Daily Papers

Sleep is an essential component of human physiology, contributing significantly to overall health and quality of life. Accurate sleep staging and disorder detection are crucial for assessing sleep quality. Studies in the literature have proposed PSG-based approaches and machine-learning methods utilizing single-modality signals. However, existing methods often lack multimodal, multilabel frameworks and address sleep stages and disorders classification separately. In this paper, we propose a 1D-Vision Transformer for simultaneous classification of sleep stages and sleep disorders. Our method exploits the sleep disorders' correlation with specific sleep stage patterns and performs a simultaneous identification of a sleep stage and sleep disorder. The model is trained and tested using multimodal-multilabel sensory data (including photoplethysmogram, respiratory flow, and respiratory effort signals). The proposed method shows an overall accuracy (cohen's Kappa) of 78% (0.66) for five-stage sleep classification and 74% (0.58) for sleep apnea classification. Moreover, we analyzed the encoder attention weights to clarify our models' predictions and investigate the influence different features have on the models' outputs. The result shows that identified patterns, such as respiratory troughs and peaks, make a higher contribution to the final classification process.

The classification of sleep stages is a pivotal aspect of diagnosing sleep disorders and evaluating sleep quality. However, the conventional manual scoring process, conducted by clinicians, is time-consuming and prone to human bias. Recent advancements in deep learning have substantially propelled the automation of sleep stage classification. Nevertheless, challenges persist, including the need for large datasets with labels and the inherent biases in human-generated annotations. This paper introduces NeuroNet, a self-supervised learning (SSL) framework designed to effectively harness unlabeled single-channel sleep electroencephalogram (EEG) signals by integrating contrastive learning tasks and masked prediction tasks. NeuroNet demonstrates superior performance over existing SSL methodologies through extensive experimentation conducted across three polysomnography (PSG) datasets. Additionally, this study proposes a Mamba-based temporal context module to capture the relationships among diverse EEG epochs. Combining NeuroNet with the Mamba-based temporal context module has demonstrated the capability to achieve, or even surpass, the performance of the latest supervised learning methodologies, even with a limited amount of labeled data. This study is expected to establish a new benchmark in sleep stage classification, promising to guide future research and applications in the field of sleep analysis.

We present PhysioLLM, an interactive system that leverages large language models (LLMs) to provide personalized health understanding and exploration by integrating physiological data from wearables with contextual information. Unlike commercial health apps for wearables, our system offers a comprehensive statistical analysis component that discovers correlations and trends in user data, allowing users to ask questions in natural language and receive generated personalized insights, and guides them to develop actionable goals. As a case study, we focus on improving sleep quality, given its measurability through physiological data and its importance to general well-being. Through a user study with 24 Fitbit watch users, we demonstrate that PhysioLLM outperforms both the Fitbit App alone and a generic LLM chatbot in facilitating a deeper, personalized understanding of health data and supporting actionable steps toward personal health goals.

In health, most large language model (LLM) research has focused on clinical tasks. However, mobile and wearable devices, which are rarely integrated into such tasks, provide rich, longitudinal data for personal health monitoring. Here we present Personal Health Large Language Model (PH-LLM), fine-tuned from Gemini for understanding and reasoning over numerical time-series personal health data. We created and curated three datasets that test 1) production of personalized insights and recommendations from sleep patterns, physical activity, and physiological responses, 2) expert domain knowledge, and 3) prediction of self-reported sleep outcomes. For the first task we designed 857 case studies in collaboration with domain experts to assess real-world scenarios in sleep and fitness. Through comprehensive evaluation of domain-specific rubrics, we observed that Gemini Ultra 1.0 and PH-LLM are not statistically different from expert performance in fitness and, while experts remain superior for sleep, fine-tuning PH-LLM provided significant improvements in using relevant domain knowledge and personalizing information for sleep insights. We evaluated PH-LLM domain knowledge using multiple choice sleep medicine and fitness examinations. PH-LLM achieved 79% on sleep and 88% on fitness, exceeding average scores from a sample of human experts. Finally, we trained PH-LLM to predict self-reported sleep quality outcomes from textual and multimodal encoding representations of wearable data, and demonstrate that multimodal encoding is required to match performance of specialized discriminative models. Although further development and evaluation are necessary in the safety-critical personal health domain, these results demonstrate both the broad knowledge and capabilities of Gemini models and the benefit of contextualizing physiological data for personal health applications as done with PH-LLM.

