Sleep/wake classification systems that rely on physiological signals suffer from intersubject differences that make accurate classification with a single, subject-independent model difficult. To overcome the limitations of intersubject variability, we suggest a novel online adaptation technique that updates the sleep/wake classifier in real time. The objective of the present study was to evaluate the performance of a newly developed adaptive classification algorithm that was embedded on a wearable sleep/wake classification system called SleePic. The algorithm processed ECG and respiratory effort signals for the classification task and applied behavioral measurements (obtained from accelerometer and press-button data) for the automatic adaptation task. When trained as a subject-independent classifier algorithm, the SleePic device was only able to correctly classify 74.94 ± 6.76% of the human-rated sleep/wake data. By using the suggested automatic adaptation method, the mean classification accuracy could be significantly improved to 92.98 ± 3.19%. A subject-independent classifier based on activity data only showed a comparable accuracy of 90.44 ± 3.57%. We demonstrated that subject-independent models used for online sleep-wake classification can successfully be adapted to previously unseen subjects without the intervention of human experts or off-line calibration.

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