Generalized Camera-Based Infant Sleep-Wake Monitoring in NICUs: A Multi-Center Clinical Trial.

The infant sleep-wake behavior is an essential indicator of physiological and neurological system maturity, the circadian transition of which is important for evaluating the recovery of preterm infants from inadequate physiological function and cognitive disorders. Recently, camera-based infant sleep-wake monitoring has been investigated, but the challenges of generalization caused by variance in infants and clinical environments are not addressed for this application. In this paper, we conducted a multi-center clinical trial at four hospitals to improve the generalization of camera-based infant sleep-wake monitoring. Using the face videos of 64 term and 39 preterm infants recorded in NICUs, we proposed a novel sleep-wake classification strategy, called consistent deep representation constraint (CDRC), that forces the convolutional neural network (CNN) to make consistent predictions for the samples from different conditions but with the same label, to address the variances caused by infants and environments. The clinical validation shows that by using CDRC, all CNN backbones obtain over 85% accuracy, sensitivity, and specificity in both the cross-age and cross-environment experiments, improving the ones without CDRC by almost 15% in all metrics. This demonstrates that by improving the consistency of the deep representation of samples with the same state, we can significantly improve the generalization of infant sleep-wake classification.

Occlusion-robust Sleep Posture Detection using Body Rolling Motion in a Video.

It has been reported that the monitoring of sleep postures is useful for the treatment and prevention of sleep diseases such as obstructive sleep apnea and heart failure. Camera-based sleep posture detection is attractive for the nature of comfort and convenience of use. However, the main challenge is to detect postures from images of the body that are occluded by bed sheets or covers. To address this issue, we propose a novel occlusion-robust sleep posture detection method exploiting the body rolling motion in a video. It uses the head orientation to indicate the posture direction (supine, left or right lateral), triggered by the full-body rolling motion (as a sign of posture change). The experimental results show that our proposed method, as compared with the state-of-the-art approaches such as skeleton-based (MediaPipe) and full-image ResNet based methods, obtained clear improvements on sleep posture detection with heavy body occlusions, with an averaged precision, recall and F1-score of 0.974, 0.993 and 0.983, respectively. The next step is to integrate the sleep posture detection algorithm into a camera-based sleep monitoring system for clinical validations.

Time-domain Features of Angular-velocity Signals for Camera-based Respiratory RoI detection: A Clinical Study in NICU.

Camera-based measurement of respiratory rate (RR) is emerging for preterm infants monitoring in Neonatal Intensive Care Units (NICU). Accurate detection of respiratory region of interest (Resp-RoI), e.g. thorax and abdomen of infants, is essential for achieving a fully-automatic solution and for high-quality RR estimation. However, the application of fast Fourier transform (FFT) for detecting Resp-RoI in premature infants may not be appropriate due to their irregular breathing patterns. This study proposes a new method for detecting Resp-RoIs in premature infants that uses time-domain features of angular-velocity of respiration. By fusing respiratory motion on orthogonal directions, the proposed method is more robust to variations of infant posture in the incubator.. In addition, using inter-beat interval (IBI) features in the time domain helps to distinguish between Resp-RoI and background. The proposed method was validated on 20 preterm infants in NICU. It obtains a clear improvement on Resp-RoI detection (RoI correspondence = 0.74) and RR estimation (MAE = 3.62 bpm) against the benchmarked approaches (maxFFT: RoI correspondence = 0.45, MAE = 5.61 bpm).