Automated sleep stage detection and classification of sleep disorders

Studies have demonstrated that more than 1 million Australians experience some sort of sleep-related disorder in their lifetime [12]. In order to improve the diagnostic and clinical treatment of sleep disorders, the first important step is to identify or automatically detect the sleep stages. The most common method, known as the visual sleep stage scoring, can be a tedious and time-consuming process. Because of that, there is a need to create or develop an improved automatic sleep stage detection method to assist the sleep physician to efficiently and accurately evaluate the sleep stages of patients or non-patients. This research project consisted of two parts. The first part focused on the automatic sleep stages detection based on two individual bio-signals, which made up an overnight polysomnography (PSG), such as the electroencephalogram (EEG), and electrooculogram (EOG). Several features were extracted from these two bio-signals in the time and frequency domains. The decision tree and classification methods were utilised for the classification of the sleep stages. The second part of this project focused on the automatic classification of different sleep and psychiatric disorders, such as patients with periodic limb movements of sleep (PLMs), sleep apnea-hypopnea syndrome (SAHS), primary insomnia, schizophrenia and healthy sleep. Different PSG parameters were computed for the classification of sleep disorders, such as descriptive statistics of sleep architecture. In conclusion, the advantage of an automatic sleep stage detection method based on a single-channel EEG or EOG signal can be undertaken with portable sleep stage recording instead of full the PSG system, which includes multichannel bio-signals. An automatic classification method of sleep and psychiatric disorders based on the descriptive statistics of sleep architecture statistics was found to be an effective technique for screening sleep and psychiatric disorders. This classification method can assist physicians to quickly undertake a diagnostic procedure

Narcolepsy beyond sleepiness : endocrine, metabolic and other aspects

The thesis contains a large study in which eight male hypocretin deficient narcolepsy with cataplexy patients and eight matched controls were enrolled. Blood was sampled before and on the 5th day of SXB administration. SXB was taken 2 times 3g per night for 5 consecutive nights. Both groups underwent 24-h blood sampling and many hormones (prolactin, Growth hormone, melatonin, ghrelin, leptin) were measured and compared before and during SXB treatment. A study using the golden standard on insuline sensitivity is decribed to compare insuline sensitivity between patients and controls, and between patients, before and during satisfactory SXB treatment. ANother study describes body and skintemperature differences between narcolepsy patients and controls. Another chapter describes a rarely described, common feature in narcolepsy, in which patients mistake the memory of a dream for a real experience. In another chapter describes that date of birth is not a risk factor for narcolepsy.SEIN, UCB Pharma, Koninklijke Auping, Wave Medical, Nederlandse vereniging voor Narcolepsie, Nederlandse vereniging voor slaap- en waak onderzoek, Heinen en Löwenstein, ChipsoftUBL - phd migration 201

An eeg based study of unintentional sleep onset

Ph.DDOCTOR OF PHILOSOPH

Physiological effects of heart rate variability biofeedback during laboratory induced congnitive stress

Includes bibliographical references.Heart rate variability (HRV) biofeedback is effective in reducing stress as well as managing chronic disease. It facilitates easy manipulation of HRV, and, therefore, potentially provides a valuable intervention for altering the activity of the autonomic nervous system. The aim of this thesis was to examine the effects of a single 10 minute episode of HRV biofeedback on measures of HRV and EEG during and immediately after the intervention, measures of HRV and cognitive performance during laboratory induced cognitive stress and subjective feelings of anxiety and relaxation states after testing. Eighteen healthy male volunteers (34 ± 6 years) exposed to work-related stress, were randomised into an HRV biofeedback intervention (BIO) and a comparative intervention group (COM)

