Sleep assessment using a passive ballistocardiography-based system: preliminary validation.

Quantitative sleep analysis through the use of polysomnography is a well established standard. Finding new ways to approach this, especially over multiple nights, is becoming more important due to a growing recognition of adverse effects from poor sleep and sleep disorders. The Non-Invasive Analysis of Physiological Signals (NAPS) system is a ballistocardiography-based monitoring system developed to measure heart rate, breathing rate and musculoskeletal movement that shows promise as a general sleep analysis tool. Overnight sleep studies were conducted on 20 healthy subjects during a validation clinical trial which compared the NAPS system to actigraphy, using polysomnography as the gold standard. The NAPS system [kappa=0.478; 95% CI (0.463, 0.494); p-value<0.001] outperformed actigraphy [kappa=0.344; 95% CI (0.324, 0.358); p-value<0.001], largely due to better performance in distinguishing sleep onset times as determined by polysomnography [NAPS mean bias estimate: -2.5 epochs; 95% CI (-16.8, 11.9); p=0.725|Actigraphy mean bias estimate: -33.6 epochs; 95% CI (-57.4, -9.7); p=0.016)].

Development and preliminary validation of heart rate and breathing rate detection using a passive, ballistocardiography-based sleep monitoring system.

Techniques such as ballistocardiography (BCG) that can provide noninvasive long-term physiological monitoring have gained interest due to a growing recognition of adverse effects from poor sleep and sleep disorders. The noninvasive analysis of physiological signals (NAPS) system is a BCG-based monitoring system developed to measure heart rate, breathing rate, and musculoskeletal movement that shows promise as a general sleep analysis tool. Overnight sleep studies were conducted on 40 healthy subjects during a clinical trial at the University of Virginia. The NAPS system's measures of heart rate and breathing rate were compared to ECG, pulse oximetry, and respiratory inductance plethysmography (RIP). The subjects were split into a training dataset and a validation dataset, maintaining similar demographics in each set. The NAPS system accurately detected heart rate, averaged over the prescribed 30-s epochs, to within less than 2.72 beats per minute of ECG, and accurately detected breathing rate, averaged over the same epochs, to within 2.10 breaths per minute of RIP bands used in polysomnography.

Impact of passive health status monitoring to care providers and payers in assisted living.

The objective of this study was to assess the impact of passive health status monitoring on the cost of care, as well as the efficiencies of professional caregivers in assisted living. We performed a case-controlled study to assess economic impact of passive health status monitoring technology in an assisted-living facility. Passive monitoring systems were installed in the assisted-living units of 21 residents to track physiological parameters (heart rate and breathing rate), the activities of daily living (ADLs), and key alert conditions. Professional caregivers were provided with access to the wellness status of the monitored residents they serve. The monitored individuals' cost of medical care was compared to that of an age, gender, and health status matched cohort. Similarly, efficiency and workloads of professional caregivers providing care to the monitored individuals were compared to those of caregivers providing care to the control cohort in the control site. Over the 3-month period of the study, a comparison between the monitored and control cohorts showed reductions in billable interventions (47 vs. 73, p = 0.040), hospital days (7 vs. 33, p = 0.004), and estimated cost of care (21,187.02 dollars vs. 67,753.88 dollars with monitoring cost included, p = 0.034). A comparison between efficiency normalized workloads of monitoring and control sites' caregivers revealed significant differences both at the beginning (0.6 vs. 1.38, p = 0.041) and the end (0.84 vs. 1.94, p = 0.002) of the study. The results demonstrate that monitoring technologies have significantly reduced billable interventions, hospital days, and cost of care to payers, and had a positive impact on professional caregivers' efficiency.