Imagine a world where AI can handle your work while you sleep - organizing your research materials, drafting a report, or creating a presentation you need for tomorrow. However, while current digital agents can perform simple tasks, they are far from capable of handling the complex real-world work that humans routinely perform. We present PC Agent, an AI system that demonstrates a crucial step toward this vision through human cognition transfer. Our key insight is that the path from executing simple "tasks" to handling complex "work" lies in efficiently capturing and learning from human cognitive processes during computer use. To validate this hypothesis, we introduce three key innovations: (1) PC Tracker, a lightweight infrastructure that efficiently collects high-quality human-computer interaction trajectories with complete cognitive context; (2) a two-stage cognition completion pipeline that transforms raw interaction data into rich cognitive trajectories by completing action semantics and thought processes; and (3) a multi-agent system combining a planning agent for decision-making with a grounding agent for robust visual grounding. Our preliminary experiments in PowerPoint presentation creation reveal that complex digital work capabilities can be achieved with a small amount of high-quality cognitive data - PC Agent, trained on just 133 cognitive trajectories, can handle sophisticated work scenarios involving up to 50 steps across multiple applications. This demonstrates the data efficiency of our approach, highlighting that the key to training capable digital agents lies in collecting human cognitive data. By open-sourcing our complete framework, including the data collection infrastructure and cognition completion methods, we aim to lower the barriers for the research community to develop truly capable digital agents.

Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.

We present a novel approach to personalized sleep health management using few-shot Chain-of-Thought (CoT) distillation, enabling small-scale language models (> 2B parameters) to rival the performance of large language models (LLMs) in specialized health domains. Our method simultaneously distills problem-solving strategies, long-tail expert knowledge, and personalized recommendation capabilities from larger models into more efficient, compact models. Unlike existing systems, our approach offers three key functionalities: generating personalized sleep health recommendations, supporting user-specific follow-up inquiries, and providing responses to domain-specific knowledge questions. We focus on sleep health due to its measurability via wearable devices and its impact on overall well-being. Our experimental setup, involving GPT-4o for data synthesis, Qwen-max for instruction set creation, and Qwen2.5 1.5B for model distillation, demonstrates significant improvements over baseline small-scale models in penalization, reasoning, and knowledge application. Experiments using 100 simulated sleep reports and 1,000 domain-specific questions shows our model achieves comparable performance to larger models while maintaining efficiency for real-world deployment. This research not only advances AI-driven health management but also provides a novel approach to leveraging LLM capabilities in resource-constrained environments, potentially enhancing the accessibility of personalized healthcare solutions.

The relationships between workload and fatigue or sleepiness are investigated through the analysis of rosters and responses to questionnaires from Brazilian aircrews, taken from Fadig\^ometro database. The approach includes temporal markers - coinciding with Samn-Perelli (SP) and Karolinska Sleepiness Scale (KSS) responses - where SAFTE-FAST model outcomes are calculated. The model results follow the increase of fatigue and sleepiness perceptions during the dawn (0h00 to 05h59), but underestimate the self-rated scores during the evening (18h00 to 23h59). On the other hand, the KSS scores fit the relative risk of pilot errors, representing a reasonable proxy for risk assessment. Linear relationships obtained between workload metrics, computed within 168-hours prior to the responses, and self-rated SP and KSS scores provide a consistent method to estimate accumulated fatigue and sleepiness. Considering 7149 rosters of 2023, the duty time (DT), the number of flight sectors (N_{CREW}) and the sum of flight sectors with sit periods longer than one hour (N_{CREW}+N_{SIT}) are associated with 70.1%/60.6% of the highest predicted scores of SP/KSS. Applying the mitigations DTleq44h, N_{CREW}leq15 and N_{CREW}+N_{SIT}leq19 for every 168-hour interval yields a significant decrease in the higher values of SP/KSS with minimal impact on aircrew productivity.