"A great perturbation in nature" : Parkinson's disease and sleep disorders

The diagnosis of Parkinson's disease has remained essentially a clinical one. The diagnostic criteria consist of cardinal motor symptoms and signs, such as bradykinesia and at least one of the following: rest tremor, muscular rigidity or postural instability. However, non-motor symptoms (i.e. cognition, mood, sleep, pain, dysautonomy) constitute a major clinical challenge. The total burden of non-motor symptoms is likely to be more important than the motor symptoms in determining the quality of life across all stages of the disease. The current study aims to evaluate, by means of a structured questionnaire approach, the occurrence of sleep disorders, sleeping difficulties, health-related quality of life and other comorbidities in a non-selected population of Finnish Parkinson patients. The response rate was 59% (N=854). The occurrence of rapid eye movement sleep behavior disorder was 39.0%, restless legs syndrome 20.3%, chronic insomnia disorder 36.9%, narcolepsy like symptoms 11.0%, sleep disordered breathing 22.1%, respectively. Low quality of life occurred in 45.0% of the participants, depression in 20.9%, excessive daytime sleepiness in 30.2%, fatigue in 43.9%.Parkinsonin tauti luetaan kuuluvaksi liikehäiriösairaudeksi. Tautidiagnostiikassa muita Parkinsonin tautiin liittyviä oireita ei oteta huomioon. Myös jatkossa ne voivat jäädä pienelle huomiolle. Muita oireita on koetettu luokitella jaotuksella kognition, mielialatekijöiden ja ahdistuksen, unen, kivun, fatiikin ja autonomisen hermoston oireisiin. Käsillä olevassa tutkimuksessa keskitytään Parkinsonin tautiin liittyviin unihäiriöihin. Niiden käytännön merkitystä potilaalle selvitettiin kysymällä potilaiden unihäiröiden vaikutusta koettuun elämän laatuun. Vuonna 2011 Suomen Parkinson Liiton jäsenille postitettiin kohdistettu kysely univaikeuksista. Kyselyn kohortti oli 1447 henkilöä, joista osallistui 854 henkilöä. Vastattujen lomakkeiden määrä oli riittävän suuri tilastollisesti merkitsevien johtopäätösten esittämiseen. Suomalaisessa unihäiriöiden esiintyvyys kyselytutkimuksessa olivat behavioraalinen unioireyhtymä esiintyi 39.0% kyselyyn vastanneista. Vastaavasti kroonista unettomuutta oli 36.9%, päiväaikaista väsymystä 30.6%, levottomat jalat oireyhtymää 20.3%, mahdollista uniapneaa 22.1% ja narkolepsian kaltaisia oireita 11.0%. Masennusta esiintyi 20.9%:lla, koettua huonoa elämänlaatua 45.0%:lla, fatiikkia 43.9%:lla ja liiallista päiväaikaista väsymystä 30.2%:lla vastanneista

