Non-Contact Sleep Monitoring

"The road ahead for preventive medicine seems clear. It is the delivery of high quality, personalised (as opposed to depersonalised) comprehensive medical care to all." Burney, Steiger, and Georges (1964) This world's population is ageing, and this is set to intensify over the next forty years. This demographic shift will result in signicant economic and societal burdens (partic- ularly on healthcare systems). The instantiation of a proactive, preventative approach to delivering healthcare is long recognised, yet is still proving challenging. Recent work has focussed on enabling older adults to age in place in their own homes. This may be realised through the recent technological advancements of aordable healthcare sen- sors and systems which continuously support independent living, particularly through longitudinally monitoring deviations in behavioural and health metrics. Overall health status is contingent on multiple factors including, but not limited to, physical health, mental health, and social and emotional wellbeing; sleep is implicitly linked to each of these factors. This thesis focusses on the investigation and development of an unobtrusive sleep mon- itoring system, particularly suited towards long-term placement in the homes of older adults. The Under Mattress Bed Sensor (UMBS) is an unobstrusive, pressure sensing grid designed to infer bed times and bed exits, and also for the detection of development of bedsores. This work extends the capacity of this sensor. Specically, the novel contri- butions contained within this thesis focus on an in-depth review of the state-of-the-art advances in sleep monitoring, and the development and validation of algorithms which extract and quantify UMBS-derived sleep metrics. Preliminary experimental and community deployments investigated the suitability of the sensor for long-term monitoring. Rigorous experimental development rened algorithms which extract respiration rate as well as motion metrics which outperform traditional forms of ambulatory sleep monitoring. Spatial, temporal, statistical and spatiotemporal features were derived from UMBS data as a means of describing movement during sleep. These features were compared across experimental, domestic and clinical data sets, and across multiple sleeping episodes. Lastly, the optimal classier (built using a combina- tion of the UMBS-derived features) was shown to infer sleep/wake state accurately and reliably across both younger and older cohorts. Through long-term deployment, it is envisaged that the UMBS-derived features (in- cluding spatial, temporal, statistical and spatiotemporal features, respiration rate, and sleep/wake state) may be used to provide unobtrusive, continuous insights into over- all health status, the progression of the symptoms of chronic conditions, and allow the objective measurement of daily (sleep/wake) patterns and routines

Physiological Information Analysis Using Unobtrusive Sensors: BCG from Load-Cell Based Infants' Bed and ECG from Patch Electrode

