Excessive daytime sleepiness is associated with relative delta frequency power among patients with mild OSA.

Background: Excessive daytime sleepiness (EDS) is a cause of low quality of life among obstructive sleep apnoea (OSA) patients. Current methods of assessing and predicting EDS are limited due to time constraints or differences in subjective experience and scoring. Electroencephalogram (EEG) power spectral densities (PSDs) have shown differences between OSA and non-OSA patients, and fatigued and non-fatigued patients. Therefore, polysomnographic EEG PSDs may be useful to assess the extent of EDS among patients with OSA. Methods: Patients presenting to Israel Loewenstein hospital reporting daytime sleepiness who recorded mild OSA on polysomnography and undertook a multiple sleep latency test. Alpha, beta, and delta relative powers were assessed between patients categorized as non-sleepy (mean sleep latency (MSL) ≥10 min) and sleepy (MSL <10 min). Results: 139 patients (74% male) were included for analysis. 73 (53%) were categorized as sleepy (median MSL 6.5 min). There were no significant differences in demographics or polysomnographic parameters between sleepy and non-sleepy groups. In multivariate analysis, increasing relative delta frequency power was associated with increased odds of sleepiness (OR 1.025 (95% CI 1.024-1.026)), while relative alpha and beta powers were associated with decreased odds. The effect size of delta PSD on sleepiness was significantly greater than that of either alpha or beta frequencies. Conclusion: Delta PSD during polysomnography is significantly associated with a greater degree of objective daytime sleepiness among patients with mild OSA. Further research is needed to corroborate our findings and identify the direction of potential causal correlation between delta PSD and EDS.

Interhemispheric differences of electroencephalography signal characteristics in different sleep stages.

OBJECTIVE: The current electroencephalography (EEG) measurement setup is complex, laborious to set up, and uncomfortable for patients. We hypothesize that differences in EEG signal characteristics for sleep staging between the left and right hemispheres are negligible; therefore, there is potential to simplify the current measurement setup. We aimed to investigate the technical hemispheric differences in EEG signal characteristics along with electrooculography (EOG) signals during different sleep stages. METHODS: Type II portable polysomnography (PSG) recordings of 50 patients were studied. Amplitudes and power spectral densities (PSDs) of the EEG and EOG signals were compared between the left (C3-M2, F3-M2, O1-M2, and E1-M2) and the right (C4-M1, F4-M1, O2-M1, and E2-M2) hemispheres. Regression analysis was performed to investigate the potential influence of sleep stages on the hemispheric differences in PSDs. Wilcoxon signed-rank tests were also employed to calculate the effect size of hemispheres across different frequency bands and sleep stages. RESULTS: The results showed statistically significant differences in signal characteristics between hemispheres, but the absolute differences were minor. The median hemispheric differences in amplitudes were smaller than 3 µv with large interquartile ranges during all sleep stages. The absolute and relative PSD characteristics were highly similar between hemispheres in different sleep stages. Additionally, there were negligible differences in the effect size between hemispheres across all sleep stages. CONCLUSIONS: Technical signal differences between hemispheres were minor across all sleep stages, indicating that both hemispheres contain similar information needed for sleep staging. A reduced measurement setup could be suitable for sleep staging without the loss of relevant information.

Multi-Level Classification of Driver Drowsiness by Simultaneous Analysis of ECG and Respiration Signals Using Deep Neural Networks.

The high number of fatal crashes caused by driver drowsiness highlights the need for developing reliable drowsiness detection methods. An ideal driver drowsiness detection system should estimate multiple levels of drowsiness accurately without intervening in the driving task. This paper proposes a multi-level drowsiness detection system by a deep neural network-based classification system using a combination of electrocardiogram and respiration signals. The proposed method is based on a combination of convolutional neural networks (CNNs) and long short-term memory (LSTM) networks for classifying drowsiness by concurrently using heart rate variability (HRV), power spectral density of HRV, and respiration rate signal as inputs. Two models, a CNN-based model and a hybrid CNN-LSTM-based model were used for multi-level classifications. The performance of the proposed method was evaluated on experimental data collected from 30 subjects in a simulated driving environment. The performance and the results of both models are presented and compared. The best performance for both three-level and five-level drowsiness classifications was achieved by the CNN-LSTM model. The results indicate that the three-level and five-level classifications of drowsiness can be achieved with 91 and 67% accuracy, respectively.

Driver drowsiness detection using facial thermal imaging in a driving simulator.

Driver drowsiness causes fatal driving accidents. Thermal imaging is a suitable drowsiness detection method as it is non-invasive and robust against changes in the ambient light. In this paper, driver drowsiness is detected by measuring the forehead temperature at the region covering the supratrochlear artery and also the cheek temperature. About 30 subjects drove on a highway in a driving simulator in two sessions. A thermal camera was used to monitor the facial temperature pattern. The subjects' drowsiness levels were estimated by three human observers. The forehead and the cheek regions were located and tracked in each frame. The forehead and the cheek skin temperatures were obtained at three levels of drowsiness. The Support Vector Machine, the K-Nearest Neighbor, and the regression tree classifiers were used. From wakefulness to extreme drowsiness, the forehead skin temperature and the absolute cheek-forehead skin temperature gradient decreased by 0.46°C and 0.81°C, respectively. But the cheek skin temperature increased by 0.35°C in two sessions. The gradient difference is on average 50% higher than the forehead or the cheek temperature change alone. The results indicate that drowsiness can be detected with an accuracy of 82%, sensitivity of 85%, specificity of 90%, and precision of 84%. Driver drowsiness can be detected by monitoring changes in the forehead and the cheek temperature signal. Also, the temperature gradient can be used as a more robust and sensitive indicator of drowsiness.