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Xu X, Lian Z. Objective sleep assessments for healthy people in environmental research: A literature review. INDOOR AIR 2022; 32:e13034. [PMID: 35622713 DOI: 10.1111/ina.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
To date, although many studies had focused on the impact of environmental factors on sleep, how to choose the proper assessment method for objective sleep quality was often ignored, especially for healthy subjects in bedroom environment. In order to provide methodological guidance for future research, this paper reviewed the assessments of objective sleep quality applied in environmental researches, compared them from the perspective of accuracy and interference, and statistically analyzed the impact of experimental type and subjects' information on method selection. The review results showed that, in contrast to polysomnography (PSG), the accuracy of actigraphy (ACT), respiratory monitoring-oxygen saturation monitoring (RM-OSM), and electrocardiograph (ECG) could reach up to 97%, 80.38%, and 79.95%, respectively. In terms of sleep staging, PSG and ECG performed the best, ACT the second, and RM-OSM the worst; as compared to single methods, mix methods were more accurate and better at sleep staging. PSG interfered with sleep a great deal, while ECG and ACT could be non-contact, and thus, the least interference with sleep was present. The type of experiment significantly influenced the choice of assessment method (p < 0.001), 85.3% of researchers chose PSG in laboratory study while 82.5% ACT in field study; moreover, PSG was often used in a relatively small number of young subjects, while ACT had a wide applicable population. In general, researchers need to pay more attention at selection of assessments in future studies, and this review can be used as a reliable reference for experimental design.
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Affiliation(s)
- Xinbo Xu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Lian
- School of Design, Shanghai Jiao Tong University, Shanghai, China
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Jindal I, Puyau M, Adolph A, Butte N, Musaad S, Bacha F. The relationship of sleep duration and quality to energy expenditure and physical activity in children. Pediatr Obes 2021; 16:e12751. [PMID: 33191656 DOI: 10.1111/ijpo.12751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/12/2020] [Accepted: 06/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Shorter sleep duration has been linked to the risk for obesity in children. The pathways linking sleep duration and quality to the risk of obesity are unclear, particularly the effect of sleep on energetics. OBJECTIVE We investigated the relationship between sleep duration, quality and timing in children, to the basal metabolic rate (BMR), total energy expenditure (TEE) and physical activity (PA). METHODS Fifty nine children in two age-groups (5-11 and 12-18 years) underwent evaluation of body composition (DXA), BMR in a room calorimeter, free-living TEE by doubly labelled water method, sleep and PA (7-day Actiheart monitor) during school break. RESULTS Sleep duration contributed to the variance in BMR (β = 0.11, P = .009) after adjusting for age-group, sex, lean and fat mass, but not to the variance in TEE. Late sleep timing was related to lower PA. In the younger age-group, children who met recommended sleep duration on ≥50% of the 7 days had higher light PA (P = .03) and lower sedentary time (P = .009). CONCLUSION Suboptimal sleep is associated with lower BMR, lower PA, and higher sedentary behaviours in young children. Prospective studies are needed to confirm if insufficient sleep duration or late sleep timing contribute to obesity risk by increasing sedentary behaviours and decreasing BMR.
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Affiliation(s)
- Ishita Jindal
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX.,Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Maurice Puyau
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Anne Adolph
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Nancy Butte
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Salma Musaad
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Fida Bacha
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX.,Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Yoon H, Hwang SH, Choi SH, Choi JW, Lee YJ, Jeong DU, Park KS. Wakefulness evaluation during sleep for healthy subjects and OSA patients using a patch-type device. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 155:127-138. [PMID: 29512493 DOI: 10.1016/j.cmpb.2017.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/30/2017] [Accepted: 12/11/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is a major sleep disorder that causes insufficient sleep, which is linked with daytime fatigue and accidents. Long-term sleep monitoring can provide meaningful information for patients with OSA to prevent and manage their symptoms. Even though various methods have been proposed to objectively measure sleep in ambulatory environments, less reliable information was provided in comparison with standard polysomnography (PSG). Therefore, this paper proposes an algorithm for distinguishing wakefulness from sleep using a patch-type device, which is applicable for both healthy individuals and patients with OSA. METHODS Electrocardiogram (ECG) and 3-axis accelerometer signals were gathered from the single device. Wakefulness was determined with six parallel methods based on information about movement and autonomic nervous activity. The performance evaluation was conducted with five-fold cross validation using the data from 15 subjects with a low respiratory disturbance index (RDI) and 10 subjects with high RDI. In addition, wakefulness information, including total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO), were extracted from the proposed algorithm and compared with those from PSG. RESULTS According to epoch-by-epoch (30 s) analysis, the performance results of detecting wakefulness were an average Cohen's kappa of 0.60, accuracy of 91.24%, sensitivity of 64.12%, and specificity of 95.73%. Moreover, significant correlations were observed in TST, SE, SOL, and WASO between the proposed algorithm and PSG (p < 0.001). CONCLUSIONS Wakefulness-related information was successfully provided using data from the patch-type device. In addition, the performance results of the proposed algorithm for wakefulness detection were competitive with those from previous studies. Therefore, the proposed system could be an appropriate solution for long-term objective sleep monitoring in both healthy individuals and patients with OSA.
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Affiliation(s)
- Heenam Yoon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, South Korea
| | - Su Hwan Hwang
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, South Korea
| | - Sang Ho Choi
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, South Korea
| | - Jae-Won Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, South Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, South Korea
| | - Do-Un Jeong
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, South Korea
| | - Kwang Suk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, South Korea.