Sleep of pre-school children and their parents : FinAdo substudy

According to the Official Statistics of Finland, approximately 75% of the Finnish population become parents. At the same time, the grave impact of poor sleep on the health and wellbeing of an individual has been shown in numerous studies. Therefore, it is regrettable that studies have also shown that having a child deteriorates the sleep of the parent for a period of six years. During these six years the physical, psychological, and social development of the child is at its peak and the child needs a loving, constructive, and consistent adult to rely on. The aim of this study was to examine the interactions of child and parental sleep and their impact on the parental perceptions of child sleep. This study on healthy children living with their biological families and internationally adopted children was conducted as a part of the FinAdo 2 study, which is an on-going follow-up study examining the health and wellbeing of internationally adopted children in Finland. This collaboration allowed for examining the impact of genetic associations within sleep-related interactions. In addition to the 78 internationally adopted children, the study included 108 children living with their biological families, recruited from day-care facilities in Turku and Kaarina, Finland. The sleep of the children was examined by an actigraphy device, an activity sensor, during a period of one week. The parents answered on questions about socio-economic factors, and the sleep and well-being of the child and themselves. The recordings were repeated at approximately one year from the baseline for those willing to participate in the follow-up study. The study revealed that poorly sleeping parents perceive the sleep of their children being worse than what sleep parameters in the child’s actigraphy recording indicate. It also found that the poor sleep experienced by the parent does not precede child sleep problems one year later. The third finding was that parents of eveningtype children, those who prefer to stay up late and wake up late in the morning, are at a higher risk of later sleep problems than parents of morning-type children, those who prefer to wake up and go to bed early. These results underline the importance of addressing poor parental sleep quality, in addition to the child’s eveningness when discovering ways to help families with sleep related problems.Lasten ja heidän vanhempiensa uni - FinAdo osatutkimus Tilastokeskuksen tietojen mukaan noin 75 % suomalaisista saa elämänsä aikana lapsen. Samaan aikaan lukemattomat tutkimukset ovat osoittaneet vähäisen unen negatiiviset vaikutukset yksilön terveydelle ja hyvinvoinnille. Siksi onkin valitettavaa, että lapsen saannin on todettu huonontavan vanhemman unta kuuden vuoden ajaksi. Juuri näiden kuuden vuoden aikana lapsen fyysinen, psyykkinen ja sosiaalinen kehitys on nopeimmillaan ja hän tarvitsee rinnalleen rakastavan, luotettavan ja johdonmukaisen aikuisen. Tämän tutkimuksen tarkoituksena oli selvittää lapsen ja hänen vanhempansa unen vuorovaikutusta ja sen yhteyttä vanhemman käsitykseen lapsensa unesta. Tutkimuksessa arvioitiin terveiden, biologisissa perheissään elävien lasten ja ulkomailta Suomeen adoptoitujen lasten unta, ja se tehtiin osana ulkomailta Suomeen adoptoitujen lasten terveyttä ja hyvinvointia tutkivan FinAdo 2- tutkimuksen kanssa. Näin voitiin ottaa huomioon myös univaikeuksien perinnölliset mekanismit. Adoptoitujen 78 lasten lisäksi tutkimukseen osallistui 108 biologisissa perheissään eläviä, Turun ja Kaarinan päiväkodeista mukaan tulleita lapsia perheineen. Lasten unta rekisteröitiin viikon ajan aktigrafilla, joka on unta arvioiva aktiivisuusmittari. Lisäksi vanhemmat vastasivat omaa ja lapsensa unenlaatua ja hyvinvointia selvittäviin kyselyihin. Tutkimus toistettiin halukkaille noin vuoden kuluttua ensimmäisestä rekisteröinnistä. Tutkimuksessa kävi ilmi, että huonosti nukkuvat vanhemmat kokevat lapsensa unen huonompana kuin se on aktigrafilla mitattuna. Lisäksi todettiin, että vanhemman huono uni ei ennusta lapsen univaikeuksia vuoden seurannassa. Kolmantena löydöksenä todettiin, että lapsen iltavirkkuus, eli taipumus herätä ja mennä nukkumaan myöhään, on yhteydessä vanhemman huonoon uneen vuoden seurannassa verrattuna aamuvirkkujen, eli varhain heräävien ja varhain nukkumaan menevien, lasten vanhempiin. Nämä tutkimustulokset muistuttavat siitä, miten tärkeää on ottaa huomioon myös vanhemman unen laatu, ja toisaalta lapsen iltavirkkuus, kun käsitellään perheen uneen liittyviä huolia ja ongelmia

