Detection of Nocturnal Slow Wave Sleep Based on Cardiorespiratory Activity in Healthy Adults

Human slow wave sleep (SWS) during bedtime is paramount for energy conservation and memory consolidation. This study aims at automatically detecting SWS from nocturnal sleep using cardiorespiratory signals that can be acquired with unobtrusive sensors in a home-based scenario. From the signals, time-dependent features are extracted for continuous 30-s epochs. To reduce the measuring noise, body motion artifacts, and/or within-subject variability in physiology conveyed by the features, and thus, enhance the detection performance, we propose to smooth the features over each night using a spline fitting method. In addition, it was found that the changes in cardiorespiratory activity precede the transitions between SWS and the other sleep stages (non-SWS). To this matter, a novel scheme is proposed that performs the SWS detection for each epoch using the feature values prior to that epoch. Experiments were conducted with a large dataset of 325 overnight polysomnography (PSG) recordings using a linear discriminant classifier and tenfold cross validation. Features were selected with a correlation-based method. Results show that the performance in classifying SWS and non-SWS can be significantly improved when smoothing the features and using the preceding feature values of 5-min earlier. We achieved a Cohen's Kappa coefficient of 0.57 (at an accuracy of 88.8%) using only six selected features for 257 recordings with a minimum of 30-min overnight SWS that were considered representative of their habitual sleeping pattern at home. These features included the standard deviation, low-frequency spectral power, and detrended fluctuation of heartbeat intervals as well as the variations of respiratory frequency and upper and lower respiratory envelopes. A marked drop in Kappa to 0.21 was observed for the other nights with SWS time of less than 30 min, which were found to more likely occur in elderly. This will be the future challenge in cardiorespiratory-based SWS detection.

[1]  Matteo Matteucci,et al.  Sleep Staging Based on Signals Acquired Through Bed Sensor , 2010, IEEE Transactions on Information Technology in Biomedicine.

[2]  Atul Malhotra,et al.  Sleep staging based on autonomic signals: a multi-center validation study. , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[3]  Ming-Chun Huang,et al.  Unobtrusive Sleep Stage Identification Using a Pressure-Sensitive Bed Sheet , 2014, IEEE Sensors Journal.

[4]  S. Akselrod,et al.  Automatic detection of slow-wave-sleep using heart rate variability , 2001, Computers in Cardiology 2001. Vol.28 (Cat. No.01CH37287).

[5]  Conor Heneghan,et al.  Cardiorespiratory-based sleep staging in subjects with obstructive sleep apnea , 2006, IEEE Transactions on Biomedical Engineering.

[6]  Rachel Leproult,et al.  Slow-wave sleep and the risk of type 2 diabetes in humans , 2008, Proceedings of the National Academy of Sciences.

[7]  A. Chesson,et al.  The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Techinical Specifications , 2007 .

[8]  Sarah Herscovici,et al.  Detecting REM sleep from the finger: an automatic REM sleep algorithm based on peripheral arterial tone (PAT) and actigraphy , 2007, Physiological measurement.

[9]  S. Havlin,et al.  Detecting long-range correlations with detrended fluctuation analysis , 2001, cond-mat/0102214.

[10]  Willis J. Tompkins,et al.  Quantitative Investigation of QRS Detection Rules Using the MIT/BIH Arrhythmia Database , 1986, IEEE Transactions on Biomedical Engineering.

[11]  B. Nolan Boosting slow oscillations during sleep potentiates memory , 2008 .

[12]  R. Berger,et al.  Energy conservation and sleep , 1995, Behavioural Brain Research.

[13]  Xi Long,et al.  A novel low-complexity post-processing algorithm for precise QRS localization , 2014, SpringerPlus.

[14]  N. Montano,et al.  Altered cardiovascular variability in obstructive sleep apnea. , 1998, Circulation.

[15]  J. Trinder,et al.  Autonomic activity during human sleep as a function of time and sleep stage , 2001, Journal of sleep research.

[16]  Mark A. Hall,et al.  Correlation-based Feature Selection for Machine Learning , 2003 .

[17]  Sabine Van Huffel,et al.  An Evaluation of Cardiorespiratory and Movement Features With Respect to Sleep-Stage Classification , 2014, IEEE Journal of Biomedical and Health Informatics.

[18]  Jacob Cohen A Coefficient of Agreement for Nominal Scales , 1960 .

[19]  J. Mendels,et al.  Sleep laboratory adaptation in normal subjects and depressed patients ("first night effect"). , 1967, Electroencephalography and clinical neurophysiology.

[20]  Mark Goadrich,et al.  The relationship between Precision-Recall and ROC curves , 2006, ICML.

[21]  M. Dumont,et al.  A study of the dynamic interactions between sleep EEG and heart rate variability in healthy young men , 2003, Clinical Neurophysiology.

[22]  Xi Long,et al.  Measuring dissimilarity between respiratory effort signals based on uniform scaling for sleep staging , 2014, Physiological measurement.

[23]  S. Cerutti,et al.  Time-variant power spectrum analysis for the detection of transient episodes in HRV signal , 1993, IEEE Transactions on Biomedical Engineering.

[24]  F. Togo,et al.  Dynamics of sleep stage transitions in healthy humans and patients with chronic fatigue syndrome. , 2008, American journal of physiology. Regulatory, integrative and comparative physiology.

[25]  Mark C. Jones PRINCIPLES AND PRACTICE OF SLEEP MEDICINE , 1990 .

[26]  M H Bonnet,et al.  Effect of sleep disruption on sleep, performance, and mood. , 1985, Sleep.

