Development and Evaluation of a Wearable Device for Sleep Quality Assessment

• Published in: IEEE transactions on biomedical engineering 2017-07, Vol.64 (7), p.1547-1557
• Main Authors: Kuo, Chih-En, Liu, Yi-Che, Chang, Da-Wei, Young, Chung-Ping, Shaw, Fu-Zen, Liang, Sheng-Fu
• Format: Article
• Language: English
• Subjects: Accelerometers; Accelerometry - instrumentation; Accuracy; Actigraphy; Actigraphy - instrumentation; Adult; Algorithms; Biomedical monitoring; Data reduction; Electromyography; Energy conservation; Equipment Design; Equipment Failure Analysis; Evaluation; Humans; Manuals; Micro-Electrical-Mechanical Systems - instrumentation; Middle Aged; Monitoring; Monitoring, Ambulatory - instrumentation; objective sleep measurements; Polysomnography - instrumentation; Quality assessment; Quality control; Recording; Reproducibility of Results; Sensitivity and Specificity; Sleep; Sleep and wakefulness; sleep efficiency (SE); Sleep Stages - physiology; Systems Integration; Technology Assessment, Biomedical; wake-sleep scoring; wearable devices; Wearable technology; Young Adult
• ISSN: 0018-9294; 1558-2531
• DOI: 10.1109/TBME.2016.2612938

Objective: In this study, a wearable actigraphy recording device with low sampling rate (1 Hz) for power saving and data reduction and a high accuracy wake-sleep scoring method for the assessment of sleep were developed. Methods: The developed actigraphy recorder was successfully applied to overnight recordings of 81 subjects with simultaneous polysomnography (PSG) measurements. The total length of recording reached 639.8 h. A wake-sleep scoring method based on the concept of movement density evaluation and adaptive windowing was proposed. Data from subjects with good (N = 43) and poor (N = 16) sleep efficiency (SE) in the range of 52.7-97.42% were used for testing. The Bland-Altman technique was used to evaluate the concordance of various sleep measurements between the manual PSG scoring and the proposed actigraphy method. Results: For wake-sleep staging, the average accuracy, sensitivity, specificity, and kappa coefficient of the proposed system were 92.16%, 95.02%, 71.30%, and 0.64, respectively. For the assessment of SE, the accuracy of classifying the subject with good or poor SE reached 91.53%. The mean biases of SE, sleep onset time, wake after sleep onset, and total sleep time were -0.95%, 0.74 min, 2.84 min, and -4.3 min, respectively. Conclusion: These experimental results demonstrate the robustness and reliability of our method using limited activity information to estimate wake-sleep stages during overnight recordings. Significance: The results suggest that the proposed wearable actigraphy system is practical for the in-home screening of objective sleep measurements and objective evaluation of sleep improvement after treatment.