Automatic and Accurate Sleep Stage Classification via a Convolutional Deep Neural Network and Nanomembrane Electrodes

A custom-built single-channel in-ear electroencephalography sensor for sleep phase detection: an interdependent solution for at-home sleep studies

Sleep is vital for health. It has regenerative and protective functions. Its disruption reduces the quality of life and increases susceptibility to disease. During sleep, there is a cyclicity of distinct phases that are studied for clinical purposes using polysomnography (PSG), a costly and technically demanding method that compromises the quality of natural sleep. The search for simpler devices for recording biological signals at home addresses some of these issues. We have reworked a single-channel in-ear electroencephalography (EEG) sensor grounded to a commercially available memory foam earplug with conductive tape. A total of 14 healthy volunteers underwent a full night of simultaneous PSG, in-ear EEG and actigraphy recordings. We analysed the performance of the methods in terms of sleep metrics and staging. In another group of 14 patients evaluated for sleep-related pathologies, PSG and in-ear EEG were recorded simultaneously, the latter in two different configurations (with and without a contralateral reference on the scalp). In both groups, the in-ear EEG sensor showed a strong correlation, agreement and reliability with the 'gold standard' of PSG and thus supported accurate sleep classification, which is not feasible with actigraphy. Single-channel in-ear EEG offers compelling prospects for simplifying sleep parameterisation in both healthy individuals and clinical patients and paves the way for reliable assessments in a broader range of clinical situations, namely by integrating Level 3 polysomnography devices. In addition, addressing the recognised overestimation of the apnea-hypopnea index, due to the lack of an EEG signal, and the sparse information on sleep metrics could prove fundamental for optimised clinical decision making.

Flexible Thermoelectric Wearable Architecture for Wireless Continuous Physiological Monitoring

Continuous monitoring of physiological signals from the human body is critical in health monitoring, disease diagnosis, and therapeutics. Despite the needs, the existing wearable medical devices rely on either bulky wired systems or battery-powered devices needing frequent recharging. Here, we introduce a wearable, self-powered, thermoelectric flexible system architecture for wireless portable monitoring of physiological signals without recharging batteries. This system harvests an exceptionally high open circuit voltage of 175-180 mV from the human body, powering the wireless wearable bioelectronics to detect electrophysiological signals on the skin continuously. The thermoelectric system shows long-term stability in performance for 7 days with stable power management. Integrating screen printing, laser micromachining, and soft packaging technologies enables a multilayered, soft, wearable device to be mounted on any body part. The demonstration of the self-sustainable wearable system for detecting electromyograms and electrocardiograms captures the potential of the platform technology to offer various opportunities for continuous monitoring of biosignals, remote health monitoring, and automated disease diagnosis.

A Review on Automated Sleep Study

In recent years, research on automated sleep analysis has witnessed significant growth, reflecting advancements in understanding sleep patterns and their impact on overall health. This review synthesizes findings from an exhaustive analysis of 87 papers, systematically retrieved from prominent databases such as Google Scholar, PubMed, IEEE Xplore, and ScienceDirect. The selection criteria prioritized studies focusing on methods employed, signal modalities utilized, and machine learning algorithms applied in automated sleep analysis. The overarching goal was to critically evaluate the strengths and weaknesses of the proposed methods, shedding light on the current landscape and future directions in sleep research. An in-depth exploration of the reviewed literature revealed a diverse range of methodologies and machine learning approaches employed in automated sleep studies. Notably, K-Nearest Neighbors (KNN), Ensemble Learning Methods, and Support Vector Machine (SVM) emerged as versatile and potent classifiers, exhibiting high accuracies in various applications. However, challenges such as performance variability and computational demands were observed, necessitating judicious classifier selection based on dataset intricacies. In addition, the integration of traditional feature extraction methods with deep structures and the combination of different deep neural networks were identified as promising strategies to enhance diagnostic accuracy in sleep-related studies. The reviewed literature emphasized the need for adaptive classifiers, cross-modality integration, and collaborative efforts to drive the field toward more accurate, robust, and accessible sleep-related diagnostic solutions. This comprehensive review serves as a solid foundation for researchers and practitioners, providing an organized synthesis of the current state of knowledge in automated sleep analysis. By highlighting the strengths and challenges of various methodologies, this review aims to guide future research toward more effective and nuanced approaches to sleep diagnostics.

