Long Xi, Haakma Reinder, Leufkens Tim R M, Fonseca Pedro, Aarts Ronald M
Department of Personal Health, Philips Research, 5656 AE Eindhoven, Netherlands ; Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, Netherlands.
Department of Personal Health, Philips Research, 5656 AE Eindhoven, Netherlands.
Comput Intell Neurosci. 2015;2015:583620. doi: 10.1155/2015/583620. Epub 2015 Aug 20.
Autonomic cardiorespiratory activity changes across sleep stages. However, it is unknown to what extent it is affected by between- and within-subject variability during sleep. As it is hypothesized that the variability is caused by differences in subject demographics (age, gender, and body mass index), time, and physiology, we quantified these effects and investigated how they limit reliable cardiorespiratory-based sleep staging. Six representative parameters obtained from 165 overnight heartbeat and respiration recordings were analyzed. Multilevel models were used to evaluate the effects evoked by differences in sleep stages, demographics, time, and physiology between and within subjects. Results show that the between- and within-subject effects were found to be significant for each parameter. When adjusted by sleep stages, the effects in physiology between and within subjects explained more than 80% of total variance but the time and demographic effects explained less. If these effects are corrected, profound improvements in sleep staging can be observed. These results indicate that the differences in subject demographics, time, and physiology present significant effects on cardiorespiratory activity during sleep. The primary effects come from the physiological variability between and within subjects, markedly limiting the sleep staging performance. Efforts to diminish these effects will be the main challenge.
自主心肺活动在睡眠各阶段会发生变化。然而，睡眠期间它受个体间和个体内变异性影响的程度尚不清楚。由于推测这种变异性是由受试者人口统计学特征（年龄、性别和体重指数）、时间和生理方面的差异引起的，我们对这些影响进行了量化，并研究了它们如何限制基于心肺功能的可靠睡眠分期。对从165份夜间心跳和呼吸记录中获得的六个代表性参数进行了分析。使用多层次模型来评估睡眠阶段、人口统计学、时间以及受试者之间和内部生理差异所引发的影响。结果表明，每个参数的个体间和个体内影响均具有显著性。经睡眠阶段调整后，受试者之间和内部生理方面的影响解释了总方差的80%以上，但时间和人口统计学影响的解释比例较小。如果对这些影响进行校正，可观察到睡眠分期有显著改善。这些结果表明，受试者人口统计学、时间和生理方面的差异对睡眠期间的心肺活动有显著影响。主要影响来自受试者之间和内部的生理变异性，这显著限制了睡眠分期表现。减少这些影响的努力将是主要挑战。
