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Introduction. Despite its high accuracy, polysomnography (PSG) has several drawbacks for diagnosing obstructive sleep apnea (OSA). Consequently, multiple portable monitors (PMs) have been proposed. Objective. This systematic review aims to investigate the current literature to analyze the sets of physiological parameters captured by a PM to select the minimum number of such physiological signals while maintaining accurate results in OSA detection. Methods. Inclusion and exclusion criteria for the selection of publications were established prior to the search. The evaluation of the publications was made based on one central question and several specific questions. Results. The abilities to detect hypopneas, sleep time, or awakenings were some of the features studied to investigate the full functionality of the PMs to select the most relevant set of physiological signals. Based on the physiological parameters collected (one to six), the PMs were classified into sets according to the level of evidence. The advantages and the disadvantages of each possible set of signals were explained by answering the research questions proposed in the methods. Conclusions. The minimum number of physiological signals detected by PMs for the detection of OSA depends mainly on the purpose and context of the sleep study. The set of three physiological signals showed the best results in the detection of OSA.
Background
This is a systematic review protocol to identify automated features, applied technologies, and algorithms in the electronic early warning/track and triage system (EW/TTS) developed to predict clinical deterioration (CD).
Methodology
This study will be conducted using PubMed, Scopus, and Web of Science databases to evaluate the features of EW/TTS in terms of their automated features, technologies, and algorithms. To this end, we will include any English articles reporting an EW/TTS without time limitation. Retrieved records will be independently screened by two authors and relevant data will be extracted from studies and abstracted for further analysis. The included articles will be evaluated independently using the JBI critical appraisal checklist by two researchers.
Discussion
This study is an effort to address the available automated features in the electronic version of the EW/TTS to shed light on the applied technologies, automated level of systems, and utilized algorithms in order to smooth the road toward the fully automated EW/TTS as one of the potential solutions of prevention CD and its adverse consequences.
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.
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.
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.
While driving, stress is caused by situations in which the driver estimates their ability to manage the driving demands as insufficient or loses the capability to handle the situation. This leads to increased numbers of driver mistakes and traffic violations. Additional stressing factors are time pressure, road conditions, or dislike for driving. Therefore, stress affects driver and road safety. Stress is classified into two categories depending on its duration and the effects on the body and psyche: short-term eustress and constantly present distress, which causes degenerative effects. In this work, we focus on distress. Wearable sensors are handy tools for collecting biosignals like heart rate, activity, etc. Easy installation and non-intrusive nature make them convenient for calculating stress. This study focuses on the investigation of stress and its implications. Specifically, the research conducts an analysis of stress within a select group of individuals from both Spain and Germany. The primary objective is to examine the influence of recognized psychological factors, including personality traits such as neuroticism, extroversion, psychoticism, stress and road safety. The estimation of stress levels was accomplished through the collection of physiological parameters (R-R intervals) using a Polar H10 chest strap. We observed that personality traits, such as extroversion, exhibited similar trends during relaxation, with an average heart rate 6% higher in Spain and 3% higher in Germany. However, while driving, introverts, on average, experienced more stress, with rates 4% and 1% lower than extroverts in Spain and Germany, respectively.
oday many scientific works are using deep learning algorithms and time series, which can detect physiological events of interest. In sleep medicine, this is particularly relevant in detecting sleep apnea, specifically in detecting obstructive sleep apnea events. Deep learning algorithms with different architectures are used to achieve decent results in accuracy, sensitivity, etc. Although there are models that can reliably determine apnea and hypopnea events, another essential aspect to consider is the explainability of these models, i.e., why a model makes a particular decision. Another critical factor is how these deep learning models determine how severe obstructive sleep apnea is in patients based on the apnea-hypopnea index (AHI). Deep learning models trained by two approaches for AHI determination are exposed in this work. Approaches vary depending on the data format the models are fed: full-time series and window-based time series.
This study investigates the application of Force Sensing Resistor (FSR) sensors and machine learning algorithms for non-invasive body position monitoring during sleep. Although reliable, traditional methods like Polysomnography (PSG) are invasive and unsuited for extended home-based monitoring. Our approach utilizes FSR sensors placed beneath the mattress to detect body positions effectively. We employed machine learning techniques, specifically Random Forest (RF), K-Nearest Neighbors (KNN), and XGBoost algorithms, to analyze the sensor data. The models were trained and tested using data from a controlled study with 15 subjects assuming various sleep positions. The performance of these models was evaluated based on accuracy and confusion matrices. The results indicate XGBoost as the most effective model for this application, followed by RF and KNN, offering promising avenues for home-based sleep monitoring systems.
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 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.
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.
Matrix methods for the computation of bounds for the range of a complex polynomial and its modulus over a rectangular region in the complex plane are presented. The approach relies on the expansion of the given polynomial into Bernstein polynomials. The results are extended to multivariate complex polynomials and rational functions.
The class of square matrices of order n having a negative determinant and all their minors up to order n-1 nonnegative is considered. A characterization of these matrices is presented which provides an easy test based on the Cauchon algorithm for their recognition. Furthermore, the maximum allowable perturbation of the entry in position (2,2) such that the perturbed matrix remains in this class is given. Finally, it is shown that all matrices lying between two matrices of this class with respect to the checkerboard ordering are contained in this class, too.
The citizen-centered health platform project is intended to provide a platform that can be used in EU cross-border regions, where social and economic exchange occurs across national borders. The overriding challenges are: (a) social: improving citizen-centered health and care provision; (b) technical: providing a digital platform for networking citizens, service providers, and municipal actors; (c) economic: developing long-term successful (sustainable) business models/value chains. The platform should strengthen and expand existing networks and establish new regional networks. Each network addresses particular challenges and apply them in a region-specific manner. Here, the national boundary conditions and the interregional needs play an essential role. These objectives require sufficient participation of civil society representatives. Furthermore, the platform will establish an overarching, sustainable, and knowledge-based network of health experts. The platform is to be jointly developed and implemented in the regions and follow an open-access approach. Therefore, synergies will be shared more quickly, strengthening competencies and competitiveness. In addition to practice partners, scientific and municipal institutions and SMEs are involved. The actors thus contribute to scientific performance, innovative strength, and resilience.
Cardiovascular diseases (CVD) are leading contributors to global mortality, necessitating advanced methods for vital sign monitoring. Heart Rate Variability (HRV) and Respiratory Rate, key indicators of cardiovascular health, are traditionally monitored via Electrocardiogram (ECG). However, ECG's obtrusiveness limits its practicality, prompting the exploration of Ballistocardiography (BCG) as a non-invasive alternative. BCG records the mechanical activity of the body with each heartbeat, offering a contactless method for HRV monitoring. Despite its benefits, BCG signals are susceptible to external interference and present a challenge in accurately detecting J-Peaks. This research uses advanced signal processing and deep learning techniques to overcome these limitations. Our approach integrates accelerometers for long-term BCG data collection during sleep, applying Discrete Wavelet Transforms (DWT) and Ensemble Empirical Mode Decomposition (EEMD) for feature extraction. The Bi-LSTM model, leveraging these features, enhances heartbeat detection, offering improved reliability over traditional methods. The study's findings indicate that the combined use of DWT, EEMD, and Bi-LSTM for J-Peak detection in BCG signals is effective, with potential applications in unobtrusive long-term cardiovascular monitoring. Our results suggest that this methodology could contribute to HRV monitoring, particularly in home settings, enhancing patient comfort and compliance.