Research and application of deep learning-based sleep staging: Data, modeling, validation, and clinical practice

Over the past few decades, researchers have attempted to simplify and accelerate the process of sleep stage classification through various approaches; however, only a few such approaches have gained widespread acceptance. Artificial intelligence technology, particularly deep learning, is promising for earning the trust of the sleep medicine community in automated sleep-staging systems, thus facilitating its application in clinical practice and integration into daily life. We aimed to comprehensively review the latest methods that are applying deep learning for enhancing sleep staging efficiency and accuracy. Starting from the requisite "data" for constructing deep learning algorithms, we elucidated the current landscape of this domain and summarized the fundamental modeling process, encompassing signal selection, data pre-processing, model architecture, classification tasks, and performance metrics. Furthermore, we reviewed the applications of automated sleep staging in scenarios such as sleep-disorder screening, diagnostic procedures, and health monitoring and management. Finally, we conducted an in-depth analysis and discussion of the challenges and future in intelligent sleep staging, particularly focusing on large-scale sleep datasets, interdisciplinary collaborations, and human-computer interactions.

Temporal Feature Extraction and Machine Learning for Classification of Sleep Stages Using Telemetry Polysomnography

Accurate sleep stage detection is crucial for diagnosing sleep disorders and tailoring treatment plans. Polysomnography (PSG) is considered the gold standard for sleep assessment since it captures a diverse set of physiological signals. While various studies have employed complex neural networks for sleep staging using PSG, our research emphasises the efficacy of a simpler and more efficient architecture. We aimed to integrate a diverse set of feature extraction measures with straightforward machine learning, potentially offering a more efficient avenue for sleep staging. We also aimed to conduct a comprehensive comparative analysis of feature extraction measures, including the power spectral density, Higuchi fractal dimension, singular value decomposition entropy, permutation entropy, and detrended fluctuation analysis, coupled with several machine-learning models, including XGBoost, Extra Trees, Random Forest, and LightGBM. Furthermore, data augmentation methods like the Synthetic Minority Oversampling Technique were also employed to rectify the inherent class imbalance in sleep data. The subsequent results highlighted that the XGBoost classifier, when used with a combination of all feature extraction measures as an ensemble, achieved the highest performance, with accuracies of 87%, 90%, 93%, 96%, and 97% and average F1-scores of 84.6%, 89%, 90.33%, 93.5%, and 93.5% for distinguishing between five-stage, four-stage, three-stage, and two distinct two-stage sleep configurations, respectively. This combined feature extraction technique represents a novel addition to the body of research since it achieves higher performance than many recently developed deep neural networks by utilising simpler machine-learning models.

A Smartphone-Based sEMG Signal Analysis System for Human Action Recognition

In lower-limb rehabilitation, human action recognition (HAR) technology can be introduced to analyze the surface electromyography (sEMG) signal generated by movements, which can provide an objective and accurate evaluation of the patient's action. To balance the long cycle required for rehabilitation and the inconvenient factors brought by wearing sEMG devices, a portable sEMG signal acquisition device was developed that can be used under daily scenarios. Additionally, a mobile application was developed to meet the demand for real-time monitoring and analysis of sEMG signals. This application can monitor data in real time and has functions such as plotting, filtering, storage, and action capture and recognition. To build the dataset required for the recognition model, six lower-limb motions were developed for rehabilitation (kick, toe off, heel off, toe off and heel up, step back and kick, and full gait). The sEMG segment and action label were combined for training a convolutional neural network (CNN) to achieve high-precision recognition performance for human lower-limb actions (with a maximum accuracy of 97.96% and recognition accuracy for all actions reaching over 97%). The results show that the smartphone-based sEMG analysis system proposed in this paper can provide reliable information for the clinical evaluation of lower-limb rehabilitation.

