Identifying an Appropriate Area to Facilitate the Cardiorespiratory Measurement during Sleep Monitoring.

Measuring cardiorespiratory parameters in sleep, using non-contact sensors and the Ballistocardiography technique has received much attention due to the low-cost, unobtrusive, and non-invasive method. Designing a user-friendly, simple-to-use, and easy-to-deployment preserving less error-prone remains open and challenging due to the complex morphology of the signal. In this work, using four forcesensitive resistor sensors, we conducted a study by designing four distributions of sensors, in order to simplify the complexity of the system by identifying the region of interest for heartbeat and respiration measurement. The sensors are deployed under the mattress and attached to the bed frame without any interference with the subjects. The four distributions are combined in two linear horizontal, one linear vertical, and one square, covering the influencing region in cardiorespiratory activities. We recruited 4 subjects and acquired data in four regular sleeping positions, each for a duration of 80 seconds. The signal processing was performed using discrete wavelet transform bior 3.9 and smooth level of 4 as well as bandpass filtering. The results indicate that we have achieved the mean absolute error of 2.35 and 4.34 for respiration and heartbeat, respectively. The results recommend the efficiency of a triangleshaped structure of three sensors for measuring heartbeat and respiration parameters in all four regular sleeping positions.

Obstructive sleep apnea event detection using explainable deep learning models for a portable monitor.

Background: 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). Materials and methods: 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). Results: 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. Conclusion: 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.

Enhancing Current Cardiorespiratory-based Approaches of Sleep Stage Classification by Temporal Feature Stacking.

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.Clinical relevance- The method can be employed generically to feature sets for (small scale) datasets to improve classification performance for classification problems with temporal relations with random forest classifiers.

Non-invasive devices for respiratory sound monitoring.

Respiratory diseases are leading causes of death and disability in the world. The recent COVID-19 pandemic is also affecting the respiratory system. Detecting and diagnosing respiratory diseases requires both medical professionals and the clinical environment. Most of the techniques used up to date were also invasive or expensive. Some research groups are developing hardware devices and techniques to make possible a non-invasive or even remote respiratory sound acquisition. These sounds are then processed and analysed for clinical, scientific, or educational purposes. We present the literature review of non-invasive sound acquisition devices and techniques. The results are about a huge number of digital tools, like microphones, wearables, or Internet of Thing devices, that can be used in this scope. Some interesting applications have been found. Some devices make easier the sound acquisition in a clinic environment, but others make possible daily monitoring outside that ambient. We aim to use some of these devices and include the non-invasive recorded respiratory sounds in a Digital Twin system for personalized health.

Embedded system for non-obtrusive sleep apnea detection.

This document presents a new complete standalone system for a recognition of sleep apnea using signals from the pressure sensors placed under the mattress. The developed hardware part of the system is tuned to filter and to amplify the signal. Its software part performs more accurate signal filtering and identification of apnea events. The overall achieved accuracy of the recognition of apnea occurrence is 91%, with the average measured recognition delay of about 15 seconds, which confirms the suitability of the proposed method for future employment. The main aim of the presented approach is the support of the healthcare system with the cost-efficient tool for recognition of sleep apnea in the home environment.

Heart rate detection with accelerometric sensors under the mattress.

The ballistocardiography is a technique that measures the heart rate from the mechanical vibrations of the body due to the heart movement. In this work a novel noninvasive device placed under the mattress of a bed estimates the heart rate using the ballistocardiography. Different algorithms for heart rate estimation have been developed.

RR interval analysis for the distinction between stress, physical activity and no activity using a portable ECG.

Methods based exclusively on heart rate hardly allow to differentiate between physical activity, stress, relaxation, and rest, that is why an additional sensor like activity/movement sensor added for detection and classification. The response of the heart to physical activity, stress, relaxation, and no activity can be very similar. In this study, we can observe the influence of induced stress and analyze which metrics could be considered for its detection. The changes in the Root Mean Square of the Successive Differences provide us with information about physiological changes. A set of measurements collecting the RR intervals was taken. The intervals are used as a parameter to distinguish four different stages. Parameters like skin conductivity or skin temperature were not used because the main aim is to maintain a minimum number of sensors and devices and thereby to increase the wearability in the future.

The Effects of the Driver's Mental State and Passenger Compartment Conditions on Driving Performance and Driving Stress.

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 CO2 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 CO2 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.

Conversion from electrocardiosignals to equivalent electrical sources on heart surface.

BACKGROUND: The actual task of electrocardiographic examinations is to increase the reliability of diagnosing the condition of the heart. Within the framework of this task, an important direction is the solution of the inverse problem of electrocardiography, based on the processing of electrocardiographic signals of multichannel cardio leads at known electrode coordinates in these leads (Titomir et al. Noninvasiv electrocardiotopography, 2003), (Macfarlane et al. Comprehensive Electrocardiology, 2nd ed. (Chapter 9), 2011). RESULTS: In order to obtain more detailed information about the electrical activity of the heart, we carry out a reconstruction of the distribution of equivalent electrical sources on the heart surface. In this area, we hold reconstruction of the equivalent sources during the cardiac cycle at relatively low hardware cost. ECG maps of electrical potentials on the surface of the torso (TSPM) and electrical sources on the surface of the heart (HSSM) were studied for different times of the cardiac cycle. We carried out a visual and quantitative comparison of these maps in the presence of pathological regions of different localization. For this purpose we used the model of the heart electrical activity, based on cellular automata. CONCLUSIONS: The model of cellular automata allows us to consider the processes of heart excitation in the presence of pathological regions of various sizes and localization. It is shown, that changes in the distribution of electrical sources on the surface of the epicardium in the presence of pathological areas with disturbances in the conduction of heart excitation are much more noticeable than changes in ECG maps on the torso surface.

Recognition of Sleep/Wake States analyzing Heart Rate, Breathing and Movement Signals.

This document presents an algorithm for a non-obtrusive recognition of Sleep/Wake states using signals derived from ECG, respiration, and body movement captured while lying in a bed. As a core mathematical base of system data analytics, multinomial logistic regression techniques were chosen. Derived parameters of the three signals are used as the input for the proposed method. The overall achieved accuracy rate is 84% for Wake/Sleep stages, with Cohen's kappa value 0.46. The presented algorithm should support experts in analyzing sleep quality in more detail. The results confirm the potential of this method and disclose several ways for its improvement.