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de Gans CJ, Burger P, van den Ende ES, Hermanides J, Nanayakkara PWB, Gemke RJBJ, Rutters F, Stenvers DJ. Sleep assessment using EEG-based wearables - A systematic review. Sleep Med Rev 2024; 76:101951. [PMID: 38754209 DOI: 10.1016/j.smrv.2024.101951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
Polysomnography (PSG) is the reference standard of sleep measurement, but is burdensome for the participant and labor intensive. Affordable electroencephalography (EEG)-based wearables are easy to use and are gaining popularity, yet selecting the most suitable device is a challenge for clinicians and researchers. In this systematic review, we aim to provide a comprehensive overview of available EEG-based wearables to measure human sleep. For each wearable, an overview will be provided regarding validated population and reported measurement properties. A systematic search was conducted in the databases OVID MEDLINE, Embase.com and CINAHL. A machine learning algorithm (ASReview) was utilized to screen titles and abstracts for eligibility. In total, 60 papers were selected, covering 34 unique EEG-based wearables. Feasibility studies indicated good tolerance, high compliance, and success rates. The 42 included validation studies were conducted across diverse populations and showed consistently high accuracy in sleep staging detection. Therefore, the recent advancements in EEG-based wearables show great promise as alternative for PSG and for at-home sleep monitoring. Users should consider factors like user-friendliness, comfort, and costs, as these devices vary in features and pricing, impacting their suitability for individual needs.
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Affiliation(s)
- C J de Gans
- Department of Internal Medicine, Section General Internal Medicine Unit Acute Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - P Burger
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - E S van den Ende
- Department of Internal Medicine, Section General Internal Medicine Unit Acute Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J Hermanides
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Anesthesiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - P W B Nanayakkara
- Department of Internal Medicine, Section General Internal Medicine Unit Acute Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - R J B J Gemke
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - F Rutters
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam University Medical Center, the Netherlands
| | - D J Stenvers
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Department Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, the Netherlands
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Radke FA, da Silva Souto CF, Pätzold W, Wolf KI. Transfer Learning for Automatic Sleep Staging Using a Pre-Gelled Electrode Grid. Diagnostics (Basel) 2024; 14:909. [PMID: 38732323 PMCID: PMC11083934 DOI: 10.3390/diagnostics14090909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Novel sensor solutions for sleep monitoring at home could alleviate bottlenecks in sleep medical care as well as enable selective or continuous observation over long periods of time and contribute to new insights in sleep medicine and beyond. Since especially in the latter case the sensor data differ strongly in signal, number and extent of sensors from the classical polysomnography (PSG) sensor technology, an automatic evaluation is essential for the application. However, the training of an automatic algorithm is complicated by the fact that the development phase of the new sensor technology, extensive comparative measurements with standardized reference systems, is often not possible and therefore only small datasets are available. In order to circumvent high system-specific training data requirements, we employ pre-training on large datasets with finetuning on small datasets of new sensor technology to enable automatic sleep phase detection for small test series. By pre-training on publicly available PSG datasets and finetuning on 12 nights recorded with new sensor technology based on a pre-gelled electrode grid to capture electroencephalography (EEG), electrooculography (EOG) and electromyography (EMG), an F1 score across all sleep phases of 0.81 is achieved (wake 0.84, N1 0.62, N2 0.81, N3 0.87, REM 0.88), using only EEG and EOG. The analysis additionally considers the spatial distribution of the channels and an approach to approximate classical electrode positions based on specific linear combinations of the new sensor grid channels.
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Affiliation(s)
- Fabian A. Radke
- Fraunhofer Institute for Digital Media Technology IDMT, Oldenburg Branch for Hearing, Speech and Audio Technology HSA, 26129 Oldenburg, Germany
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Emish M, Young SD. Remote Wearable Neuroimaging Devices for Health Monitoring and Neurophenotyping: A Scoping Review. Biomimetics (Basel) 2024; 9:237. [PMID: 38667247 PMCID: PMC11048695 DOI: 10.3390/biomimetics9040237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Digital health tracking is a source of valuable insights for public health research and consumer health technology. The brain is the most complex organ, containing information about psychophysical and physiological biomarkers that correlate with health. Specifically, recent developments in electroencephalogram (EEG), functional near-infra-red spectroscopy (fNIRS), and photoplethysmography (PPG) technologies have allowed the development of devices that can remotely monitor changes in brain activity. The inclusion criteria for the papers in this review encompassed studies on self-applied, remote, non-invasive neuroimaging techniques (EEG, fNIRS, or PPG) within healthcare applications. A total of 23 papers were reviewed, comprising 17 on using EEGs for remote monitoring and 6 on neurofeedback interventions, while no papers were found related to fNIRS and PPG. This review reveals that previous studies have leveraged mobile EEG devices for remote monitoring across the mental health, neurological, and sleep domains, as well as for delivering neurofeedback interventions. With headsets and ear-EEG devices being the most common, studies found mobile devices feasible for implementation in study protocols while providing reliable signal quality. Moderate to substantial agreement overall between remote and clinical-grade EEGs was found using statistical tests. The results highlight the promise of portable brain-imaging devices with regard to continuously evaluating patients in natural settings, though further validation and usability enhancements are needed as this technology develops.