Current status and prospects of automatic sleep stages scoring: Review

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.

At-home wireless sleep monitoring patches for the clinical assessment of sleep quality and sleep apnea

Although many people suffer from sleep disorders, most are undiagnosed, leading to impairments in health. The existing polysomnography method is not easily accessible; it's costly, burdensome to patients, and requires specialized facilities and personnel. Here, we report an at-home portable system that includes wireless sleep sensors and wearable electronics with embedded machine learning. We also show its application for assessing sleep quality and detecting sleep apnea with multiple patients. Unlike the conventional system using numerous bulky sensors, the soft, all-integrated wearable platform offers natural sleep wherever the user prefers. In a clinical study, the face-mounted patches that detect brain, eye, and muscle signals show comparable performance with polysomnography. When comparing healthy controls to sleep apnea patients, the wearable system can detect obstructive sleep apnea with an accuracy of 88.5%. Furthermore, deep learning offers automated sleep scoring, demonstrating portability, and point-of-care usability. At-home wearable electronics could ensure a promising future supporting portable sleep monitoring and home healthcare.

Anomaly Detection for Sensor Signals Utilizing Deep Learning Autoencoder-Based Neural Networks

Anomaly detection is a significant task in sensors' signal processing since interpreting an abnormal signal can lead to making a high-risk decision in terms of sensors' applications. Deep learning algorithms are effective tools for anomaly detection due to their capability to address imbalanced datasets. In this study, we took a semi-supervised learning approach, utilizing normal data for training the deep learning neural networks, in order to address the diverse and unknown features of anomalies. We developed autoencoder-based prediction models to automatically detect anomalous data recorded by three electrochemical aptasensors, with variations in the signals' lengths for particular concentrations, analytes, and bioreceptors. Prediction models employed autoencoder networks and the kernel density estimation (KDE) method for finding the threshold to detect anomalies. Moreover, the autoencoder networks were vanilla, unidirectional long short-term memory (ULSTM), and bidirectional LSTM (BLSTM) autoencoders for the training stage of the prediction models. However, the decision-making was based on the result of these three networks and the integration of vanilla and LSTM networks' results. The accuracy as a performance metric of anomaly prediction models showed that the performance of vanilla and integrated models were comparable, while the LSTM-based autoencoder models showed the least accuracy. Considering the integrated model of ULSTM and vanilla autoencoder, the accuracy for the dataset with the lengthier signals was approximately 80%, while it was 65% and 40% for the other datasets. The lowest accuracy belonged to the dataset with the least normal data in its dataset. These results demonstrate that the proposed vanilla and integrated models can automatically detect abnormal data when there is sufficient normal data for training the models.

Recent Advances in Materials for Wearable Thermoelectric Generators and Biosensing Devices

Recently, self-powered health monitoring systems using a wearable thermoelectric generator (WTEG) have been rapidly developed since no battery is needed for continuous signal monitoring, and there is no need to worry about battery leakage. However, the existing materials and devices have limitations in rigid form factors and small-scale manufacturing. Moreover, the conventional bulky WTEG is not compatible with soft and deformable tissues, including human skins or internal organs. These limitations restrict the WTEG from stabilizing the thermoelectric gradient that is necessary to harvest the maximum body heat and generate valuable electrical energy. This paper summarizes recent advances in soft, flexible materials and device designs to overcome the existing challenges. Specifically, we discuss various organic and inorganic thermoelectric materials with their properties for manufacturing flexible devices. In addition, this review discusses energy budgets required for effective integration of WTEGs with wearable biomedical systems, which is the main contribution of this article compared to previous articles. Lastly, the key challenges of the existing WTEGs are discussed, followed by describing future perspectives for self-powered health monitoring systems.