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Healthy and good sleep is a prerequisite for a rested mind and body. Both form the basis for physical and mental health. Healthy sleep is hindered by sleep disorders, the medically diagnosed frequency of which increases sharply from the age of 40. This chapter describes the formal specification of an on-course practical implementation for a non-invasive system based on biomedical signal processing to support the diagnosis and treatment of sleep-related diseases. The system aims to continuously monitor vital data during sleep in a patient’s home environment over long periods by using non-invasive technologies. At the center of the development is the MORPHEUS Box (MoBo), which consists of five main conceptualizations: the MoBo core, the MoBo-HW, the MoBo algorithm, the MoBo API, and the MoBo app. These synergistic elements aim to support the diagnosis and treatment of sleep-related diseases. Although there are related developments in individual aspects concerning the system, no comparative approach is known that gives a similar scope of functionality, deployment flexibility, extensibility, or the possibility to use multiple user groups. With the specification provided in this chapter, the MORPHEUS project sets a good platform, data model, and transmission strategies to bring an innovative proposal to measure sleep quality and detect sleep diseases from non-invasive sensors.
With the advancement in sensor technology and the trend shift of health measurement from treatment after diagnosis to abnormalities detection long before the occurrence, the approach of turning private spaces into diagnostic spaces has gained much attention. In this work, we designed and implemented a low-cost and compact form factor module that can be deployed on the steering wheel of cars as well as most frequently touch objects at home in order to measure physiological signals from the fingertip of the subject as well as environmental parameters. We estimated the heart rate and SpO2 with the error of 2.83 bpm and 3.52%, respectively. The signal evaluation of skin temperature shows a promising output with respect to environmental recalibration. In addition, the electrodermal activity sensor followed the reference signal, appropriately which indicates the potential for further development and application in stress measurement.
The perception of the amount of stress is subjective to every person, and the perception of it changes depending on many factors. One of the factors that has an impact on perceived stress is the emotional state. In this work, we compare the emotional state of 40 German driving students and present different partitions that can be advantageous for using artificial intelligence and classification. Like this, we evaluate the data quality and prepare for the specific use. The Stress Perceived Questionnaire (PSQ20) was employed to assess the level of stress experienced by individuals while participating in a driving simulation for 5 and 25 min. As a result of our analysis, we present a categorisation of various emotional states into intervals, comparing different classifications and facilitating a more straightforward implementation of artificial intelligence for classification purposes.
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.
Unintrusive health monitoring systems is important when continuous monitoring of the patient vital signals is required. In this paper, signals obtained from accelerometers placed under a bed are processed with ballistocardiography algorithms and compared with synchronized electrocardiographic signals.
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.
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 massive use of patient data for the training of artificial intelligence algorithms is common nowadays in medicine. In this scientific work, a statistical analysis of one of the most used datasets for the training of artificial intelligence models for the detection of sleep disorders is performed: sleep health heart study 2. This study focuses on determining whether the gender and age of the patients have a relevant influence to consider working with differentiated datasets based on these variables for the training of artificial intelligence models.
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.
This paper compares two popular scripting implementations for hardware prototyping: Python scripts exe- cut from User-Space and C-based Linux-Driver processes executed from Kernel-Space, which can provide information to researchers when considering one or another in their implementations. Conclusions exhibit that deploying software scripts in the kernel space makes it possible to grant a certain quality of sensor information using a Raspberry Pi without the need for advanced real-time operational systems.
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.
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.
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.
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.
The digital twin concept has been widely known for asset monitoring in the industry for a long time. A clear example is the automotive industry. Recently, there has also been significant interest in the application of digital twins in healthcare, especially in genomics in what is known as precision medicine. This work focuses on another medical speciality where digital twins can be applied, sleep medicine. However, there is still great controversy about the fundamentals that constitute digital twins, such as what this concept is based on and how it can be included in healthcare effectively and sustainably. This article reviews digital twins and their role so far in what is known as personalized medicine. In addition, a series of steps will be exposed for a possible implementation of a digital twin for a patient suffering from sleep disorders. For this, artificial intelligence techniques, clinical data management, and possible solutions for explaining the results derived from artificial intelligence models will be addressed.
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.
There have been substantial research efforts for algorithms to improve continuous and automated assessment of various health-related questions in recent years. This paper addresses the deployment gap between those improving algorithms and their usability in care and mobile health applications. In practice, most algorithms require significant and founded technical knowledge to be deployed at home or support healthcare professionals. Therefore, the digital participation of persons in need of health care professionals lacks a usable interface to use the current technological advances. In this paper, we propose applying algorithms taken from research as web-based microservices following the common approach of a RESTful service to bridge the gap and make algorithms accessible to caregivers and patients without technical knowledge and extended hardware capabilities. We address implementation details, interpretation and realization of guidelines, and privacy concerns using our self-implemented example. Also, we address further usability guidelines and our approach to those.
