Authors
Wanlin Chen, Xinhui He, Jing Zheng, Shulin Chen, Xiang Tian
Published in
Journal of medical systems. Volume 50. Issue 1. Jul 07, 2026. Epub Jul 07, 2026.
Abstract
Cardiorespiratory-based methods offer promising alternatives to traditional PSG for longitudinal sleep monitoring, holding significant systemic medical value for scalable sleep health management. This systematic review synthesizes methodological frameworks and performance outcomes of automatic sleep staging using cardiorespiratory signals. Four databases were searched and a total of 35 studies published since 2010 were identified. The analysis revealed that cardiorespiratory signal-based sleep staging achieved a practically meaningful accuracy of 70%, with no significant performance differences observed among signal modalities (cardiac signals, cardiorespiratory signals, or cardiac/cardiorespiratory signals combined with other non-EEG modalities) or between modeling algorithms (traditional machine learning vs. deep learning). However, we identified significant methodological heterogeneity and several critical model failure modes that hinder clinical translation, including the widespread lack of external validation, consistently poor classification of the N1 sleep stage, and limited generalization across diverse patient populations. To realize the technology's potential, future research must establish consensus-driven methodological guidelines and rigorously validate algorithms on large, demographically and clinically diverse datasets. These advances are essential for integrating cardiorespiratory-based sleep staging into healthcare systems as a scalable tool for population-level screening, longitudinal monitoring, and tiered clinical decision support.
PMID:
42412255
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.
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