  Evidence suggests Rapid-Eye-Movement (REM) Sleep Behaviour Disorder (RBD) is
an early predictor of Parkinson's disease. This study proposes a
fully-automated framework for RBD detection consisting of automated sleep
staging followed by RBD identification. Analysis was assessed using a limited
polysomnography montage from 53 participants with RBD and 53 age-matched
healthy controls. Sleep stage classification was achieved using a Random Forest
(RF) classifier and 156 features extracted from electroencephalogram (EEG),
electrooculogram (EOG) and electromyogram (EMG) channels. For RBD detection, a
RF classifier was trained combining established techniques to quantify muscle
atonia with additional features that incorporate sleep architecture and the EMG
fractal exponent. Automated multi-state sleep staging achieved a 0.62 Cohen's
Kappa score. RBD detection accuracy improved by 10% to 96% (compared to
individual established metrics) when using manually annotated sleep staging.
Accuracy remained high (92%) when using automated sleep staging. This study
outperforms established metrics and demonstrates that incorporating sleep
architecture and sleep stage transitions can benefit RBD detection. This study
also achieved automated sleep staging with a level of accuracy comparable to
manual annotation. This study validates a tractable, fully-automated, and
sensitive pipeline for RBD identification that could be translated to wearable
take-home technology.