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Affiliation(s)
- Mohamed Emish
- Department of Informatics, University of California, Irvine, CA 92697-3100, USA;
| | - Sean D. Young
- Department of Informatics, University of California, Irvine, CA 92697-3100, USA;
- Department of Emergency Medicine, University of California, Irvine, CA 92697-3100, USA
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van Klaren C, Maij A, Marsman L, van Drongelen A. The evaluation of cEEGrids for fatigue detection in aviation. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae009. [PMID: 38420258 PMCID: PMC10901434 DOI: 10.1093/sleepadvances/zpae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/26/2024] [Indexed: 03/02/2024]
Abstract
Operator fatigue poses a major concern in safety-critical industries such as aviation, potentially increasing the chances of errors and accidents. To better understand this risk, there is a need for noninvasive objective measures of fatigue. This study aimed to evaluate the performance of cEEGrids, a type of ear-EEG, for fatigue detection by analyzing the alpha and theta power before and after sleep restriction in four sessions on two separate days, employing a within-participants design. Results were compared to traditional, highly validated methods: the Karolinska Sleepiness Scale (KSS) and Psychomotor Vigilance Task (PVT). After sleep restriction and an office workday, 12 participants showed increased alpha band power in multiple electrode channels, but no channels correlated with KSS scores and PVT response speed. These findings indicate that cEEGrids can detect differences in alpha power following mild sleep loss. However, it should be noted that this capability was limited to specific channels, and no difference in theta power was observed. The study shows the potential and limitations of ear-EEG for fatigue detection as a less invasive alternative to cap-EEG. Further design and electrode configuration adjustments are necessary before ear-EEG can be implemented for fatigue detection in the field.
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Affiliation(s)
- Carmen van Klaren
- Royal Netherlands Aerospace Centre (NLR), Department of Safety and Human Performance, Amsterdam, The Netherlands
| | - Anneloes Maij
- Royal Netherlands Aerospace Centre (NLR), Department of Safety and Human Performance, Amsterdam, The Netherlands
| | - Laurie Marsman
- Royal Netherlands Aerospace Centre (NLR), Department of Safety and Human Performance, Amsterdam, The Netherlands
| | - Alwin van Drongelen
- Royal Netherlands Aerospace Centre (NLR), Department of Safety and Human Performance, Amsterdam, The Netherlands
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Fiedler P, Graichen U, Zimmer E, Haueisen J. Simultaneous Dry and Gel-Based High-Density Electroencephalography Recordings. SENSORS (BASEL, SWITZERLAND) 2023; 23:9745. [PMID: 38139591 PMCID: PMC10747542 DOI: 10.3390/s23249745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023]
Abstract
Evaluations of new dry, high-density EEG caps have only been performed so far with serial measurements and not with simultaneous (parallel) measurements. For a first comparison of gel-based and dry electrode performance in simultaneous high-density EEG measurements, we developed a new EEG cap comprising 64 gel-based and 64 dry electrodes and performed simultaneous measurements on ten volunteers. We analyzed electrode-skin impedances, resting state EEG, triggered eye blinks, and visual evoked potentials (VEPs). To overcome the issue of different electrode positions in the comparison of simultaneous measurements, we performed spatial frequency analysis of the simultaneously measured EEGs using spatial harmonic analysis (SPHARA). The impedances were 516 ± 429 kOhm (mean ± std) for the dry electrodes and 14 ± 8 kOhm for the gel-based electrodes. For the dry EEG electrodes, we obtained a channel reliability of 77%. We observed no differences between dry and gel-based recordings for the alpha peak frequency and the alpha power amplitude, as well as for the VEP peak amplitudes and latencies. For the VEP, the RMSD and the correlation coefficient between the gel-based and dry recordings were 1.7 ± 0.7 μV and 0.97 ± 0.03, respectively. We observed no differences in the cumulative power distributions of the spatial frequency components for the N75 and P100 VEP peaks. The differences for the N145 VEP peak were attributed to the different noise characteristics of gel-based and dry recordings. In conclusion, we provide evidence for the equivalence of simultaneous dry and gel-based high-density EEG measurements.