Sleep is an important part of our life that significantly influences our health and well-being. The monitoring of sleep can provide data based on which sleep quality could be improved. This paper presents a system for heart rate detection during sleep. The data is collected from sensors underneath the test subjects. Though the data contains noise, it needs to be filtered to remove it. Due to the low strength of the signals, they need to be amplified after filtering. At some points of the signal, particular heartbeats may not be tracked by sensors due to the failure of a sensor or other reasons, which should be considered. The heart rate is detected in intervals of 15 s. A tool is implemented that detects the heart rate and visualizes it. The preprocessing of the data is performed with several filters: a highpass filter, a band-reject filter, a lowpass filter, and a motion detector. After the preprocessing of the data, the quality of the signal is significantly increased, and detection is possible.
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.
Deep Learning-based EEG Detection of Mental Alertness States from Drivers under Ethical Aspects
(2022)
One of the most critical factors for a successful road trip is a high degree of alertness while driving. Even a split second of inattention or sleepiness in a crucial moment, will make the difference between life and death. Several prestigious car manufacturers are currently pursuing the aim of automated drowsiness identification to resolve this problem. The path between neuro-scientific research in connection with artificial intelligence and the preservation of the dignity of human individual’s and its inviolability, is very narrow. The key contribution of this work is a system of data analysis for EEGs during a driving session, which draws on previous studies analyzing heart rate (ECG), brain waves (EEG), and eye function (EOG). The gathered data is hereby treated as sensitive as possible, taking ethical regulations into consideration. Obtaining evaluable signs of evolving exhaustion includes techniques that obtain sleeping stage frequencies, problematic are hereby the correlated interference’s in the signal. This research focuses on a processing chain for EEG band splitting that involves band-pass filtering, principal component analysis (PCA), independent component analysis (ICA) with automatic artefact severance, and fast fourier transformation (FFT). The classification is based on a step-by-step adaptive deep learning analysis that detects theta rhythms as a drowsiness predictor in the pre-processed data. It was possible to obtain an offline detection rate of 89% and an online detection rate of 73%. The method is linked to the simulated driving scenario for which it was developed. This leaves space for more optimization on laboratory methods and data collection during wakefulness-dependent operations.
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.
The last decades have shown that the volume of tourism, in general, is constantly increasing (with some justified exceptions). To offer a possibility of travel for all groups of people, it is necessary to pay attention to accessibility. One of the possibilities for increasing accessibility is digital technologies, which could assist in planning and the implementation and completion of trips. To make a selection of technologies, first, a study of barriers was conducted, which was then analyzed, and finally, some technologies were made available in a test setup. A focus on two technologies was made: 360°-Tours and mobile app with the travel information. The two technologies were implemented and presented to the test subjects.
The evaluation results showed that both technologies could increase accessibility if some essential aspects (such as usability, completeness, relevance, etc.) are considered during the implementation.
The development of home health systems can provide continuous and user-friendly monitoring of key health parameters. This project aims to create a concept for such a system, implement it on a test basis, and evaluate it. Three health areas were selected for this purpose:
Sleep, Stress, and Rehabilitation. Appropriate devices were installed in the homes of test subjects and used by them for two weeks. Besides, relevant questionnaires were completed to obtain a complete picture. Finally, the implemented system was evaluated, and the results of the conducted study showed that home health systems have great potential. However, it is necessary to consider some points to increase the usability of the system and the motivation of the users. Among others, ease of use of the equipment is of extreme importance.
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.
Due to the rising need for palliative care in Russia, it is crucial to provide timely and high-quality solutions for patients, relatives, and caregivers. A methodology for remote monitoring of patients in need of palliative care and the requirements will be developed for a hardware-software complex for remote monitoring of patients' health at home.
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 non-obtrusive way. The first results confirm the potential of measurement of breathing and movement signals with the proposed system.
Autismus-Spektrum-Störungen (ASD) bei Kindern werden häufig zu spät diagnostiziert und die Begleitung der chronischen Krankheit gestaltet sich schwierig. Der vorgestellte Ansatz erlaubt die Behandlung der Kinder in dem bekannten häuslichen Umfeld und versucht die Beziehungen zwischen Schlaf und Verhalten herauszuarbeiten. Die gewonnenen Erkenntnisse sollen die Lebensqualität der Patienten verbessern und den Eltern Hilfestellung geben. Die notwendige infrastrukturelle Unterstützung wird durch medizinisches Fachpersonal geleistet, das auf einen web-basierten Service zurückgreifen kann, der sämtliche Prozesse (Diagnostik, Datenerfassung, -aufzeichnung und Training etc.) begleitet. Die anonymisierten Daten werden in einem Diagnosesystem zentral abgelegt und können so für zukünftige Behandlungsstrategien nutzbar sein. Die umfassende Lösung setzt auf zentrale Elemente von Smart-Homes und AAL auf.