Ear-EEG for sleep assessment: a comparison with actigraphy and PSG
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METHODS • ORIGINAL ARTICLE
Ear-EEG for sleep assessment: a comparison with actigraphy and PSG Yousef Rezaei Tabar 1 Preben Kidmose 1
&
Kaare B. Mikkelsen 1 & Mike Lind Rank 2 & Martin Christian Hemmsen 2 & Marit Otto 3 &
Received: 12 June 2020 / Revised: 20 October 2020 / Accepted: 7 November 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose To assess automatic sleep staging of three ear-EEG setups with different electrode configurations and compare performance with concurrent polysomnography and wrist-worn actigraphy recordings. Methods Automatic sleep staging was performed for single-ear, single-ear with ipsilateral mastoid, and cross-ear electrode configurations, and for actigraphy data. The polysomnography data were manually scored and used as the gold standard. The automatic sleep staging was tested on 80 full-night recordings from 20 healthy subjects. The scoring performance and sleep metrics were determined for all ear-EEG setups and the actigraphy device. Results The single-ear, the single-ear with ipsilateral mastoid setup, and the cross-ear setup performed five class sleep staging with kappa values 0.36, 0.63, and 0.72, respectively. For the single-ear with mastoid electrode and the cross-ear setup, the performance of the sleep metrics, in terms of mean absolute error, was better than the sleep metrics estimated from the actigraphy device in the current study, and also better than current state-of-the-art actigraphy studies. Conclusion A statistically significant improvement in both accuracy and kappa was observed from single-ear to single-ear with ipsilateral mastoid, and from single-ear with ipsilateral mastoid to cross-ear configurations for both two and five-sleep stage classification. In terms of sleep metrics, the results were more heterogeneous, but in general, actigraphy and single-ear with ipsilateral mastoid configuration were better than the single-ear configuration; and the cross-ear configuration was consistently better than both the actigraphy device and the single-ear configuration. Keywords Ear-EEG . Ambulatory sleep monitoring . Long-term sleep monitoring . Outpatient sleep monitoring
Introduction Sleep plays an essential role in health, general well-being, and quality of life, and abnormal sleep can be an early indicator of several diseases such as depression [1] and Alzheimer’s disease [2]. Many different sleep assessment methods have been developed in order to measure sleep and describe its quality. These methods vary by the sensing modalities and thus in the quality of information that they provide.
* Yousef Rezaei Tabar [email protected] 1
Department of Electrical and Computer Engineering, Aarhus University, Finlandsgade 22, Building 5125, 8200 Aarhus, Denmark
2
UNEEG Medical A/S, Lynge, Denmark
3
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
The gold standard for sleep assessment is manual scoring of polysomnography (PSG) recordings, which provides detailed information about sleep, including brain activity, sleep stages (N1,
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