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Nowadays, the importance of early active patient mobilization in the recovery and rehabilitation phase has increased significantly. One way to involve patients in the treatment is a gamification-like approach, which is one of the methods of motivation in various life processes. This article shows a system prototype for patients who require physical activity because of active early mobilization after medical interventions or during illness. Bedridden patients and people with a sedentary lifestyle (predominantly lying in bed) are also potential users. The main idea for the concept was non-contact system implementation for the patients making them feel effortless during its usage. The system consists of three related parts: hardware, software, and game application. To test the relevance and coherence of the system, it was used by 35 people. The participants were asked to play a video game requiring them to make body movements while lying down. Then they were asked to take part in a small survey to evaluate the system's usability. As a result, we offer a prototype consisting of hardware and software parts that can increase and diversify physical activity during active early mobilization of patients and prevent the occurrence of possible health problems due to predominantly low activity. The proposed design can be possibly implemented in hospitals, rehabilitation centers, and even at home.
Monitoring heart rate and breathing is essential in understanding the physiological processes for sleep analysis. Polysomnography (PSG) system have traditionally been used for sleep monitoring, but alternative methods can help to make sleep monitoring more portable in someone's home. This study conducted a series of experiments to investigate the use of pressure sensors placed under the bed as an alternative to PSG for monitoring heart rate and breathing during sleep. The following sets of experiments involved the addition of small rubber domes - transparent and black - that were glued to the pressure sensor. The resulting data were compared with the PSG system to determine the accuracy of the pressure sensor readings. The study found that the pressure sensor provided reliable data for extracting heart rate and respiration rate, with mean absolute errors (MAE) of 2.32 and 3.24 for respiration and heart rate, respectively. However, the addition of small rubber hemispheres did not significantly improve the accuracy of the readings, with MAEs of 2.3 bpm and 7.56 breaths per minute for respiration rate and heart rate, respectively. The findings of this study suggest that pressure sensors placed under the bed may serve as a viable alternative to traditional PSG systems for monitoring heart rate and breathing during sleep. These sensors provide a more comfortable and non-invasive method of sleep monitoring. However, the addition of small rubber domes did not significantly enhance the accuracy of the readings, indicating that it may not be a worthwhile addition to the pressure sensor system.
Sleep analysis using a Polysomnography system is difficult and expensive. That is why we suggest a non-invasive and unobtrusive measurement. Very few people want the cables or devices attached to their bodies during sleep. The proposed approach is to implement a monitoring system, so the subject is not bothered. As a result, the idea is a non-invasive monitoring system based on detecting pressure distribution. This system should be able to measure the pressure differences that occur during a single heartbeat and during breathing through the mattress. The system consists of two blocks signal acquisition and signal processing. This whole technology should be economical to be affordable enough for every user. As a result, preprocessed data is obtained for further detailed analysis using different filters for heartbeat and respiration detection. In the initial stage of filtration, Butterworth filters are used.
The evaluation of the effectiveness of different machine learning algorithms on a publicly available database of signals derived from wearable devices is presented with the goal of optimizing human activity recognition and classification. Among the wide number of body signals we choose a couple of signals, namely photoplethysmographic (optically detected subcutaneous blood volume) and tri-axis acceleration signals that are easy to be simultaneously acquired using commercial widespread devices (e.g. smartwatches) as well as custom wearable wireless devices designed for sport, healthcare, or clinical purposes. To this end, two widely used algorithms (decision tree and k-nearest neighbor) were tested, and their performance were compared to two new recent algorithms (particle Bernstein and a Monte Carlo-based regression) both in terms of accuracy and processing time. A data preprocessing phase was also considered to improve the performance of the machine learning procedures, in order to reduce the problem size and a detailed analysis of the compression strategy and results is also presented.
Gamification is one of the recognized methods of motivating people in various life processes, and it has spread to many spheres of life, including healthcare. This article proposes a system design for long-term care patients using the method mentioned. The proposed system aims to increase patient engagement in the treatment and rehabilitation process via gamification. Literature research on available and earlier proposed systems was conducted to develop a suited system design. The primary target group includes bedridden patients and a sedentary lifestyle (predominantly lying in bed). One of the main criteria for selecting a suitable option was its contactless realization for the mentioned target groups in long-term care cases. As a result, we developed the system design for hardware and software that could prevent bedsores and other health problems from occurring because of low activity. The proposed design can be tested in hospitals, nursing homes, and rehabilitation centers.
