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This paper presents a generic method to enhance performance and incorporate temporal information for cardiorespiratory-based sleep stage classification with a limited feature set and limited data. The classification algorithm relies on random forests and a feature set extracted from long-time home monitoring for sleep analysis. Employing temporal feature stacking, the system could be significantly improved in terms of Cohen’s κ and accuracy. The detection performance could be improved for three classes of sleep stages (Wake, REM, Non-REM sleep), four classes (Wake, Non-REM-Light sleep, Non-REM Deep sleep, REM sleep), and five classes (Wake, N1, N2, N3/4, REM sleep) from a κ of 0.44 to 0.58, 0.33 to 0.51, and 0.28 to 0.44 respectively by stacking features before and after the epoch to be classified. Further analysis was done for the optimal length and combination method for this stacking approach. Overall, three methods and a variable duration between 30 s and 30 min have been analyzed. Overnight recordings of 36 healthy subjects from the Interdisciplinary Center for Sleep Medicine at Charité-Universitätsmedizin Berlin and Leave-One-Out-Cross-Validation on a patient-level have been used to validate the method.
This work is a study about a comparison of survey tools and it should help developers in selecting a suited tool for application in an AAL environment. The first step was to identify the basic required functionality of the survey tools used for AAL technologies and to compare these tools by their functionality and assignments. The comparative study was derived from the data obtained, previous literature studies and further technical data. A list of requirements was stated and ordered in terms of relevance to the target application domain. With the help of an integrated assessment method, the calculation of a generalized estimate value was performed and the result is explained. Finally, the planned application of this tool in a running project is explained.
The development of automatic solutions for the detection of physiological events of interest is booming. Improvements in the collection and storage of large amounts of healthcare data allow access to these data faster and more efficiently. This fact means that the development of artificial intelligence models for the detection and monitoring of a large number of pathologies is becoming increasingly common in the medical field. In particular, developing deep learning models for detecting obstructive apnea (OSA) events is at the forefront. Numerous scientific studies focus on the architecture of the models and the results that these models can provide in terms of OSA classification and Apnea-Hypopnea-Index (AHI) calculation. However, little focus is put on other aspects of great relevance that are crucial for the training and performance of the models. Among these aspects can be found the set of physiological signals used and the preprocessing tasks prior to model training. This paper covers the essential requirements that must be considered before training the deep learning model for obstructive sleep apnea detection, in addition to covering solutions that currently exist in the scientific literature by analyzing the preprocessing tasks prior to training.
Assistive environments are entering our homes faster than ever. However, there are still various barriers to be broken. One of the crucial points is a personalization of offered services and integration of assistive technologies in common objects and therefore in a regular daily routine. Recognition of sleep patterns for the preliminary sleep study is one of the Health services that could be performed in an undisturbing way. This article proposes the hardware system for the measurement of bio-vital signals necessary for initial sleep study in a nonobtrusive way. The first results confirm the potential of measurement of breathing and movement signals with the proposed system.
The goal of this paper pretends to show how a bed system with an embedded system with sensor is able to analyze a person’s movement, breathing and recognizing the positions that the subject is lying on the bed during the night without any additional physical contact. The measurements are performed with sensors placed between the mattress and the frame. An Intel Edison board was used as an endpoint that served as a communication node from the mesh network to external service. Two nodes and Intel Edison are attached to the bottom of the bed frame and they are connected to the sensors.
Preliminary results of homomorphic deconvolution application to surface EMG signals during walking
(2021)
Homomorphic deconvolution is applied to sEMG signals recorded during walking. Gastrocnemius lateralis and tibialis anterior signals were acquired according to SENIAM recommendation. MUAP parameters like amplitude and scale were estimated, whilst the MUAP shape parameter was fixed. This features a useful time-frequency representation of sEMG signal. Estimation of scale MUAP parameter was verified extracting the mean frequency of filtered EMG signal, extracted from the scale parameter estimated with two different MUAP shape values.
The present work proposes the use of modern ICT technologies such as smartphones, NFCs, internet, and web technologies, to help patients in carrying out their therapies. The implemented system provides a calendar with a reminder of the assumptions, ensures the drug identification through NFC, allows remote assistance from healthcare staff and family members to check and manage the therapy in real-time. The system also provides centralized information on the patient's therapeutic situation, helpful in choosing new compatible therapies.
A sleep study is a test used to diagnose sleep disorders and is usually done in sleep laboratories. The golden standard for evaluation of sleep is overnight polysomnography (PSG). Unfortunately, in-lab sleep studies are expensive and complex procedures. Furthermore, with a minimum of 22 wire attachments to the patient for sleep recording, this medical procedure is invasive and unfamiliar for the subjects. To solve this problem, low-cost home diagnostic systems, based on noninvasive recording methods requires further researches.