Sleep abnormalities can have severe health consequences. Automated sleep staging, i.e. labelling the sequence of sleep stages from the patient's physiological recordings, could simplify the diagnostic process. Previous work on automated sleep staging has achieved great results, mainly relying on the EEG signal. However, often multiple sources of information are available beyond EEG. This can be particularly beneficial when the EEG recordings are noisy or even missing completely. In this paper, we propose CoRe-Sleep, a Coordinated Representation multimodal fusion network that is particularly focused on improving the robustness of signal analysis on imperfect data. We demonstrate how appropriately handling multimodal information can be the key to achieving such robustness. CoRe-Sleep tolerates noisy or missing modalities segments, allowing training on incomplete data. Additionally, it shows state-of-the-art performance when testing on both multimodal and unimodal data using a single model on SHHS-1, the largest publicly available study that includes sleep stage labels. The results indicate that training the model on multimodal data does positively influence performance when tested on unimodal data. This work aims at bridging the gap between automated analysis tools and their clinical utility.

This research proposes a new database and method to detect the reduction of alertness conditions due to alcohol, drug consumption and sleepiness deprivation from Near-Infra-Red (NIR) periocular eye images. The study focuses on determining the effect of external factors on the Central Nervous System (CNS). The goal is to analyse how this impacts iris and pupil movement behaviours and if it is possible to classify these changes with a standard iris NIR capture device. This paper proposes a modified MobileNetV2 to classify iris NIR images taken from subjects under alcohol/drugs/sleepiness influences. The results show that the MobileNetV2-based classifier can detect the Unfit alertness condition from iris samples captured after alcohol and drug consumption robustly with a detection accuracy of 91.3% and 99.1%, respectively. The sleepiness condition is the most challenging with 72.4%. For two-class grouped images belonging to the Fit/Unfit classes, the model obtained an accuracy of 94.0% and 84.0%, respectively, using a smaller number of parameters than the standard Deep learning Network algorithm. This work is a step forward in biometric applications for developing an automatic system to classify "Fitness for Duty" and prevent accidents due to alcohol/drug consumption and sleepiness.

Sleep is a complex physiological process evaluated through various modalities recording electrical brain, cardiac, and respiratory activities. We curate a large polysomnography dataset from over 14,000 participants comprising over 100,000 hours of multi-modal sleep recordings. Leveraging this extensive dataset, we developed SleepFM, the first multi-modal foundation model for sleep analysis. We show that a novel leave-one-out approach for contrastive learning significantly improves downstream task performance compared to representations from standard pairwise contrastive learning. A logistic regression model trained on SleepFM's learned embeddings outperforms an end-to-end trained convolutional neural network (CNN) on sleep stage classification (macro AUROC 0.88 vs 0.72 and macro AUPRC 0.72 vs 0.48) and sleep disordered breathing detection (AUROC 0.85 vs 0.69 and AUPRC 0.77 vs 0.61). Notably, the learned embeddings achieve 48% top-1 average accuracy in retrieving the corresponding recording clips of other modalities from 90,000 candidates. This work demonstrates the value of holistic multi-modal sleep modeling to fully capture the richness of sleep recordings. SleepFM is open source and available at https://github.com/rthapa84/sleepfm-codebase.

Accurate sleep stage classification is significant for sleep health assessment. In recent years, several machine-learning based sleep staging algorithms have been developed , and in particular, deep-learning based algorithms have achieved performance on par with human annotation. Despite improved performance, a limitation of most deep-learning based algorithms is their black-box behavior, which have limited their use in clinical settings. Here, we propose a cross-modal transformer, which is a transformer-based method for sleep stage classification. The proposed cross-modal transformer consists of a novel cross-modal transformer encoder architecture along with a multi-scale one-dimensional convolutional neural network for automatic representation learning. Our method outperforms the state-of-the-art methods and eliminates the black-box behavior of deep-learning models by utilizing the interpretability aspect of the attention modules. Furthermore, our method provides considerable reductions in the number of parameters and training time compared to the state-of-the-art methods. Our code is available at https://github.com/Jathurshan0330/Cross-Modal-Transformer. A demo of our work can be found at https://bit.ly/Cross_modal_transformer_demo.

