Validation of a sleep staging classification model for healthy adults based on two combinations of a single-channel EEG headband and wrist actigraphy.

STUDY OBJECTIVES: The aim of this study was to develop a sleep staging classification model capable of accurately performing on different wearable devices. METHODS: Twenty-three healthy participants underwent a full-night type I polysomnography and used two device combinations: (A) flexible single-channel electroencephalogram (EEG) headband + actigraphy (n = 12) and (B) rigid single-channel EEG headband + actigraphy (n = 11). The signals were segmented into 30-second epochs according to polysomnographic stages (scored by a board-certified sleep technologist; model ground truth) and 18 frequency and time features were extracted. The model consisted of an ensemble of bagged decision trees. Bagging refers to bootstrap aggregation to reduce overfitting and improve generalization. To evaluate the model, a training dataset under 5-fold cross-validation and an 80-20% dataset split was used. The headbands were also evaluated without the actigraphy feature. Participants also completed a usability evaluation (comfort, pain while sleeping, and sleep disturbance). RESULTS: Combination A had an F1-score of 98.4% and the flexible headband alone of 97.7% (error rate for N1: combination A = 9.8%; flexible headband alone = 15.7%). Combination B had an F1-score of 96.9% and the rigid headband alone of 95.3% (error rate for N1: combination B = 17.0%; rigid headband alone = 27.7%); in both, N1 was more confounded with N2. CONCLUSIONS: We developed an accurate sleep classification model based on a single-channel EEG device, and actigraphy was not an important feature of the model. Both headbands were found to be useful, with the rigid one being more disruptive to sleep. Future research can improve our results by applying the developed model in a population with sleep disorders. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Actigraphy, Wearable EEG Band and Smartphone for Sleep Staging; URL: https://clinicaltrials.gov/study/NCT04943562; Identifier: NCT04943562. CITATION: Melo MC, Vallim JRS, Garbuio S, et al. Validation of a sleep staging classification model for healthy adults based on 2 combinations of a single-channel EEG headband and wrist actigraphy. J Clin Sleep Med. 2024;20(6):983-990.

2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association.

Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P - Patient, problem, or population; I - Intervention; C - Comparison, control, or comparator; O - Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.

Mental Violence: The COVID-19 Nightmare.

The year 2020 has generated profound changes in personal and working relations, and in dreams of millions of people worldwide. The aim of this study was to investigate the frequency and content of nightmares during the COVID-19 pandemic in Brazil, evaluating its associations with sociodemographic, occupational, and clinical factors. Cross-sectional exploratory study, including 1,057 participants who responded to an online survey about mental violence and nightmares during the pandemic, between May 25 and June 1, 2020. A descriptive analysis of the results was done to obtain frequency tables. McNemar's non-parametric test was used to compare the frequency of nightmares before and after the pandemic, and logistic regression models, to identify factors most strongly associated with the pandemic nightmares. Participants were from 21 Brazilian states, with a mean age of 38 ± 14 years, and 78% women. Half of them (n = 529) reported at least one nightmare episode during the pandemic, and 32.9% (n = 348) described a pandemic content. There was nearly a 3-fold increase in the occurrence of nightmares "once a week or more" during the pandemic, 9% before vs. 25% after. Prior psychiatric care, suicidal ideation, sleep medication, increased pandemic alcohol consumption, perceiving high risk of contamination, being woman, and of younger age were factors associated with having nightmares during the pandemic. Prior psychiatric care, sleep medication, and age remained significant after excluding participants without nightmares and comparing between individuals with and without a pandemic content. We conclude the COVID-19 pandemic has affected people's dreams. The increase in the frequency of nightmares, their pandemic content, and association with previous conditions are a concerning public mental health issue and should be taken into consideration by authorities and policy makers.