Evaluation of a contactless accelerometer sensor system for heart rate monitoring during sleep
(2024)
The monitoring of a patient's heart rate (HR) is critical in the diagnosis of diseases. In the detection of sleep disorders, it also plays an important role. Several techniques have been proposed, including using sensors to record physiological signals that are automatically examined and analysed. This work aims to evaluate using a contactless HR monitoring system based on an accelerometer sensor during sleep. For this purpose, the oscillations caused by chest movements during heart contractions are recorded by an installation mounted under the bed mattress. The processing algorithm presented in this paper filters the signals and determines the HR. As a result, an average error of about 5 bpm has been documented, i.e., the system can be considered to be used for the forecasted domain.
Sleep is extremely important for physical and mental health. Although polysomnography is an established approach in sleep analysis, it is quite intrusive and expensive. Consequently, developing a non-invasive and non-intrusive home sleep monitoring system with minimal influence on patients, that can reliably and accurately measure cardiorespiratory parameters, is of great interest. The aim of this study is to validate a non-invasive and unobtrusive cardiorespiratory parameter monitoring system based on an accelerometer sensor. This system includes a special holder to install the system under the bed mattress. The additional aim is to determine the optimum relative system position (in relation to the subject) at which the most accurate and precise values of measured parameters could be achieved. The data were collected from 23 subjects (13 males and 10 females). The obtained ballistocardiogram signal was sequentially processed using a sixth-order Butterworth bandpass filter and a moving average filter. As a result, an average error (compared to reference values) of 2.24 beats per minute for heart rate and 1.52 breaths per minute for respiratory rate was achieved, regardless of the subject’s sleep position. For males and females, the errors were 2.28 bpm and 2.19 bpm for heart rate and 1.41 rpm and 1.30 rpm for respiratory rate. We determined that placing the sensor and system at chest level is the preferred configuration for cardiorespiratory measurement. Further studies of the system’s performance in larger groups of subjects are required, despite the promising results of the current tests in healthy subjects.
Sleep is an essential part of human existence, as we are in this state for approximately a third of our lives. Sleep disorders are common conditions that can affect many aspects of life. Sleep disorders are diagnosed in special laboratories with a polysomnography system, a costly procedure requiring much effort for the patient. Several systems have been proposed to address this situation, including performing the examination and analysis at the patient's home, using sensors to detect physiological signals automatically analysed by algorithms. This work aims to evaluate the use of a contactless respiratory recording system based on an accelerometer sensor in sleep apnea detection. For this purpose, an installation mounted under the bed mattress records the oscillations caused by the chest movements during the breathing process. The presented processing algorithm performs filtering of the obtained signals and determines the apnea events presence. The performance of the developed system and algorithm of apnea event detection (average values of accuracy, specificity and sensitivity are 94.6%, 95.3%, and 93.7% respectively) confirms the suitability of the proposed method and system for further ambulatory and in-home use.
Sleep is essential to physical and mental health. However, the traditional approach to sleep analysis—polysomnography (PSG)—is intrusive and expensive. Therefore, there is great interest in the development of non-contact, non-invasive, and non-intrusive sleep monitoring systems and technologies that can reliably and accurately measure cardiorespiratory parameters with minimal impact on the patient. This has led to the development of other relevant approaches, which are characterised, for example, by the fact that they allow greater freedom of movement and do not require direct contact with the body, i.e., they are non-contact. This systematic review discusses the relevant methods and technologies for non-contact monitoring of cardiorespiratory activity during sleep. Taking into account the current state of the art in non-intrusive technologies, we can identify the methods of non-intrusive monitoring of cardiac and respiratory activity, the technologies and types of sensors used, and the possible physiological parameters available for analysis. To do this, we conducted a literature review and summarised current research on the use of non-contact technologies for non-intrusive monitoring of cardiac and respiratory activity. The inclusion and exclusion criteria for the selection of publications were established prior to the start of the search. Publications were assessed using one main question and several specific questions. We obtained 3774 unique articles from four literature databases (Web of Science, IEEE Xplore, PubMed, and Scopus) and checked them for relevance, resulting in 54 articles that were analysed in a structured way using terminology. The result was 15 different types of sensors and devices (e.g., radar, temperature sensors, motion sensors, cameras) that can be installed in hospital wards and departments or in the environment. The ability to detect heart rate, respiratory rate, and sleep disorders such as apnoea was among the characteristics examined to investigate the overall effectiveness of the systems and technologies considered for cardiorespiratory monitoring. In addition, the advantages and disadvantages of the considered systems and technologies were identified by answering the identified research questions. The results obtained allow us to determine the current trends and the vector of development of medical technologies in sleep medicine for future researchers and research.