[27]  Dario Floreano,et al.  Sleep and Wake Classification With ECG and Respiratory Effort Signals , 2009, IEEE Transactions on Biomedical Circuits and Systems.

[28]  S Akselrod,et al.  Fluctuations in autonomic nervous activity during sleep displayed by power spectrum analysis of heart rate variability , 1995, Neurology.

[29]  Ronald M. Aarts,et al.  The acoustics of snoring. , 2010, Sleep medicine reviews.

[30]  John Allen Photoplethysmography and its application in clinical physiological measurement , 2007, Physiological measurement.

[31]  Xi Long,et al.  Automatic detection of overnight deep sleep based on heart rate variability: A preliminary study , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[32]  H. Otzenberger,et al.  Temporal relationship between dynamic heart rate variability and electroencephalographic activity during sleep in man , 1997, Neuroscience Letters.

[33]  C. Heneghan,et al.  Sleep staging using cardiorespiratory signals , 2007 .

[34]  M. Zakrzewski,et al.  Comparison of Center Estimation Algorithms for Heart and Respiration Monitoring With Microwave Doppler Radar , 2012, IEEE Sensors Journal.

[35]  R. Kimoff,et al.  Sleep fragmentation in obstructive sleep apnea. , 1996, Sleep.

[36]  P. Fonseca,et al.  Time delay between cardiac and brain activity during sleep transitions , 2015 .

[37]  J. Richman,et al.  Physiological time-series analysis using approximate entropy and sample entropy. , 2000, American journal of physiology. Heart and circulatory physiology.

[38]  Y. Istefanopulos,et al.  IEEE Engineering in Medicine and Biology Society , 2019, IEEE Transactions on Biomedical Engineering.

[39]  F. Schlindwein,et al.  A study on the optimum order of autoregressive models for heart rate variability. , 2002, Physiological measurement.

[40]  M. Bonnet,et al.  Heart rate variability: sleep stage, time of night, and arousal influences. , 1997, Electroencephalography and clinical neurophysiology.

[41]  Xiaohua Douglas Zhang Strictly Standardized Mean Difference, Standardized Mean Difference and Classical t-test for the Comparison of Two Groups , 2010 .

[42]  Madalena Costa,et al.  Multiscale entropy analysis of biological signals. , 2005, Physical review. E, Statistical, nonlinear, and soft matter physics.

[43]  P. Mahalanobis On the generalized distance in statistics , 1936 .

[44]  J. Born,et al.  Auditory Closed-Loop Stimulation of the Sleep Slow Oscillation Enhances Memory , 2013, Neuron.

[45]  Thomas Penzel,et al.  Comparison of detrended fluctuation analysis and spectral analysis for heart rate variability in sleep and sleep apnea , 2003, IEEE Transactions on Biomedical Engineering.

[46]  D M Wallace,et al.  Sodium oxybate-induced sleep driving and sleep-related eating disorder. , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[47]  Michael Unser,et al.  Splines: a perfect fit for signal and image processing , 1999, IEEE Signal Process. Mag..

[48]  A. Rechtschaffen A manual of Standardized Terminology , 1968 .

[49]  Mary A. Carskadon,et al.  Chapter 2 - Normal Human Sleep : An Overview , 2005 .

[50]  Xi Long,et al.  Time-frequency analysis of heart rate variability for sleep and wake classification , 2012, 2012 IEEE 12th International Conference on Bioinformatics & Bioengineering (BIBE).

[51]  R. Stickgold Sleep-dependent memory consolidation , 2005, Nature.

[52]  J. A. van Alsté,et al.  ECG baseline wander reduction using linear phase filters , 1986 .

[53]  O. E. Herrmann,et al.  ECG baseline wander reduction using linear phase filters. , 1986, Computers and biomedical research, an international journal.

[54]  Xi Long,et al.  Sleep and Wake Classification With Actigraphy and Respiratory Effort Using Dynamic Warping , 2014, IEEE Journal of Biomedical and Health Informatics.

[55]  G. Tononi,et al.  Triggering sleep slow waves by transcranial magnetic stimulation , 2007, Proceedings of the National Academy of Sciences.

[56]  D. White,et al.  Respiration during sleep in normal man. , 1982, Thorax.

[57]  W C Dement,et al.  Sleep apnoea syndrome: states of sleep and autonomic dysfunction. , 1977, Journal of neurology, neurosurgery, and psychiatry.

[58]  S. Nevsimalova,et al.  Spectral analysis of heart rate variability in sleep. , 2005, Physiological Research.

[59]  Xi Long,et al.  Analyzing respiratory effort amplitude for automated sleep stage classification , 2014, Biomed. Signal Process. Control..

[60]  Daniel McDuff,et al.  Advancements in Noncontact, Multiparameter Physiological Measurements Using a Webcam , 2011, IEEE Transactions on Biomedical Engineering.

[61]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[62]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[63]  A. Varri,et al.  The SIESTA project polygraphic and clinical database , 2001, IEEE Engineering in Medicine and Biology Magazine.

[64]  C. Guilleminault,et al.  Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. , 2004, Sleep.

[65]  M. Bresler,et al.  Differentiating between light and deep sleep stages using an ambulatory device based on peripheral arterial tonometry , 2008, Physiological measurement.

[66]  S. Cash,et al.  Obstructive Sleep Apnea Alters Sleep Stage Transition Dynamics , 2010, PloS one.

[67]  P. Anderer,et al.  Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard , 2009, Journal of sleep research.

[68]  C. R. Deboor,et al.  A practical guide to splines , 1978 .

[69]  Matteo Matteucci,et al.  Sleep staging from Heart Rate Variability: time-varying spectral features and Hidden Markov Models , 2010 .

[70]  E. Wolpert A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .