The cyclic alternating pattern is the periodic electroencephalogram activity occurring during non-rapid eye movement sleep. It is a marker of sleep instability and is correlated with several sleep-related pathologies. Considering the connection between the human heart and brain, our study explores the feasibility of using cardiopulmonary features to automatically detect the cyclic alternating pattern of sleep and hence diagnose sleep-related pathologies. By statistically analyzing and comparing the cardiopulmonary characteristics of a healthy group and groups with sleep-related diseases, an automatic recognition scheme of the cyclic alternating pattern is proposed based on the cardiopulmonary resonance indices. Using the Hidden Markov and Random Forest, the scheme combines the variation and stability of measurements of the coupling state of the cardiopulmonary system during sleep. In this research, the F1 score of the sleep-wake classification reaches 92.0%. In terms of the cyclic alternating pattern, the average recognition rate of A-phase reaches 84.7% on the CAP Sleep Database of 108 cases of people. The F1 score of disease diagnosis is 87.8% for insomnia and 90.0% for narcolepsy.

BACKGROUND The Cyclic Alternating Pattern is a periodic electroencephalogram activity occurring during No Rapid Eye Movement sleep. It is a marker of sleep instability and correlated with several sleep-related pathologies. OBJECTIVE The objective of our study is to automatic detect the Cyclic Alternating Pattern of sleep and to diagnose sleep-related pathologies based on ECG and respiratory signals. METHODS Considering the connection between heart and brain of people, by statistically analysising and comparing the cardiopulmonary characteristics of people with no pathology and patients with sleep-related diseases, an automatic recognition scheme of Cyclic Alternating Pattern is proposed based on the Cardiopulmonary Resonance Indices. Using improved Hidden Markov and Random Forest, the scheme combines both the measurements of coupling state and the stability of the cardiopulmonary system during sleep. RESULTS In this article, the average recognition rate of A-phase reaches 84.67% and F1 score reaches 80.35% on the CAP Sleep Database in MIT-BIH database. CONCLUSIONS The scheme could automatically recognize the Cyclic Alternating Pattern accurately, and diagnose insomnia and narcolepsy using ECG and respiratory signals.

UNSTRUCTURED The Cyclic Alternating Pattern is a periodic electroencephalogram activity occurring during No Rapid Eye Movement sleep. It is a marker of sleep instability and correlated with several sleep-related pathologies. In this article, considering the connection between heart and brain of people, by statistically analysising and comparing the cardiopulmonary characteristics of people with no pathology and patients with sleep-related diseases, an automatic recognition scheme of Cyclic Alternating Pattern is proposed based on the Cardiopulmonary Resonance Indices. Using improved Hidden Markov and Random Forest, the scheme combines both the measurements of coupling state and the stability of the cardiopulmonary system during sleep. The average recognition rate of A-phase reaches 84.67% and F1 score reaches 80.35%. Results show that our scheme could automatically recognize the Cyclic Alternating Pattern accurately, and diagnose insomnia and narcolepsy.