Determination of accelerometer sensor position for respiration rate detection: initial research
(2022)
Continuous monitoring of a patient's vital signs is essential in many chronic illnesses. The respiratory rate (RR) is one of the vital signs indicating breathing diseases. This article proposes the initial investigation for determining the accelerometric sensor position of a non-invasive and unobtrusive respiratory rate monitoring system. This research aims to determine the sensor position in relation to the patient, which can provide the most accurate values of the mentioned physiological parameter. In order to achieve the result, the particular system setup, including a mechanical sensor holder construction was used. The breathing signals from 5 participants were analyzed corresponding to the relaxed state. The main criterion for selecting a suitable sensor position was each patient's average acceleration amplitude excursion, which corresponds to the respiratory signal. As a result, we provided one more defined important parameter for the considered system, which was not determined before.
The respiratory rate is a vital sign indicating breathing illness. It is necessary to analyze the mechanical oscillations of the patient's body arising from chest movements. An inappropriate holder on which the sensor is mounted, or an inappropriate sensor position is some of the external factors which should be minimized during signal registration. This paper considers using a non-invasive device placed under the bed mattress and evaluates the respiratory rate. The aim of the work is the development of an accelerometer sensor holder for this system. The normal and deep breathing signals were analyzed, corresponding to the relaxed state and when taking deep breaths. The evaluation criterion for the holder's model is its influence on the patient's respiratory signal amplitude for each state. As a result, we offer a non-invasive system of respiratory rate detection, including the mechanical component providing the most accurate values of mentioned respiratory rate.
The ballistocardiography is a technique that measures the heart rate from the mechanical vibrations of the body due to the heart movement. In this work a novel noninvasive device placed under the mattress of a bed estimates the heart rate using the ballistocardiography. Different algorithms for heart rate estimation have been developed.
Personalized remote healthcare monitoring is in continuous development due to the technology improvements of sensors and wearable electronic systems. A state of the art of research works on wearable sensors for healthcare applications is presented in this work. Furthermore, a state of the art of wearable devices, chest and wrist band and smartwatches available on the market for health and sport monitoring is presented in this paper. Many activity trackers are commercially available. The prices are continuously reducing and the performances are improving, but commercial devices do not provide raw data and are therefore not useful for research purposes.
Globalization has increased the number of road trips and vehicles. The result has been an intensification of traffic accidents, which are becoming one of the most important causes of death worldwide. Traffic accidents are often due to human error, the probability of which increases when the cognitive ability of the driver decreases. Cognitive capacity is closely related to the driver’s mental state, as well as other external factors such as the CO2 concentration inside the vehicle. The objective of this work is to analyze how these elements affect driving. We have conducted an experiment with 50 drivers who have driven for 25 min using a driving simulator. These drivers completed a survey at the start and end of the experiment to obtain information about their mental state. In addition, during the test, their stress level was monitored using biometric sensors and the state of the environment (temperature, humidity and CO2 level) was recorded. The results of the experiment show that the initial level of stress and tiredness of the driver can have a strong impact on stress, driving behavior and fatigue produced by the driving test. Other elements such as sadness and the conditions of the interior of the vehicle also cause impaired driving and affect compliance with traffic regulations.
The impact of stress of every human being has become a serious problem. Reported impact on persons are a higher rate or health disorders like heart problems, obesity, asthma, diabetes, depressions and many others. An individual in a stressful situation has to deal with altered cognition as well as an affected decision making skill and problem solving. This could lead to a higher risk for accidents in dynamic environments such as automotive. Different papers faced the estimation as well as prediction of drivers’ stress level during driving. Another important question is not only the stress level of the driver himself, but also the influence on and of a group of other drivers in the near area. This paper proposes a system, which determines a group of drivers in a near area as clusters and it derives or computes the individual stress level. This information will be analyzed to generate a stress map, which represents a graphical view about road section with a higher stress influence. Aggregated data can be used to generate navigation routes with a lower stress influence as well as recommend driving behavior to decrease stress influenced driving as well as improve road safety.
