使用软电极阵列监测睡眠阶段:与 vPSG 的比较以及 REM 睡眠无张力的家庭式检测。

Monitoring sleep stages with a soft electrode array: Comparison against vPSG and home-based detection of REM sleep without atonia.

机构信息

Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel.

Laboratory for Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

出版信息

J Sleep Res. 2023 Oct;32(5):e13909. doi: 10.1111/jsr.13909. Epub 2023 May 2.

Abstract

Sleep disorders are symptomatic hallmarks of a variety of medical conditions. Accurately identifying the specific stage in which these disorders occur is particularly important for the correct diagnosis of non-rapid eye movement and rapid eye movement parasomnias. In-lab polysomnography suffers from limited availability and does not reflect habitual sleep conditions, which is especially important in older adults and those with neurodegenerative diseases. We aimed to explore the feasibility and validity of a new wearable system for accurately measuring sleep at home. The system core technology is soft, printed dry electrode arrays and a miniature data acquisition unit with a cloud-based data storage for offline analysis. The positions of the electrodes allow manual scoring following the American Association of Sleep Medicine guidelines. Fifty participants (21 healthy subjects, mean age 56.6 ± 8.4 years; and 29 patients with Parkinson's disease, 65.4 ± 7.6 years) underwent a polysomnography evaluation with parallel recording with the wearable system. Total agreement between the two systems reached Cohen's kappa (k) of 0.688 with agreement in each stage of: wake k = 0.701; N1 = 0.224; N2 = 0.584; N3 = 0.410; and rapid eye movement = 0.723. Moreover, the system reliably detected rapid eye movement sleep without atonia with a sensitivity of 85.7%. Additionally, a comparison between sleep as measured in the sleep lab with data collected from a night at home showed significantly lower wake after sleep onset at home. The results demonstrate that the system is valid, accurate and allows for the exploration of sleep at home. This new system offers an opportunity to help detect sleep disorders on a larger scale than possible today, fostering better care.

摘要

睡眠障碍是多种医学病症的症状标志。准确识别这些障碍发生的具体阶段对于正确诊断非快速眼动和快速眼动性睡眠障碍尤为重要。在实验室进行的多导睡眠图受到可用性的限制,并且不能反映习惯性的睡眠条件,这在老年人和神经退行性疾病患者中尤为重要。我们旨在探索一种新的可穿戴系统在家中准确测量睡眠的可行性和有效性。该系统的核心技术是软质、印刷的干电极阵列和带有基于云的数据存储的微型数据采集单元,用于离线分析。电极的位置允许根据美国睡眠医学协会的指南进行手动评分。50 名参与者(21 名健康受试者,平均年龄 56.6±8.4 岁;和 29 名帕金森病患者,65.4±7.6 岁)接受了多导睡眠图评估,并与可穿戴系统进行了平行记录。两种系统之间的总一致性达到了 Cohen 的 kappa(k)值为 0.688,每个阶段的一致性为:清醒 k=0.701;N1=0.224;N2=0.584;N3=0.410;和快速眼动=0.723。此外,该系统可靠地检测到快速眼动睡眠无动性,灵敏度为 85.7%。此外,与在睡眠实验室测量的睡眠数据与在家中一晚上收集的数据进行比较,结果显示在家中睡眠后醒来的清醒时间显著降低。研究结果表明,该系统有效、准确,并且可以在家中进行睡眠探索。这个新系统为在更大范围内检测睡眠障碍提供了机会,从而可以提供更好的护理。

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