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Introduction Typically, neurological signals are not recorded in home sleep apnea testing (HSAT) and thus standard sleep scoring is not applicable. The respiratory event index is calculated using total recording time rather than total sleep time (TST) resulting in a risk of underestimating sleep apnea severity. The objective of the study was to evaluate if artificial intelligence approaches can provide sleep scoring based on cardiorespiratory signals (CReSS) with reasonable accuracy. Methods Supervised deep learning for scoring sleep was trained with 472 and tested in 116 polysomnographies (PSG), scored independently by two experts and by a consensus scorer. The resulting bidirectional long short-term memory recurrent neural network (RNN) was integrated in the Somnolyzer system and validated in 97 PSGs of patients with obstructive sleep apnea (OSA) which had been scored independently by four human experts. Cohen’s kappa agreement for four stages (W, L: N1+N2, D: N3, R) was determined as compared to a consensus scoring. Results Epoch-by-epoch comparison between CReSS autoscoring and manual consensus scoring resulted in Cohen’s kappa of 0.68 (W: 0.74, L: 0.63, D: 0.54, R: 0.79). The intra-class correlation coefficient (ICC) between TST derived from CReSS and from neurological scoring was 0.86 (95%-CI: 0.79-0.90), while the ICC between subjective TST from sleep questionnaire and the objective TST was only 0.65 (95%-CI: 0.45-0.77). REM-related OSA had a prevalence of 16% and was detected with an accuracy of 95%. Conclusion With a kappa of 0.68, the cardiorespiratory-based RNN classifier is far above previously published values and reflects a substantial agreement with the manual consensus scoring in patients with sleep-disordered breathing. Thus, applying CReSS allows a more accurate determination of the OSA-severity and even a detection of REM related OSA in HSAT studies. Support All authors are employees of Philips

0436 Deep Learning for Scoring Sleep Based on Signals Available in Home Sleep Apnea Test Studies: Cardiorespiratory Sleep Staging