Sleep is an important aspect in life of every human being. The average sleep duration for an adult is approximately 7 h per day. Sleep is necessary to regenerate physical and psychological state of a human. A bad sleep quality has a major impact on the health status and can lead to different diseases. In this paper an approach will be presented, which uses a long-term monitoring of vital data gathered by a body sensor during the day and the night supported by mobile application connected to an analyzing system, to estimate sleep quality of its user as well as give recommendations to improve it in real-time. Actimetry and historical data will be used to improve the individual recommendations, based on common techniques used in the area of machine learning and big data analysis.
Stress is becoming an important topic in modern life. The influence of stress results in a higher rate of health disorders such as burnout, heart problems, obesity, asthma, diabetes, depressions and many others. Furthermore individual’s behavior and capabilities could be directly affected leading to altered cognition, inappropriate decision making and problem solving skills. In a dynamic and unpredictable environment, such as automotive, this can result in a higher risk for accidents. Different papers faced the estimation as well as prediction of drivers’ stress level during driving. Another important question is not only the stress level of the driver himself, but also the influence on and of a group of other drivers in the near area. This paper proposes a system, which determines a group of drivers in a near area as clusters and it derives the individual stress level. This information will be analyzed to generate a stress map, which represents a graphical view about road section with a higher stress influence. Aggregated data can be used to generate navigation routes with a lower stress influence to decrease stress influenced driving as well as improve road safety.
Home health applications have evolved over the last few decades. Assistive systems such as a data platform in connection with health devices can allow for health-related data to be automatically transmitted to a database. However, there remain significant challenges concerning intermodular communication. Central among them is the challenge of achieving interoperability, the ability of devices to communicate and share data with each other. A major goal of this project was to extend an existing data platform (COMES®) and establish working interoperability by connecting assistive devices with differing approaches. We describe this process for a sleep monitoring and a physical exercise device. Furthermore, we aimed to test this setup and the implementation with a data platform in both a laboratory and an in-home setting with 11 elderly participants. The platform modification was realized, and the relevant changes were made so that the incoming data could be processed by the data platform, as well as visually displayed in real-time. Data was recorded by the respective device and transmitted into the data server with minor disruptions. Our observations affirmed that difficulties and data loss are far more likely to occur with increasing technical complexity, in the event of instable internet connection, or when the device setup requires (elderly) subjects to take specific steps for proper functioning. We emphasize the importance for tests and evaluations of home health technologies in real-life circumstances.
Accurate monitoring of a patient's heart rate is a key element in the medical observation and health monitoring. In particular, its importance extends to the identification of sleep-related disorders. Various methods have been established that involve sensor-based recording of physiological signals followed by automated examination and analysis. This study attempts to evaluate the efficacy of a non-invasive HR monitoring framework based on an accelerometer sensor specifically during sleep. To achieve this goal, the motion induced by thoracic movements during cardiac contractions is captured by a device installed under the mattress. Signal filtering techniques and heart rate estimation using the symlets6 wavelet are part of the implemented computational framework described in this article. Subsequent analysis indicates the potential applicability of this system in the prognostic domain, with an average error margin of approximately 3 beats per minute. The results obtained represent a promising advancement in non-invasive heart rate monitoring during sleep, with potential implications for improved diagnosis and management of cardiovascular and sleep-related disorders.
Sleep quality and in general, behavior in bed can be detected using a sleep state analysis. These results can help a subject to regulate sleep and recognize different sleeping disorders. In this work, a sensor grid for pressure and movement detection supporting sleep phase analysis is proposed. In comparison to the leading standard measuring system, which is Polysomnography (PSG), the system proposed in this project is a non invasive sleep monitoring device. For continuous analysis or home use, the PSG or wearable actigraphy devices tends to be uncomfortable. Besides this fact, they are also very expensive. The system represented in this work classifies respiration and body movement with only one type of sensor and also in a non invasive 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 the potential for classification of breathing rate and body movements. Although previous researches show the use of pressure sensors in recognizing posture and breathing, they have been mostly used by positioning the sensors between the mattress and bedsheet. This project however, shows an innovative way to position the sensors under the mattress.
This document presents a new complete standalone system for a recognition of sleep apnea using signals from the pressure sensors placed under the mattress. The developed hardware part of the system is tuned to filter and to amplify the signal. Its software part performs more accurate signal filtering and identification of apnea events. The overall achieved accuracy of the recognition of apnea occurrence is 91%, with the average measured recognition delay of about 15 seconds, which confirms the suitability of the proposed method for future employment. The main aim of the presented approach is the support of the healthcare system with the cost-efficient tool for recognition of sleep apnea in the home environment.
In many cases continuous monitoring of vital signals is required and low intrusiveness is an important requirement. Incorporating monitoring systems in the hospital or home bed could have benefits for patients and caregivers. The objective of this work is the definition of a measurement protocol and the creation of a data set of measurements using commercial and low-cost prototypes devices to estimate heart rate and breathing rate. The experimental data will be used to compare results achieved by the devices and to develop algorithms for feature extraction of vital signals.
The scoring of sleep stages is an essential part of sleep studies. The main objective of this research is to provide an algorithm for the automatic classification of sleep stages using signals that may be obtained in a non-obtrusive way. After reviewing the relevant research, the authors selected a multinomial logistic regression as the basis for their approach. Several parameters were derived from movement and breathing signals, and their combinations were investigated to develop an accurate and stable algorithm. The algorithm was implemented to produce successful results: the accuracy of the recognition of Wake/NREM/REM stages is equal to 73%, with Cohen's kappa of 0.44 for the analyzed 19324 sleep epochs of 30 seconds each. This approach has the advantage of using the only movement and breathing signals, which can be recorded with less effort than heart or brainwave signals, and requiring only four derived parameters for the calculations. Therefore, the new system is a significant improvement for non-obtrusive sleep stage identification compared to existing approaches.
Health monitoring in a home environment can have broader use since it may provide continuous control of health parameters with relatively minor intrusiveness into regular life. This work aims to verify if it is possible to replace the typical in some sleep medicine areas subjective questioning by an objective measurement using electronic devices. For this purpose, a study was conducted with ten subjects, in which objective and subjective measurement of relevant sleep parameters took place. The results of both measurement methods were evaluated and analyzed. The results showed that while for some measures, such as Total Time in Bed, there is a high agreement between objective and subjective measurements, for others, such as sleep quality, there are significant differences. For this reason, currently, a combination of both measurement methods may be beneficial and provide the most detailed results, while a partial replacement can already reduce the number of questions at the subjective measurement by measurement through electronic devices.
To analyze the humans’ sleep it is necessary as to identify the sleep stages, occurring during the sleep, their durations and sleep cycles. The gold standard procedure for this approach is polysomnography (PSG), which classify the sleep stages based on Rechtschaffen and Kales (R-K) method. This method aside the advantages as high accuracy has however some disadvantages, among others time-consuming and uncomfortable for the patient procedure. Therefore, the development of further methods for the sleep classification in addition to PSG is a promising topic for the investigation and this work has as its aim the presentation of possible ways and goals for this development.
The importance of sleep for human life is enormous. It affects physical, mental, and psychological health. Therefore, it is vital to recognise sleep disorders in a timely manner in order to be able to initiate therapy. There are two methods for measuring sleep-related parameters - objective and subjective. Whether the substitution of a subjective method for an objective one is possible is investigated in this paper. Such replacement may bring several advantages, including increased comfort for the user. To answer this research question, a study was conducted in which 75 overnight recordings were evaluated. The primary purpose of this study was to compare both ways of measurement for total sleep time and sleep efficiency, which are essential parameters for, e.g., insomnia diagnosis and treatment. The evaluation results demonstrated that, on average, there are 32 minutes of difference between the two measurement methods when total sleep time is analysed. In contrast, on average, both measurement methods differ by 7.5% for sleep efficiency measurement. It should also be noted that people typically overestimate total sleep time and efficiency with the subjective method, where the perceived values are measured.
