Unobtrusive classification of sleep and wakefulness using load cells under the bed

Abstract

Poor quality of sleep increases the risk of many adverse health outcomes. Some measures of sleep, such as sleep efficiency or sleep duration, are calculated from periods of time when a patient is asleep and awake. The current method for assessing sleep and wakefulness is based on polysomnography, an expensive and inconvenient method of measuring sleep in a clinical setting. In this paper, we suggest an alternative method of detecting periods of sleep and wake that can be obtained unobtrusively in a patient's own home by placing load cells under the supports of their bed. Specifically, we use a support vector machine to classify periods of sleep and wake in a cohort of patients admitted to a sleep lab. The inputs to the classifier are subject demographic information, a statistical characterization of the load cell derived signals, and several sleep parameters estimated from the load cell data that are related to movement and respiration. Our proposed classifier achieves an average sensitivity of 0.808 and specificity of 0.812 with 90% confidence intervals of (0.790, 0.821) and (0.798, 0.826), respectively, when compared to the "gold-standard" sleep/wake annotations during polysomnography. As this performance is over 27 sleep patients with a wide variety of diagnosis levels of sleep disordered breathing, age, body mass index, and other demographics, our method is robust and works well in clinical practice.

Figure 1

Three example traces from one subject for the center of pressure signal, x_cop, in both the x (top) and y (bottom) directions for periods of sleep (red) and wakefulness (black). Sleep and wake epochs were labeled by an experienced sleep technician using the polysomnography data.

Figure 2

Three example traces from one subject of the composite msd signal (top) and respiration signal (bottom) for periods of sleep (red) and wakefulness (black). Sleep and wake epochs were labeled by an experienced sleep technician using the polysomnography data.