slow waves during adulthood. Journal of Neuroscience, 35, 7795-7807. https://doi.org/10.1523/JNEUROSCI.3956-14.2015
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
Gaudreau, H., Carrier, J., & Montplaisir, J. (2001). Age-related modifications of NREM sleep EEG: From childhood to middle age. Journal of Sleep Research, 10, 165-172. https://doi.org/10.1046/j.1365-2869.2001.00252.x
Gaudreau, H., Morettini, J., Lavoie, H.B., & Carrier, J. (2001). Effects of a 25-h sleep deprivation on daytime sleep in the middle-aged. Neurobiology of Aging, 22, 461-468. https://doi.org/10.1016/S0197-4580(00)00251-7
Iber, C., Ancoli-Israel, S., Chesson, A., & Quan, S. (2007). The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine.
Klerman, E.B., & Dijk, D.J. (2008). Age-related reduction in the maximal capacity for sleep-implications for insomnia. Current Biology, 18, 1118-1123. https://doi.org/10.1016/j.cub.2008.06.047
Landis, J.R., & Koch, G.G. (1977). The measurement of observer agreement for categorical data. Journal of Biometrics, 33, 159-174. https://doi.org/10.2307/2529310
Landolt, H.P., & Borbély, A.A. (2001). Age-dependent changes in sleep EEG topography. Clinical Neurophysiology, 112, 369-377. https://doi.org/10.1016/S1388-2457(00)00542-3
Landolt, H.P., Dijk, D.J., Achermann, P., & Borbély, A.A. (1996). Effect of age on the sleep EEG: Slow-wave activity and spindle frequency activity in young and middle-aged men. Brain Research, 738, 205-212. https://doi.org/10.1016/S0006-8993(96)00770-6
Mander, B.A., Winer, J.R., & Walker, M.P. (2017). Sleep and human aging. Neuron, 94, 19-36. https://doi.org/10.1016/j.neuron.2017.02.004
Monroe, L.J. (1969). Inter-rater reliability and the role of experience in scoring EEG sleep records: phase 1. Psychophysiology, 5, 376-384. https://doi.org/10.1111/j.1469-8986.1969.tb02836.x
Ohayon, M.M., Carskadon, M.A., Guilleminault, C., & Vitiello, M.V. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep, 27, 1255-1273. https://doi.org/10.1093/sleep/27.7.1255
Pannese, E. (2011). Morphological changes in nerve cells during normal aging. Brain Structure and Function, 216, 85-89. https://doi.org/10.1007/s00429-011-0308-y
Peter-Derex, L., Berthomier, C., Taillard, J., Berthomier, P., Bouet, R., Mattout, J., Brandewinder, M., & Bastuji, H. (2020). Automatic analysis of single-channel sleep EEG in a large spectrum of sleep disorders. Journal of Clinical Sleep Medicine, 17(3), 393-402. https://doi.org/10.5664/jcsm.8864
Redline, S., Kirchner, H.L., Quan, S.F., Gottlieb, D.J., Kapur, V., & Newman, A. (2004). The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Archives of Internal Medicine, 164, 406-418. https://doi.org/10.1001/archinte.164.4.406
Rosenberg, R.S., & Van Hout, S. (2013). The American Academy of Sleep Medicine inter-scorer reliability program: Respiratory events. Journal of Clinical Sleep Medicine, 10, 447-454. https://doi.org/10.5664/jcsm.3630
Rosinvil, T., Bouvier, J., Dubé, J., Lafrenière, A., Bouchard, M., Cronier, J., Gosselin, N., Carrier, J., & Lina, J.M. (2020). Are age and sex effects on sleep slow waves only a matter of EEG amplitude? Sleep, 44(3), 1-33. https://doi.org/10.1093/sleep/zsaa186
Silber, M.H., Ancoli-Israel, S., Bonnet, M.H., Chokroverty, S., Grigg-Damberger, M.M., Hirshkowitz, M., Kapen, S., Keenan, S., Kryger, M., Penzel, T., Pressman, M., & Iber, C. (2007). The visual scoring of sleep in adults. Journal of Clinical Sleep Medicine, 3, 121-131. https://doi.org/10.5664/jcsm.26814
Webb, W.B., & Dreblow, L.M. (1982). A modified method for scoring slow wave sleep of older subjects. Sleep, 5, 195-199. https://doi.org/10.1093/sleep/5.2.195
Whitney, C.W., Gottlieb, D.J., Redline, S., Norman, R.G., Dodge, R.R., Shahar, E., Surovec, S., & Nieto, F.J. (1998). Reliability of scoring respiratory disturbance indices and sleep staging. Sleep, 21, 749-757. https://doi.org/10.1093/sleep/21.7.749
Zhang, X., Dong, X., Kantelhardt, J.W., Li, J., Zhao, L., Garcia, C., … Han, F. (2015). Process and outcome for international reliability in sleep scoring. Sleep Breath., 19, 191-195. https://doi.org/10.1007/s11325-014-0990-0