The influence of sleep on human health is enormous. Accordingly, sleep disorders can have a negative impact on it. To avoid this, they should be identified and treated in time. For this purpose, objective (with an appropriate device) or subjective (based on perceived values) measurement methods are used for sleep analysis to understand the problem. The aim of this work is to find out whether an exchange of the two methods is possible and can provide reliable results. In accordance with this goal, a study was conducted with people aged over 65 years old (a total of 154 night-time recordings) in which both measurement methods were compared. Sleep questionnaires and electronic devices for sleep assessment placed under the mattress were applied to achieve the study aims. The obtained results indicated that the correlation between both measurement methods could be observed for sleep characteristics such as total sleep time, total time in bed and sleep efficiency. However, there are also significant differences in absolute values of the two measurement approaches for some subjects/nights, which leads us to conclude that the substitution is more likely to be considered in case of long-term monitoring where the trends are of more importance and not the absolute values for individual nights.
The recovery of our body and brain from fatigue directly depends on the quality of sleep, which can be determined from the results of a sleep study. The classification of sleep stages is the first step of this study and includes the measurement of vital data and their further processing. The non-invasive sleep analysis system is based on a hardware sensor network of 24 pressure sensors providing sleep phase detection. The pressure sensors are connected to an energy-efficient microcontroller via a system-wide bus. A significant difference between this system and other approaches is the innovative way in which the sensors are placed under the mattress. This feature facilitates the continuous use of the system without any noticeable influence on the sleeping person. The system was tested by conducting experiments that recorded the sleep of various healthy young people. Results indicate the potential to capture respiratory rate and body movement.
Healthy sleep is required for sufficient restoration of the human body and brain. Therefore, in the case of sleep disorders, appropriate therapy should be applied timely, which requires a prompt diagnosis. Traditionally, a sleep diary is a part of diagnosis and therapy monitoring for some sleep disorders, such as cognitive behaviour therapy for insomnia. To automatise sleep monitoring and make it more comfortable for users, substituting a sleep diary with a smartwatch measurement could be considered. With the aim of providing accurate results, a study with a total of 30 night recordings was conducted. Objective sleep measurement with a Samsung Galaxy Watch 4 was compared with a subjective approach (sleep diary), evaluating the four relevant sleep characteristics: time of getting asleep, wake up time, sleep efficiency (SE), and total sleep time (TST). The performed analysis has demonstrated that the median difference between both measurement approaches was equal to 7 and 3 minutes for a time of getting asleep and wake up time correspondingly, which allows substituting a subjective measurement with a smartwatch. The SE was determined with a median difference between the two measurement methods of 5.22%. This result also implicates a possibility of substitution. Some single recordings have indicated a higher variance between the two approaches. Therefore, the conclusion can be made that a substitution provides reliable results primarily in the case of long-term monitoring. The results of the evaluation of the TST measurement do not allow to recommend substitution of the measurement method.
Sustainable technologies are being increasingly used in various areas of human life. While they have a multitude of benefits, they are especially useful in health monitoring, especially for certain groups of people, such as the elderly. However, there are still several issues that need to be addressed before its use becomes widespread. This work aims to clarify the aspects that are of great importance for increasing the acceptance of the use of this type of technology in the elderly. In addition, we aim to clarify whether the technologies that are already available are able to ensure acceptable accuracy and whether they could replace some of the manual approaches that are currently being used. A two-week study with people 65 years of age and over was conducted to address the questions posed here, and the results were evaluated. It was demonstrated that simplicity of use and automatic functioning play a crucial role. It was also concluded that technology cannot yet completely replace traditional methods such as questionnaires in some areas. Although the technologies that were tested were classified as being “easy to use”, the elderly population in the current study indicated that they were not sure that they would use these technologies regularly in the long term because the added value is not always clear, among other issues. Therefore, awareness-raising must take place in parallel with the development of technologies and services.