Lapses in Responsiveness: Characteristics and Detection from the EEG

Performance lapses in occupations where public safety is paramount can have disastrous consequences, resulting in accidents with multiple fatalities. Drowsy individuals performing an active task, like driving, often cycle rapidly between periods of wake and sleep, as exhibited by cyclical variation in both EEG power spectra and task performance measures. The aim of this project was to identify reliable physiological cues indicative of lapses, related to behavioural microsleep episodes, from the EEG, which could in turn be used to develop a real-time lapse detection (or better still, prediction) system. Additionally, the project also sought to achieve an increased understanding of the characteristics of lapses in responsiveness in normal subjects. A study was conducted to determine EEG and/or EOG cues (if any) that expert raters use to detect lapses that occur during a psychomotor vigilance task (PVT), with the subsequent goal of using these cues to design an automated system. A previously-collected dataset comprising physiological and performance data of 10 air traffic controllers (ATCs) was used. Analysis showed that the experts were unable to detect the vast majority of lapses based on EEG and EOG cues. This suggested that, unlike automated sleep staging, an automated lapse detection system needed to identify features not generally visible in the EEG. Limitations in the ATC dataset led to a study where more comprehensive physiological and performance data were collected from normal subjects. Fifteen non-sleep-deprived male volunteers aged 18-36 years were recruited. All performed a 1-D continuous pursuit visuomotor tracking task for 1 hour during each of two sessions that occurred between 1 and 7 weeks apart. A video camera was used to record head and facial expressions of the subject. EEG was recorded from electrodes at 16 scalp locations according to the 10-20 system at 256 Hz. Vertical and horizontal EOG was also recorded. All experimental sessions were held between 12:30 and 17:00 hours. Subjects were asked to refrain from consuming stimulants or depressants, for 4 h prior to each session. Rate and duration were estimated for lapses identified by a tracking flat spot and/or video sleep. Fourteen of the 15 subjects had one or more lapses, with an overall rate of 39.3 ± 12.9 lapses per hour (mean ± SE) and a lapse duration of 3.4 ± 0.5 s. The study also showed that lapsing and tracking error increased during the first 30 or so min of a 1-h session, then decreased during the remaining time, despite the absence of external temporal cues. EEG spectral power was found to be higher during lapses in the delta, theta, and alpha bands, and lower in the beta, gamma, and higher bands, but correlations between changes in EEG power and lapses were low. Thus, complete lapses in responsiveness are a frequent phenomenon in normal subjects - even when not sleep-deprived - undertaking an extended, monotonous, continuous visuomotor task. This is the first study to investigate and report on the characteristics of complete lapses of responsiveness during a continuous tracking task in non-sleep-deprived subjects. The extent to which non-sleep-deprived subjects experience complete lapses in responsiveness during normal working hours was unexpected. Such findings will be of major concern to individuals and companies in various transport sectors. Models based on EEG power spectral features, such as power in the traditional bands and ratios between bands, were developed to detect the change of brain state during behavioural microsleeps. Several other techniques including spectral coherence and asymmetry, fractal dimension, approximate entropy, and Lempel-Ziv (LZ) complexity were also used to form detection models. Following the removal of eye blink artifacts from the EEG, the signal was transformed into z-scores relative to the baseline of the signal. An epoch length of 2 s and an overlap of 1 s (50%) between successive epochs were used for all signal processing algorithms. Principal component analysis was used to reduce redundancy in the features extracted from the 16 EEG derivations. Linear discriminant analysis was used to form individual classification models capable of detecting lapses using data from each subject. The overall detection model was formed by combining the outputs of the individual models using stacked generalization with constrained least-squares fitting used to determine the optimal meta-learner weights of the stacked system. The performance of the lapse detector was measured both in terms of its ability to detect lapse state (in 1-s epochs) and lapse events. Best performance in lapse state detection was achieved using the detector based on spectral power (SP) features (mean correlation of φ = 0.39 ± 0.06). Lapse event detection performance using SP features was moderate at best (sensitivity = 73.5%, selectivity = 25.5%). LZ complexity feature-based detector showed the highest performance (φ = 0.28 ± 0.06) out of the 3 non-linear feature-based detectors. The SP+LZ feature-based model had no improvement in performance over the detector based on SP alone, suggesting that LZ features contributed no additional information. Alpha power contributed the most to the overall SP-based detection model. Analysis showed that the lapse detection model was detecting phasic, rather than tonic, changes in the level of drowsiness. The performance of these EEG-based lapse detection systems is modest. Further research is needed to develop more sensitive methods to extract cues from the EEG leading to devices capable of detecting and/or predicting lapses

