Multimodal Cardiovascular Risk Profiling Using Self-Supervised Learning of Polysomnography

TL;DR

This study introduces a self-supervised deep learning framework that extracts multimodal features from polysomnography data to improve cardiovascular risk prediction, validated across large cohorts and outperforming traditional models.

Contribution

The paper presents a novel self-supervised learning approach for multimodal PSG data that enhances CVD risk prediction and integrates seamlessly with existing clinical risk scores.

Findings

Projection scores reveal meaningful patterns across modalities.

ECG features predict prevalent and incident CVD outcomes.

Combining projection scores with Framingham Risk Score improves predictive accuracy.

Abstract

Methods: We developed a self-supervised deep learning model that extracts meaningful patterns from multi-modal signals (Electroencephalography (EEG), Electrocardiography (ECG), and respiratory signals). The model was trained on data from 4,398 participants. Projection scores were derived by contrasting embeddings from individuals with and without CVD outcomes. External validation was conducted in an independent cohort with 1,093 participants. The source code is available on https://github.com/miraclehetech/sleep-ssl. Results: The projection scores revealed distinct and clinically meaningful patterns across modalities. ECG-derived features were predictive of both prevalent and incident cardiac conditions, particularly CVD mortality. EEG-derived features were predictive of incident hypertension and CVD mortality. Respiratory signals added complementary predictive value. Combining these projection scores with the Framingham Risk Score consistently improved predictive performance, achieving area under the curve values ranging from 0.607 to 0.965 across different outcomes. Findings were robustly replicated and validated in the external testing cohort. Conclusion: Our findings demonstrate that the proposed framework can generate individualized CVD risk scores directly from PSG data. The resulting projection scores have the potential to be integrated into clinical practice, enhancing risk assessment and supporting personalized care.