In order to ensure sufficient recovery of the human body and brain, healthy sleep is indispensable. For this purpose, appropriate therapy should be initiated at an early stage in the case of sleep disorders. For some sleep disorders (e.g., insomnia), a sleep diary is essential for diagnosis and therapy monitoring. However, subjective measurement with a sleep diary has several disadvantages, requiring regular action from the user and leading to decreased comfort and potential data loss. To automate sleep monitoring and increase user comfort, one could consider replacing a sleep diary with an automatic measurement, such as a smartwatch, which would not disturb sleep. To obtain accurate results on the evaluation of the possibility of such a replacement, a field study was conducted with a total of 166 overnight recordings, followed by an analysis of the results. In this evaluation, objective sleep measurement with a Samsung Galaxy Watch 4 was compared to a subjective approach with a sleep diary, which is a standard method in sleep medicine. The focus was on comparing four relevant sleep characteristics: falling asleep time, waking up time, total sleep time (TST), and sleep efficiency (SE). After evaluating the results, it was concluded that a smartwatch could replace subjective measurement to determine falling asleep and waking up time, considering some level of inaccuracy. In the case of SE, substitution was also proved to be possible. However, some individual recordings showed a higher discrepancy in results between the two approaches. For its part, the evaluation of the TST measurement currently does not allow us to recommend substituting the measurement method for this sleep parameter. The appropriateness of replacing sleep diary measurement with a smartwatch depends on the acceptable levels of discrepancy. We propose four levels of similarity of results, defining ranges of absolute differences between objective and subjective measurements. By considering the values in the provided table and knowing the required accuracy, it is possible to determine the suitability of substitution in each individual case. The introduction of a “similarity level” parameter increases the adaptability and reusability of study findings in individual practical cases.
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.
Die Erholung unseres Körpers und Gehirns von Müdigkeit ist direkt abhängig von der Qualität des Schlafes, die aus den Ergebnissen einer Schlafstudie ermittelt werden kann. Die Klassifizierung der Schlafstadien ist der erste Schritt dieser Studie und beinhaltet die Messung von Biovitaldaten und deren weitere Verarbeitung. Das non-invasive Schlafanalyse-System basiert auf einem Hardware-Sensornetz aus 24 Drucksensoren, das die Schlafphasenerkennung ermöglicht. Die Drucksensoren sind mit einem energieeffizienten Mikrocontroller über einen systemweiten Bus mit Adressarbitrierung verbunden. Ein wesentlicher Unterschied dieses Systems im Vergleich zu anderen Ansätzen ist die innovative Art, die Sensoren unter der Matratze zu platzieren. Diese Eigenschaft erleichtert die kontinuierliche Nutzung des Systems ohne fühlbaren Einfluss auf das gewohnte Bett. Das System wurde getestet, indem Experimente durchgeführt wurden, die den Schlaf verschiedener gesunder junger Personen aufzeichneten. Die ersten Ergebnisse weisen auf das Potenzial hin, nicht nur Atemfrequenz und Körperbewegung, sondern auch Herzfrequenz zu erfassen.
Identifikation von Schlaf- und Wachzuständen durch die Auswertung von Atem- und Bewegungssignalen
(2021)
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.
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.
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.
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.
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.
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.
In recent decades, it can be observed that a steady increase in the volume of tourism is a stable trend. To offer travel opportunities to all groups, it is also necessary to prepare offers for people in need of long-term care or people with disabilities. One of the ways to improve accessibility could be digital technologies, which could help in planning as well as in carrying out trips. In the work presented, a study of barriers was first conducted, which led to selecting technologies for a test setup after analysis. The main focus was on a mobile app with travel information and 360° tours. The evaluation results showed that both technologies could increase accessibility, but some essential aspects (such as usability, completeness, relevance, etc.) need to be considered when implementing them.
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.
Fatigue and drowsiness are responsible for a significant percentage of road traffic accidents. There are several approaches to monitor the driver's drowsiness, ranging from the driver's steering behavior to the analysis of the driver, e.g. eye tracking, blinking, yawning, or electrocardiogram (ECG). This paper describes the development of a low-cost ECG sensor to derive heart rate variability (HRV) data for drowsiness detection. The work includes hardware and software design. The hardware was implemented on a printed circuit board (PCB) designed so that the board can be used as an extension shield for an Arduino. The PCB contains a double, inverted ECG channel including low-pass filtering and provides two analog outputs to the Arduino, which combines them and performs the analog-to-digital conversion. The digital ECG signal is transferred to an NVidia embedded PC where the processing takes place, including QRS-complex, heart rate, and HRV detection as well as visualization features. The resulting compact sensor provides good results in the extraction of the main ECG parameters. The sensor is being used in a larger frame, where facial-recognition-based drowsiness detection is combined with ECG-based detection to improve the recognition rate under unfavorable light or occlusion conditions.
