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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.
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.
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.
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.
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.