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.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both ...these domains indicates the ongoing expansion of digital technologies in this market segment.
Objective
This paper aims to review the feasibility of blockchain technology for telemedicine.
Methods
The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex).
Results
Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%).
Conclusions
These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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 CO
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 CO
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.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objective: This paper presents an algorithm for non-invasive sleep stage identification using respiratory, heart rate and movement signals. The algorithm is part of a system suitable for long-term ...monitoring in a home environment, which should support experts analysing sleep. Approach: As there is a strong correlation between bio-vital signals and sleep stages, multinomial logistic regression was chosen for categorical distribution of sleep stages. Several derived parameters of three signals (respiratory, heart rate and movement) are input for the proposed method. Sleep recordings of five subjects were used for the training of a machine learning model and 30 overnight recordings collected from 30 individuals with about 27 000 epochs of 30 s intervals each were evaluated. Main results: The achieved rate of accuracy is 72% for Wake, NREM, REM (with Cohen's kappa value 0.67) and 58% for Wake, Light (N1 and N2), Deep (N3) and REM stages (Cohen's kappa is 0.50). Our approach has confirmed the potential of this method and disclosed several ways for its improvement. Significance: The results indicate that respiratory, heart rate and movement signals can be used for sleep studies with a reasonable level of accuracy. These inputs can be obtained in a non-invasive way applying it in a home environment. The proposed system introduces a convenient approach for a long-term monitoring system which could support sleep laboratories. The algorithm which was developed allows for an easy adjustment of input parameters that depend on available signals and for this reason could also be used with various hardware systems.
Polysomnography (PSG) is the gold standard for detecting obstructive sleep apnea (OSA). However, this technique has many disadvantages when using it outside the hospital or for daily use. Portable ...monitors (PMs) aim to streamline the OSA detection process through deep learning (DL).
We studied how to detect OSA events and calculate the apnea-hypopnea index (AHI) by using deep learning models that aim to be implemented on PMs. Several deep learning models are presented after being trained on polysomnography data from the National Sleep Research Resource (NSRR) repository. The best hyperparameters for the DL architecture are presented. In addition, emphasis is focused on model explainability techniques, concretely on Gradient-weighted Class Activation Mapping (Grad-CAM).
The results for the best DL model are presented and analyzed. The interpretability of the DL model is also analyzed by studying the regions of the signals that are most relevant for the model to make the decision. The model that yields the best result is a one-dimensional convolutional neural network (1D-CNN) with 84.3% accuracy.
The use of PMs using machine learning techniques for detecting OSA events still has a long way to go. However, our method for developing explainable DL models demonstrates that PMs appear to be a promising alternative to PSG in the future for the detection of obstructive apnea events and the automatic calculation of AHI.
Introduction: With advancements in sensor and communication technologies, sleep monitoring is moving out of specialized clinics and into everyday homes. Extracting sleep-related data using far less ...complicated tools and procedures is possible than polysomnography. Respiratory and cardiovascular data are extracted from the signals such as the electrocardiogram (ECG), photoplethysmogram (PPG), and ballistocardiogram (BCG) to identify the aberrant respiratory events of apnea/hypopnea as well as to estimate sleep parameters. However, due to the different sleeping positions, such systems lack accuracy and/or complicated sensor network topology. In this work, we proposed an optimal topology of forcesensitive resistor (FSR) sensors to simplify the system design by identifying the region of interest for estimating cardiorespiratory parameters with minimal error. The sensors are deployed under the mattress and located on the bed frame. Methods: We proposed a low-cost, unobtrusive, non-invasive, and reliable solution with robust signal processing algorithms for cardiorespiratory measurements and automatic signal validation based on signal quality. The solution is established based on a multi-physical layer (MPL) and sensor interfaces coping with the embedded system’s specifications, and signal processing is performed onboard with two independent and simultaneous pipelines for heart rate and respiratory rate using discrete wavelet transform (DWT) and bandpass filter, respectively. Results: We identified the three most contributing FSR sensors forming a triangle shape covering the left upper side of the subject (in the supine position) as the region of interest. We reduced the mean absolute error (MAE) to as low as 3.94 and 2.35 for heart rate and respiratory rate. Conclusions: The approach with the topology of triangle-shaped performs appropriately in estimating the cardiorespiratory parameters in all four regular sleeping positions, i.e. supine, prone, left lateral, and right lateral.
PDF