Endocrine and neurophysiological examination of sleep disorders in Williams syndrome

Background: A high rate of sleep disturbances have been reported in individuals with Williams syndrome (WS), but the underlying aetiology has yet to be identified. Melatonin and cortisol levels are known to affect and regulate sleep/wake patterns. We investigated the changing levels of these hormones in order to explore any relationship with sleep disturbances in children with WS. Methods: Twenty seven children with WS and 27 typically developing (TD) children were recruited. Sleep was monitored using actigraphy and pulse oximetry. Parents completed Children’s Sleep Habit Questionnaire (CSHQ). Saliva and first void morning urine samples were collected from the children. Saliva was collected at three time points: 4-6pm, before bedtime and first thing after awakening. Levels of salivary melatonin and cortisol were analysed by enzyme linked immunoassays. For determination of melatonin, cortisol and their metabolites in urine samples, specific Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) method was developed. Results: CSHQ and actigraphy indicated that children with WS were significantly affected by several types of sleep disturbances, including: abnormally high sleep latency and excessive night waking. Children in WS group had shallower falls in salivary cortisol levels and less pronounced rises in salivary melatonin at bedtime compared to TD controls (p < 0.01 and p = 0.04 respectively). Furthermore, it was found that children with WS also had significantly higher levels of bedtime cortisol compared to TD controls (p = 0.03). Using UHPLC-MS/MS analysis it was shown that children with WS secrete less melatonin during the night compared to healthy controls (p < 0.01). Also, levels of cortisone, a metabolite of cortisol were significantly higher in the WS group (p = 0.05). Conclusions: We found that children with WS had significant sleep disturbances which may be associated with their increased bedtime cortisol and lower evening melatonin. Both hormones play a significant role in the circadian rhythm and sleep/wake cycle, therefore it was necessary to look closely at these endocrine markers in individuals suffering from sleep disorders. Sleep problems in children with WS may adversely affect daytime activity and the quality of life, as well as social, emotional, health and economic functioning of the entire family. Hence, finding their cause is of great importance for affected children and their families

Pharmacognostical, Phytochemical, Evaluvation of Sedative and Hypnotic Activity on Seed Aril of Myristica Malabarica Lam

AIM:To evaluate Pharmacognostical, Phytochemical, Sedative and Hypnotic activity on the seed aril of the plant Myristica malabarica Lam. OBJECTIVE: Pharmacognostical Studies:To perform Macroscopical, Microscopical, Qualitative and Quantitative estimation of various Physico Phemical constituents of the seed aril. Thus to establish a Pharmacogonostical profile. Phytochemical Studies: To perform Preliminary Photochemical Screening of powder and plant extracts. Estimation of various Phytochemical Constituents through analytical method. Isolation of Active Constituents in the seed aril by Column Chromatography. Analysis of the Isolated Constituents by TLC, IR and FTIR spectroscopy. Elucidation of the Isolated Constituents by GC-MS. Pharmacological Studies: In-vitro Anti-Oxidant activity is used to determine the presence active constituents present in various extracts. In-vivo Spontaneous Locomotor Activity is to be done by Actophotometer for Sedative activity. In-vivo Potentiation of Hexobarbital Induced Sleep Time is to be done for Hypnotic activity.CONCLUSION: The ethanolic extract showed a significant sedative and hypnotic activity than the benzene and aqueous extracts. This may be due to one or more phytoconstituents like flavonoids present in the extract and it can be due to the isolated compound Malabaricone C with IUPAC name as (2,6-dihydroxyphenyl)-9-(3,4-dihydroxyphenyl)nonan-1-one.. Further research work has to be carried out to standardize the isolated molecule Malabaricone C and which can further screened for preclinical and clinical studies for sedative and hypnotic activity