Chronotype compares individuals' circadian phase to others. It contextualizes mental health risk assessments and detection of social jet lag, which can hamper mental health and cognitive performance. Existing ways of determining chronotypes, such as Dim Light Melatonin Onset (DLMO) or the Morningness-Eveningness Questionnaire (MEQ), are limited by being discrete in time and time-intensive to update, meaning they rarely capture real-world variability across time. Chronotyping users based on a daily planner app might augment existing methods to enable assessment continuously and at scale. This paper reports the construction of a supervised binary classifier that attempts to demonstrate the feasibility of this approach. 1,460 registered users from the Owaves app opted in by filling out the MEQ survey between July 14, 2022, and May 1, 2023. 142 met the eligibility criteria. We used multimodal app data from individuals identified as morning and evening types from MEQ data, basing the classifier on app time series data. This included daily timing for 8 main lifestyle activity types: exercise, sleep, social interactions, meal times, relaxation, work, play, and miscellaneous, as defined in the app. The timing of activities showed substantial change across time, as well as heterogeneity by activity type. Our novel chronotyping classifier was able to predict the morningness and eveningness of its users with an ROC AUC of 0.70. Our findings demonstrate the feasibility of chronotype classification from multimodal, real-world app data, while highlighting fundamental challenges to applying discrete and fixed labels to complex, dynamic, multimodal behaviors. Our findings suggest a potential for real-time monitoring of shifts in chronotype specific to different causes (i.e. types of activity), which could feasibly be used to support future, prospective mental health support research.

Temporally dense single-person "small data" have become widely available thanks to mobile apps and wearable sensors. Many caregivers and self-trackers want to use these data to help a specific person change their behavior to achieve desired health outcomes. Ideally, this involves discerning possible causes from correlations using that person's own observational time series data. In this paper, we estimate within-individual average treatment effects of physical activity on sleep duration, and vice-versa. We introduce the model twin randomization (MoTR; "motor") method for analyzing an individual's intensive longitudinal data. Formally, MoTR is an application of the g-formula (i.e., standardization, back-door adjustment) under serial interference. It estimates stable recurring effects, as is done in n-of-1 trials and single case experimental designs. We compare our approach to standard methods (with possible confounding) to show how to use causal inference to make better personalized recommendations for health behavior change, and analyze 222 days of Fitbit sleep and steps data for one of the authors.

In this study, we present a comprehensive public dataset for driver drowsiness detection, integrating multimodal signals of facial, behavioral, and biometric indicators. Our dataset includes 3D facial video using a depth camera, IR camera footage, posterior videos, and biometric signals such as heart rate, electrodermal activity, blood oxygen saturation, skin temperature, and accelerometer data. This data set provides grip sensor data from the steering wheel and telemetry data from the American truck simulator game to provide more information about drivers' behavior while they are alert and drowsy. Drowsiness levels were self-reported every four minutes using the Karolinska Sleepiness Scale (KSS). The simulation environment consists of three monitor setups, and the driving condition is completely like a car. Data were collected from 19 subjects (15 M, 4 F) in two conditions: when they were fully alert and when they exhibited signs of sleepiness. Unlike other datasets, our multimodal dataset has a continuous duration of 40 minutes for each data collection session per subject, contributing to a total length of 1,400 minutes, and we recorded gradual changes in the driver state rather than discrete alert/drowsy labels. This study aims to create a comprehensive multimodal dataset of driver drowsiness that captures a wider range of physiological, behavioral, and driving-related signals. The dataset will be available upon request to the corresponding author.