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. 2023 Apr 1;19(4):711-718.
doi: 10.5664/jcsm.10416.

Validation of a wearable forehead sleep recorder against polysomnography in sleep staging and desaturation events in a clinical sample

Xinru Chen  1   2 , Xinyi Jin  3 , Jihui Zhang  2 , Kwok Wah Ho  4 , Yongli Wei  5 , Hanrong Cheng  5
Affiliations

Validation of a wearable forehead sleep recorder against polysomnography in sleep staging and desaturation events in a clinical sample

Xinru Chen et al. J Clin Sleep Med. .

Abstract

Study objectives: Wearable sleep recording devices may be a helpful alternative method for polysomnography (PSG) due to their higher accessibility and comfort as well as lower cost, but their validities need to be examined. The aim of this study was to evaluate the accuracy of a novel single-channel, electroencephalography-based wearable forehead sleep recorder (UMindSleep) to assess sleep staging and oxygen desaturation.

Methods: Two hundred and three Chinese adults recruited from a sleep medicine center underwent an overnight study wearing UMindSleep and PSG simultaneously. Sleep parameters including sleep staging and oxygen desaturation index were compared between UMindSleep and PSG.

Results: A total of 195,349 valid epochs from 197 participants (171 with obstructive sleep apnea, 86.8%) were included in analyses of sleep staging. Sensitivities of UMindSleep compared to PSG were 79.7% for wake, 85.8% for light sleep, 79.4% for deep sleep, and 82.7% for rapid eye movement sleep. Specificities were 95.3% for wake, 83.4% for light sleep, 97.0% for deep sleep, and 96.8% for rapid eye movement sleep. Furthermore, the kappa agreements of 0.69-0.79 were indicative of a substantial agreement for sleep staging between UMindSleep and PSG. Sensitivity and specificity regarding oxygen desaturation index were 93.4% and 88.9%, yielding a kappa coefficient of 0.82.

Conclusions: Our findings suggest that UMindSleep may serve as a feasible, accurate, and dependable device for screening of sleep disorders (eg, obstructive sleep apnea) and assessing sleep structure.

Citation: Chen X, Jin X, Zhang J, Ho KW, Wei Y, Cheng H. Validation of a wearable forehead sleep recorder against polysomnography in sleep staging and desaturation events in a clinical sample. J Clin Sleep Med. 2023;19(4):711-718.

Keywords: automatic scoring algorithm; forehead sleep recorder; sleep staging; validation; wearable.

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Conflict of interest statement

All authors have seen and approved the manuscript. This study was funded by EEGSmart Co., Ltd., which also provided the UMindSleep devices used in the study. The funding source played no role in the study design, data collection and analyses, finding interpretation, manuscript preparation, review and approval, or decision to submit the manuscript for publication. Dr. Jihui Zhang collaborated with EEGSmart Co., Ltd. for a grant funded by the National key Research and Development Program of China (2021YFC2501500), which also played no role in any part of the current study.

Figures

Figure 1
Figure 1. Flow chart of the study participants.
PSG = polysomnography, UMS = UMindSleep forehead sleep recorder.
Figure 2
Figure 2. Bland-Altman plot comparisons between the PSG and UMS for detection of the indexes of sleep architecture.
The horizontal coordinate of the Bland-Altman plot is the mean of the sleep parameters recorded by the UMS and the PSG, and the vertical coordinate is the difference between them. Each dot represents a participant, the solid black line represents the mean difference of PSG minus the mean difference of UMS, and the upper and lower red dashed lines represent the 95% confidence interval for the mean difference, which indicates very good agreement between the two detection methods when the difference lies within the 95% confidence interval. PSG = polysomnography, REM = rapid eye movement, UMS = UMindSleep forehead sleep recorder.
Figure 3
Figure 3. Bland-Altman plot comparisons between PSG and UMS for detection of oxygen desaturation index.
The horizontal coordinate of the Bland-Altman plot is the mean of the ODI recorded by the UMS and the PSG, and the vertical coordinate is the difference between them. Each dot represents a participant, the solid black line represents the mean difference of PSG minus the mean difference of UMS, and the upper and lower red dashed lines represent the 95% confidence interval for the mean difference, which indicates very good agreement between the two detection methods when the difference lies within the 95% confidence interval. ODI = oxygen desaturation index, PSG = polysomnography, REM = rapid eye movement, UMS = UMindSleep forehead sleep recorder.
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