For this intention it is important to find suitable bio vital parameters for classifying sleep phases WAKE, REM, light sleep and deep sleep without any physical impairment at the same time. We decided to analyse body movement (BM), respiration rate (RR) and heart rate variability (HRV) from existing sleep recordings to develop an algorithm which is able to classify the sleep phases automatically. The preliminary results of this project show that BM, RR and HRV are suitable to identify WAKE, REM and NREM stage.
Normal breathing during sleep is essential for people’s health and well-being. Therefore, it is crucial to diagnose apnoea events at an early stage and apply appropriate therapy. Detection of sleep apnoea is a central goal of the system design described in this article. To develop a correctly functioning system, it is first necessary to define the requirements outlined in this manuscript clearly. Furthermore, the selection of appropriate technology for the measurement of respiration is of great importance. Therefore, after performing initial literature research, we have analysed in detail three different methods and made a selection of a proper one according to determined requirements. After considering all the advantages and disadvantages of the three approaches, we decided to use the impedance measurement-based one. As a next step, an initial conceptual design of the algorithm for detecting apnoea events was created. As a result, we developed an activity diagram on which the main system components and data flows are visually represented.
The scoring of sleep stages is one of the essential tasks in sleep analysis. Since a manual procedure requires considerable human and financial resources, and incorporates some subjectivity, an automated approach could result in several advantages. There have been many developments in this area, and in order to provide a comprehensive overview, it is essential to review relevant recent works and summarise the characteristics of the approaches, which is the main aim of this article. To achieve it, we examined articles published between 2018 and 2022 that dealt with the automated scoring of sleep stages. In the final selection for in-depth analysis, 125 articles were included after reviewing a total of 515 publications. The results revealed that automatic scoring demonstrates good quality (with Cohen's kappa up to over 0.80 and accuracy up to over 90%) in analysing EEG/EEG + EOG + EMG signals. At the same time, it should be noted that there has been no breakthrough in the quality of results using these signals in recent years. Systems involving other signals that could potentially be acquired more conveniently for the user (e.g. respiratory, cardiac or movement signals) remain more challenging in the implementation with a high level of reliability but have considerable innovation capability. In general, automatic sleep stage scoring has excellent potential to assist medical professionals while providing an objective assessment.
Healthy sleep is one of the prerequisites for a good human body and brain condition, including general well-being. Unfortunately, there are several sleep disorders that can negatively affect this. One of the most common is sleep apnoea, in which breathing is impaired. Studies have shown that this disorder often remains undiagnosed. To avoid this, developing a system that can be widely used in a home environment to detect apnoea and monitor the changes once therapy has been initiated is essential. The conceptualisation of such a system is the main aim of this research. After a thorough analysis of the available literature and state of the art in this area of knowledge, a concept of the system was created, which includes the following main components: data acquisition (including two parts), storage of the data, apnoea detection algorithm, user and device management, data visualisation. The modules are interchangeable, and interfaces have been defined for data transfer, most of which operate using the MQTT protocol. System diagrams and detailed component descriptions, including signal requirements and visualisation mockups, have also been developed. The system's design includes the necessary concepts for the implementation and can be realised in a prototype in the next phase.
This document presents an algorithm for a nonobtrusive recognition of Sleep/Wake states using signals derived from ECG, respiration, and body movement captured while lying in a bed. As a core mathematical base of system data analytics, multinomial logistic regression techniques were chosen. Derived parameters of the three signals are used as the input for the proposed method. The overall achieved accuracy rate is 84% for Wake/Sleep stages, with Cohen’s kappa value 0.46. The presented algorithm should support experts in analyzing sleep quality in more detail. The results confirm the potential of this method and disclose several ways for its improvement.
Comparison of sleep characteristics measurements: a case study with a population aged 65 and above
(2020)
Good sleep is crucial for a healthy life of every person. Unfortunately, its quality often decreases with aging. A common approach to measuring the sleep characteristics is based on interviews with the subjects or letting them fill in a daily questionnaire and afterward evaluating the obtained data. However, this method has time and personal costs for the interviewer and evaluator of responses. Therefore, it would be important to execute the collection and evaluation of sleep characteristics automatically. To do that, it is necessary to investigate the level of agreement between measurements performed in a traditional way using questionnaires and measurements obtained using electronic monitoring devices. The study presented in this manuscript performs this investigation, comparing such sleep characteristics as "time going to bed", "total time in bed", "total sleep time" and "sleep efficiency". A total number of 106 night records of elderly persons (aged 65+) were analyzed. The results achieved so far reveal the fact that the degree of agreement between the two measurement methods varies substantially for different characteristics, from 31 minutes of mean difference for "time going to bed" to 77 minutes for "total sleep time". For this reason, a direct exchange of objective and subjective measuring methods is currently not possible.