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Affiliation(s)
- Patrique Fiedler
- Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Uwe Graichen
- Department of Biostatistics and Data Science, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Ellen Zimmer
- Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau, Germany
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Mohamed M, Mohamed N, Kim JG. Advancements in Wearable EEG Technology for Improved Home-Based Sleep Monitoring and Assessment: A Review. BIOSENSORS 2023; 13:1019. [PMID: 38131779 PMCID: PMC10741861 DOI: 10.3390/bios13121019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
Sleep is a fundamental aspect of daily life, profoundly impacting mental and emotional well-being. Optimal sleep quality is vital for overall health and quality of life, yet many individuals struggle with sleep-related difficulties. In the past, polysomnography (PSG) has served as the gold standard for assessing sleep, but its bulky nature, cost, and the need for expertise has made it cumbersome for widespread use. By recognizing the need for a more accessible and user-friendly approach, wearable home monitoring systems have emerged. EEG technology plays a pivotal role in sleep monitoring, as it captures crucial brain activity data during sleep and serves as a primary indicator of sleep stages and disorders. This review provides an overview of the most recent advancements in wearable sleep monitoring leveraging EEG technology. We summarize the latest EEG devices and systems available in the scientific literature, highlighting their design, form factors, materials, and methods of sleep assessment. By exploring these developments, we aim to offer insights into cutting-edge technologies, shedding light on wearable EEG sensors for advanced at-home sleep monitoring and assessment. This comprehensive review contributes to a broader perspective on enhancing sleep quality and overall health using wearable EEG sensors.
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Affiliation(s)
| | | | - Jae Gwan Kim
- Biomedical Science and Engineering Department, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea; (M.M.); (N.M.)
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Kaongoen N, Choi J, Woo Choi J, Kwon H, Hwang C, Hwang G, Kim BH, Jo S. The future of wearable EEG: a review of ear-EEG technology and its applications. J Neural Eng 2023; 20:051002. [PMID: 37748474 DOI: 10.1088/1741-2552/acfcda] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/25/2023] [Indexed: 09/27/2023]
Abstract
Objective.This review paper provides a comprehensive overview of ear-electroencephalogram (EEG) technology, which involves recording EEG signals from electrodes placed in or around the ear, and its applications in the field of neural engineering.Approach.We conducted a thorough literature search using multiple databases to identify relevant studies related to ear-EEG technology and its various applications. We selected 123 publications and synthesized the information to highlight the main findings and trends in this field.Main results.Our review highlights the potential of ear-EEG technology as the future of wearable EEG technology. We discuss the advantages and limitations of ear-EEG compared to traditional scalp-based EEG and methods to overcome those limitations. Through our review, we found that ear-EEG is a promising method that produces comparable results to conventional scalp-based methods. We review the development of ear-EEG sensing devices, including the design, types of sensors, and materials. We also review the current state of research on ear-EEG in different application areas such as brain-computer interfaces, and clinical monitoring.Significance.This review paper is the first to focus solely on reviewing ear-EEG research articles. As such, it serves as a valuable resource for researchers, clinicians, and engineers working in the field of neural engineering. Our review sheds light on the exciting future prospects of ear-EEG, and its potential to advance neural engineering research and become the future of wearable EEG technology.
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Affiliation(s)
- Netiwit Kaongoen
- Information and Electronics Research Institute, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Jaehoon Choi
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Jin Woo Choi
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States of America
| | - Haram Kwon
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Chaeeun Hwang
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Guebin Hwang
- Robotics Program, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Byung Hyung Kim
- Department of Artificial Intelligence, Inha University, Incheon, Republic of Korea
| | - Sungho Jo
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
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Yin J, Xu J, Ren TL. Recent Progress in Long-Term Sleep Monitoring Technology. BIOSENSORS 2023; 13:395. [PMID: 36979607 PMCID: PMC10046225 DOI: 10.3390/bios13030395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/11/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.
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Affiliation(s)
- Jiaju Yin
- School of Integrated Circuits, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Jiandong Xu
- School of Integrated Circuits, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
| | - Tian-Ling Ren
- School of Integrated Circuits, Tsinghua University, Beijing 100084, China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, China
- Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, China
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