Adaptive wake and sleep detection for wearable systems

Sleep problems and disorders have a serious impact on human health and wellbeing. The rising costs for treating sleep-related chronic diseases in industrialized countries demands efficient prevention. Low-cost, wearable sleep / wake detection systems which give feedback on the wearer's "sleep performance" are a promising approach to reduce the risk of developing serious sleep disorders and fatigue. Not all bio-medical signals that are useful for sleep / wake discrimination can be easily recorded with wearable systems. Sensors often need to be placed in an obtrusive location on the body or cannot be efficiently embedded into a wearable frame. Furthermore, wearable systems have limited computational and energetic resources, which restrict the choice of sensors and algorithms for online processing and classification. Since wearable systems are used outside the laboratory, the recorded signals tend to be corrupted with additional noise that influences the precision of classification algorithms. In this thesis we present the research on a wearable sleep / wake classifier system that relies on cardiorespiratory (ECG and respiratory effort) and activity recordings and that works autonomously with minimal user interaction. This research included the selection of optimal signals and sensors, the development of a custom-tailored hardware demonstrator with embedded classification algorithms, and the realization of experiments in real-world environments for the customization and validation of the system. The processing and classification of the signals were based on Fourier transformations and artificial neural networks that are efficiently implementable into digital signal controllers. Literature analysis and empiric measurements revealed that cardiorespiratory signals are more promising for a wearable sleep / wake classification than clinically used signals such as brain potentials. The experiments conducted during this thesis showed that inter-subject differences within the recorded physiological signals make it difficult to design a sleep / wake classification model that can generalize to a group of subjects. This problem was addressed in two ways: First by adding features from another signal to the classifier, that is, measuring the behavioral quiescence during sleep using accelerometers. Conducted research on different feature extraction methods from accelerometer data showed that this data generalizes well for distinct subjects in the study group. In addition, research on user-adaptation methods was conducted. Behavioral sleep and wake measures, notably the measurement of reactivity and activity, were developed to build up a priori knowledge that was used to adapt the classification algorithm automatically to new situations. This thesis demonstrates the design and development of a low-cost, wearable hardware and embedded software for on-line sleep / wake discrimination. The proposed automatic user-adaptive classifier is advantageous compared to previously suggested classification methods that generalize over multiple subjects, because it can take changes in the wearer's physiology and sleep / wake behavior into account without adjustment from a human expert. The results of this thesis contribute to the development of smart, wearable, bio-physiological monitoring systems which require a high degree of autonomy and have only low computational resources available. We believe that the proposed sleep / wake classification system is a first promising step toward a context-aware system for sleep management, sleep disorder prevention, and reduction of fatigue.