Sleep study can be used for detection of sleep quality and in general bed behaviors. These results can helpful for regulating sleep and recognizing different sleeping disorders of human. In comparison to the leading standard measuring system, which is Polysomnography (PSG), the system proposed in this work is a non-invasive sleep monitoring device. For continuous analysis or home use, the PSG or wearable Actigraphy devices tends to be uncomfortable. Besides, these methods not only decrease practicality due to the process of having to put them on, but they are also very expensive. The system proposed in this paper classifies respiration and body movement with only one type of sensor and also in a noninvasive way. The sensor used is a pressure sensor. This sensor is low cost and can be used for commercial proposes. The system was tested by carrying out an experiment that recorded the sleep process of a subject. These recordings showed excellent results in the classification of breathing rate and body movements.
Recognition of sleep and wake states is one of the relevant parts of sleep analysis. Performing this measurement in a contactless way increases comfort for the users. We present an approach evaluating only movement and respiratory signals to achieve recognition, which can be measured non-obtrusively. The algorithm is based on multinomial logistic regression and analyses features extracted out of mentioned above signals. These features were identified and developed after performing fundamental research on characteristics of vital signals during sleep. The achieved accuracy of 87% with the Cohen’s kappa of 0.40 demonstrates the appropriateness of a chosen method and encourages continuing research on this topic.
Fragestellung: Das klinische Standardverfahren und Referenz der Schlafmessung und der Klassifizierung der einzelnen Schlafstadien ist die Polysomnographie (PSG). Alternative Ansätze zu diesem aufwändigen Verfahren könnten einige Vorteile bieten, wenn die Messungen auf eine komfortablere Weise durchgeführt werden. Das Hauptziel dieser Forschung Studie ist es, einen Algorithmus für die automatische Klassifizierung von Schlafstadien zu entwickeln, der ausschließlich Bewegungs- und Atmungssignale verwendet [1].
Patienten und Methoden: Nach der Analyse der aktuellen Forschungsarbeiten haben wir multinomiale logistische Regression als Grundlage für den Ansatz gewählt [2]. Um die Genauigkeit der Auswertung zu erhöhen, wurden vier Features entwickelt, die aus Bewegungs- und Atemsignalen abgeleitet wurden. Für die Auswertung wurden die nächtlichen Aufzeichnungen von 35 Personen verwendet, die von der Charité-Universitätsmedizin Berlin zur Verfügung gestellt wurden. Das Durchschnittsalter der Teilnehmer betrug 38,6 +/– 14,5 Jahre und der BMI lag bei durchschnittlich 24,4 +/– 4,9 kg/m2. Da der Algorithmus mit drei Stadien arbeitet, wurden die Stadien N1, N2 und N3 zum NREM-Stadium zusammengeführt. Der verfügbare Datensatz wurde strikt aufgeteilt: in einen Trainingsdatensatz von etwa 100 h und in einen Testdatensatz mit etwa 160 h nächtlicher Aufzeichnungen. Beide Datensätze wiesen ein ähnliches Verhältnis zwischen Männern und Frauen auf, und der durchschnittliche BMI wies keine signifikante Abweichung auf.
Ergebnisse: Der Algorithmus wurde implementiert und lieferte erfolgreiche Ergebnisse: die Genauigkeit der Erkennung von Wach-/NREM-/REM-Phasen liegt bei 73 %, mit einem Cohen’s Kappa von 0,44 für die analysierten 19.324 Schlafepochen von jeweils 30 s. Die beobachtete gewisse Überschätzung der NREM-Phase lässt sich teilweise durch ihre Prävalenz in einem typischen Schlafmuster erklären. Selbst die Verwendung eines ausbalancierten Trainingsdatensatzes konnte dieses Problem nicht vollständig lösen.
Schlussfolgerungen: Die erreichten Ergebnisse haben die Tauglichkeit des Ansatzes prinzipiell bestätigt. Dieser hat den Vorteil, dass nur Bewegungs- und Atemsignale verwendet werden, die mit weniger Aufwand und komfortabler für Benutzer aufgezeichnet werden können als z. B. Herz- oder EEG-Signale. Daher stellt das neue System eine deutliche Verbesserung im Vergleich zu bestehenden Ansätzen dar. Die Zusammenführung der beschriebenen algorithmischen Software mit dem in [1] beschriebenen Hardwaresystem zur Messung von Atem- und Körperbewegungssignalen zu einem autonomen, berührungslosen System zur kontinuierlichen Schlafüberwachung ist eine mögliche Richtung zukünftiger Arbeiten.
Identifikation von Schlaf- und Wachzuständen durch die Auswertung von Atem- und Bewegungssignalen
(2021)
The main aim of presented in this manuscript research is to compare the results of objective and subjective measurement of sleep quality for older adults (65+) in the home environment. A total amount of 73 nights was evaluated in this study. Placing under the mattress device was used to obtain objective measurement data, and a common question on perceived sleep quality was asked to collect the subjective sleep quality level. The achieved results confirm the correlation between objective and subjective measurement of sleep quality with the average standard deviation equal to 2 of 10 possible quality points.