Sleep disorders can impact daily life, affecting physical, emotional, and cognitive well-being. Due to the time-consuming, highly obtrusive, and expensive nature of using the standard approaches such as polysomnography, it is of great interest to develop a noninvasive and unobtrusive in-home sleep monitoring system that can reliably and accurately measure cardiorespiratory parameters while causing minimal discomfort to the user’s sleep. We developed a low-cost Out of Center Sleep Testing (OCST) system with low complexity to measure cardiorespiratory parameters. We tested and validated two force-sensitive resistor strip sensors under the bed mattress covering the thoracic and abdominal regions. Twenty subjects were recruited, including 12 males and 8 females. The ballistocardiogram signal was processed using the 4th smooth level of the discrete wavelet transform and the 2nd order of the Butterworth bandpass filter to measure the heart rate and respiration rate, respectively. We reached a total error (concerning the reference sensors) of 3.24 beats per minute and 2.32 rates for heart rate and respiration rate, respectively. For males and females, heart rate errors were 3.47 and 2.68, and respiration rate errors were 2.32 and 2.33, respectively. We developed and verified the reliability and applicability of the system. It showed a minor dependency on sleeping positions, one of the major cumbersome sleep measurements. We identified the sensor under the thoracic region as the optimal configuration for cardiorespiratory measurement. Although testing the system with healthy subjects and regular patterns of cardiorespiratory parameters showed promising results, further investigation is required with the bandwidth frequency and validation of the system with larger groups of subjects, including patients.
Sleep is essential to existence, much like air, water, and food, as we spend nearly one-third of our time sleeping. Poor sleep quality or disturbed sleep causes daytime solemnity, which worsens daytime activities' mental and physical qualities and raises the risk of accidents. With advancements in sensor and communication technology, sleep monitoring is moving out of specialized clinics and into our everyday homes. It is possible to extract data from traditional overnight polysomnographic recordings using more basic tools and straightforward techniques. Ballistocardiogram is an unobtrusive, non-invasive, simple, and low-cost technique for measuring cardiorespiratory parameters. In this work, we present a sensor board interface to facilitate the communication between force sensitive resistor sensor and an embedded system to provide a high-performing prototype with an efficient signal-to-noise ratio. We have utilized a multi-physical-layer approach to locate each layer on top of another, yet supporting a low-cost, compact design with easy deployment under the bed frame.
The proposed approach applies current unsupervised clustering approaches in a different dynamic manner. Instead of taking all the data as input and finding clusters among them, the given approach clusters Holter ECG data (longterm electrocardiography data from a holter monitor) on a given interval which enables a dynamic clustering approach (DCA). Therefore advanced clustering techniques based on the well known Dynamic TimeWarping algorithm are used. Having clusters e.g. on a daily basis, clusters can be compared by defining cluster shape properties. Doing this gives a measure for variation in unsupervised cluster shapes and may reveal unknown changes in healthiness. Embedding this approach into wearable devices offers advantages over the current techniques. On the one hand users get feedback if their ECG data characteristic changes unforeseeable over time which makes early detection possible. On the other hand cluster properties like biggest or smallest cluster may help a doctor in making diagnoses or observing several patients. Further, on found clusters known processing techniques like stress detection or arrhythmia classification may be applied.
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.
To assess the quality of a person’s sleep, it is essential to examine the sleep behaviour by identifying the several sleep stages, their durations and sleep cycles. The established and gold standard procedure for sleep stage scoring is overnight polysomnography (PSG) with the Rechtschaffen and Kales (R-K) method. Unfortunately, the conduct of PSG is time-consuming and unfamiliar for the subjects and might have an impact of the recorded data. To avoid the disadvantages with PSG, it is important to make further investigations in low-cost home diagnostic systems. For this intention it is necessary to find suitable bio vital parameters for classifying sleep stages without any physical impairments at the same time. Due to the promising results in several publications we want to analyse existing methods for sleep stage classification based on the parameters body movement,
heartbeat and respiration. Our aim was to find different behaviour patterns in the several sleep stages. Therefore, the average values of 15 whole-night PSG recordings -obtained from the ‘DREAMS
Subjects Database’- where analysed in the light of heartbeat, body movement and respiration with 10 different methods.