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Willemen T, Van Deun D, Verhaert V, Vandekerckhove M, Exadaktylos V, Verbraecken J, Van Huffel S, Haex B, Vander Sloten J. An Evaluation of Cardiorespiratory and Movement Features With Respect to Sleep-Stage Classification. IEEE J Biomed Health Inform 2014; 18:661-9. [DOI: 10.1109/jbhi.2013.2276083] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lee YJG. Nocturnal awakening and sleep efficiency estimation using unobtrusively measured ballistocardiogram. IEEE Trans Biomed Eng 2013; 61:131-8. [PMID: 23955694 DOI: 10.1109/tbme.2013.2278020] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fragmented sleep due to frequent awakenings represents a major cause of impaired daytime performance and adverse health outcomes. Currently, the gold standard for studying and assessing sleep fragmentation is polysomnography (PSG). Here, we propose an alternative method for real-time detection of nocturnal awakening via ballistocardiography using an unobtrusive polyvinylidene fluoride (PVDF) film sensor on a bed mattress. From ballistocardiogram, heart rate and body movement information were extracted to develop an algorithm for classifying sleeping and awakening epochs. In total, ten normal subjects (mean age 38.7 ± 14.6 years) and ten patients with obstructive sleep apnea (OSA) (mean age 44.2 ± 16.5 years) of varying symptom severity participated in this study. Our study detected awakening epochs with an average sensitivity of 85.3% and 85.2%, specificity of 98.4% and 97.7%, accuracy of 97.4% and 96.5%, and Cohen's kappa coefficient of 0.83 and 0.81 for normal subjects and OSA patients, respectively. Also, sleep efficiency was estimated using detected awakening epochs and then compared with PSG results. Mean absolute errors in sleep efficiency were 1.08% and 1.44% for normal subjects and OSA patients, respectively. The results presented here indicate that our suggested method could be reliably applied to real-time nocturnal awakening detection and sleep efficiency estimation. Furthermore, our method may ultimately be an effective tool for long-term, home monitoring of sleep-wake behavior.
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Vehkaoja A, Rajala S, Kumpulainen P, Lekkala J. Correlation approach for the detection of the heartbeat intervals using force sensors placed under the bed posts. J Med Eng Technol 2013; 37:327-33. [DOI: 10.3109/03091902.2013.807523] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Peltokangas M, Verho J, Vehkaoja A. Night-Time EKG and HRV Monitoring With Bed Sheet Integrated Textile Electrodes. ACTA ACUST UNITED AC 2012; 16:935-42. [DOI: 10.1109/titb.2012.2208982] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hwang S, Chung G, Lee J, Shin J, Lee SJ, Jeong DU, Park K. Sleep/wake estimation using only anterior tibialis electromyography data. Biomed Eng Online 2012; 11:26. [PMID: 22624953 PMCID: PMC3476968 DOI: 10.1186/1475-925x-11-26] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 05/07/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In sleep efficiency monitoring system, actigraphy is the simplest and most commonly used device. However, low specificity to wakefulness of actigraphy was revealed in previous studies. In this study, we assumed that sleep/wake estimation using actigraphy and electromyography (EMG) signals would show different patterns. Furthermore, each EMG pattern in two states (sleep, wake during sleep) was analysed. Finally, we proposed two types of method for the estimation of sleep/wake patterns using only EMG signals from anterior tibialis muscles and the results were compared with PSG data. METHODS Seven healthy subjects and five patients (2 obstructive sleep apnea, 3 periodic limb movement disorder) participated in this study. Night time polysomnography (PSG) recordings were conducted, and electrooculogram, EMG, electroencephalogram, electrocardiogram, and respiration data were collected. Time domain analysis and frequency domain analysis were applied to estimate the sleep/wake patterns. Each method was based on changes in amplitude or spectrum (total power) of anterior tibialis electromyography signals during the transition from the sleep state to the wake state. To obtain the results, leave-one-out-cross-validation technique was adopted. RESULTS Total sleep time of the each group was about 8 hours. For healthy subjects, the mean epoch-by-epoch results between time domain analysis and PSG data were 99%, 71%, 80% and 0.64 (sensitivity, specificity, accuracy and kappa value), respectively. For frequency domain analysis, the corresponding values were 99%, 73%, 81% and 0.67, respectively. Absolute and relative differences between sleep efficiency index from PSG and our methods were 0.8 and 0.8% (for frequency domain analysis). In patients with sleep-related disorder, our proposed methods revealed the substantial agreement (kappa > 0.61) for OSA patients and moderate or fair agreement for PLMD patients. CONCLUSIONS The results of our proposed methods were comparable to those of PSG. The time and frequency domain analyses showed the similar sleep/wake estimation performance.
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Affiliation(s)
- SuHwan Hwang
- Interdisciplinary program of Bioengineering, Seoul National University, Seoul, Republic of Korea
| | - GihSung Chung
- Interdisciplinary program of Bioengineering, Seoul National University, Seoul, Republic of Korea
| | - JeongSu Lee
- Interdisciplinary program of Bioengineering, Seoul National University, Seoul, Republic of Korea
| | - JaeHyuk Shin
- Interdisciplinary program of Bioengineering, Seoul National University, Seoul, Republic of Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Do-Un Jeong
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - KwangSuk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, Republic of Korea
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