학위논문 (박사)-- 서울대학교 대학원 : 바이오엔지니어링전공, 2016. 8. 박광석.The aging population, chronic diseases, and infectious diseases are major challenges for our current healthcare system. To address these unmet healthcare needs, especially for the early prediction and treatment of major diseases, acquiring physiological information of different types has emerged as a promising interdisciplinary research area. Unobtrusive sensing techniques are instrumental in constructing a routine health management system, because they can be incorporated in daily life without confining individuals or causing any discomfort. This dissertation is dedicated to summarizing our research on monitoring of cardiorespiratory activities by means of unobtrusive sensing methods. Ballistocardiography and electrocardiography, which record the activity of the cardiorespiratory system with respect to mechanical or electrical characteristics, are both being actively investigated as important physiological signal measurement that provide the information required to monitor human health states. This research was carried out to evaluate the feasibility of new application methods of unobtrusive sensing that not been investigated significantly in previous investigations. We also tried to incorporate improvement essential for bringing these technologies to practical use. Our first device is a non-confining system for monitoring the physiological information of infants using ballistocardiography technology. Techniques to observe continuous biological signals without confinement may be even more important for infants since they could be used effectively to detect respiratory distress and cardiac abnormalities. We also expect to find extensive applications in the field of sleep research for analyzing sleep efficiency and sleep patterns of infants. Specifically, the sleep of infants is closely related to their health, growth, and development. Children who experience abnormal sleep and activity rhythms during their early infantile period are more prone to developing sleep-related disorders in late childhood, which are also more difficult to overcome. Therefore, studying their sleep characteristics is extremely important. Although ballistocardiography technology seems to represent a possible solution to overcome the limitations of conventional physiological signal monitoring, most studies investigating the application of these methods have focused on adults, and few have been focused on infants. To verify the usefulness of ballistocardiogram (BCG)-based physiological measurement in infants, we describe a load-cell based signal monitoring bed and assess an algorithm to estimate heartbeat and respiratory information. Four infants participated in 13 experiments. As a reference signal, electrocardiogram (ECG) and respiration signals were simultaneously measured using a commercial device. The proposed automatic algorithm then selected the optimal sensor from which to estimate the heartbeat and respiratory information. The results from the load-cell sensor signals were compared with those of the reference signals, and the heartbeat and respiratory information were found to have average performance errors of 2.55% and 2.66%, respectively. We believe that our experimental results verify the feasibility of BCG-based measurements in infants. Next, we developed a small, light, ECG monitoring device with enhanced portability and wearability, with software that contains a peak detection algorithm for analyzing heart rate variability (HRV). A mobile ECG monitoring system, which can assess an individuals condition efficiently during daily life activities, could be beneficial for management of their health care. A portable ECG monitoring patch with a minimized electrode array pad, easily attached to a persons chest, was developed. To validate the devices performance and efficacy, signal quality analysis in terms of robustness under motion, and HRV results obtained under stressful conditions were assessed by comparing the developed device with a commercially available ECG device. The R-peak detection results obtained with the device exhibited a sensitivity of 99.29%, a positive predictive value of 100.00%, and an error of 0.71%. The device also exhibited less motional noise than conventional ECG recording, being stable up to a walking speed of 5 km/h. When applied to mental stress analysis, the device evaluated the variation in HRV parameters in the same way as a reference ECG signal, with very little difference. Thus, our portable ECG device with its integrated minimized electrode patch carries promise as a form of ECG measurement technology that can be used for daily health monitoring. There is currently an increased demand for continuous health monitoring systems with unobtrusive sensors. All of the experimental results in this dissertation verify the feasibility of our unobtrusive cardiorespiratory activity monitoring system. We believe that the proposed device and algorithm presented here are essential prerequisites toward substantiating the utility of unobtrusive physiological measurements. We also expect this system can help users better understand their state of health and provide physicians with more reliable data for objective diagnosis.Chapter 1. Introduction 1 1.1. Cardiorespiratory signal and its related physiological information 2 1.1.1. Electrocardiogram 2 1.1.2. Ballistocardiogram 3 1.1.3. Respiration 4 1.1.4. Heart rate and breathing rate 5 1.1.5. Variability analysis of heart and respiratory rate 5 1.2. Unobtrusive sensing methods for continuous physiological monitoring 6 1.3. Outline of the dissertation 9 Chapter 2. Development of sensor device for unobtrusive physiological signal measurement 13 2.1. Unobtrusive BCG measurement device for infants health monitoring 13 2.1.1. Specifications of the device 17 2.1.2. Signal processing in hardware 18 2.1.3. Performance of the device 21 2.2. Unobtrusive ECG measurement device for health monitoring in daily life 25 2.2.1. Specifications of the device 26 2.2.2. Signal processing in hardware 28 2.2.3. Performance of the device 30 Chapter 3. Development of algorithm for physiological information analysis from unobtrusively measured signal 35 3.1. Algorithm for automatically analyzing unobtrusively measured BCG signal 35 3.1.1. Process flow of the algorithm 36 3.1.2. Performance evaluation 47 3.2. Algorithm for automatically analyzing unobtrusively measured ECG signal 57 3.2.1. Process flow of the algorithm 57 3.2.2. Performance evaluation 60 3.3. HRV analysis for processing unobtrusively measured signals 63 3.3.1. Optimum HRV algorithm selection in data missing simulation 64 3.3.2. Stress assessment using HRV parameters 67 Chapter 4. Discussion 71 Chapter 5. Conclusion 79 Reference 81 Abstract in Korean 89 Appendix 93Docto

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio