Comparison of Bed-Sensors for Nocturnal Behaviour Assessment

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Comparison of Bed-Sensors for Nocturnal Behaviour Assessment Presented by: Bruce Wallace Email:wally@sce.carleton.ca Bruce Wallace 1,2,3, Frank Knoefel 1,2,3,4,5, Rafik Goubran 1,2,3, Jeffrey Kaye 6,7, Neil Thomas 2,3,4,5 1 Systems and Computer Engineering, Carleton University 2 Bruyère Research Institute 3 AGE-WELL NIH-SAM 3 4 Bruyere Continuing Care 5 Faculty of Medicine, University of Ottawa 6 NIA-Layton Aging & Alzheimer's Disease Center 7 Oregon Center for Aging & Technology (ORCATECH)

Dr. Bruce Wallace Executive Director, AGEWELL NIH SAM 3 Sensors and Analytics for Monitoring Mobility and Memory Adjunct Research Professor and Contract Instructor, Carleton University Affiliated Investigator, Bruyere Research Institute Research Focus: Ambient assessment of well-being and supportive smart systems to support independence and aging in place.

Disclosure The work was also supported in part by the CABHI Spark program and AGE-WELL NCE. BestBuy Canada Inc provided their Assured Living platform for the study. It was also supported in part by the Natural Sciences and Engineering Research Council (NSERC) Discovery Grant.

Agenda Why Bed Sensing The Bed Sensors Test Method Experimental Results Summary

Bed Sensing Applications Applications looking at just the bed Presence: Time in bed, Nocturnal events Sleep state Respiration: Rate, breathing patterns, apnea Physical Health: Dynamics of bed exit Sensor Technologies force sensitive resistors vibration/sound sensors piezoelectric film sensors fibre optic Infrared proximity Sensor under mattress

Background Use Case Supportive Smart Home Providing supportive cues to reorient PLWD e. g. Bed Sensor Cue lighting for Bathroom Issue Detecting the bed exit Sensor used in that study was a source of many issues (errors, did not function in some beds) It actually would not work in the bed in this study Research focus for this work Are emerging commercial sensor an option? Do they provide additional knowledge (sleep)?

Sensors pt 1 The Emfit QS Pressure sensitive capacitor Assesses the subjects motion through ballistocardiography. Reports presence, sleep state & score Withings Sleep Single air bladder and pneumatic sensor Assesses the variations in the pressure in air chamber associated with the movements. Reports presence, sleep state & score Emfit QS (E) Withings Sleep (W)

Sensors pt 2 Best Buy Canada s Assured Living solution / Telehealth Sensors Pressure sensitive capacitor with adaptive threshold. Reports presence Best Buy Canada s Assured Living solution motion sensors Sensors located in the bathroom and a flight of stairs Reports activity BestBuy Assured Living (B)

Method Double occupancy queen sized bed Sensors placed on subject 1 side of bed. Sensors placed in the bed per their respective installation instructions Each connected to the Internet/cloud. Test period of 75 consecutive nights The B sensor introduced 21 days into the study when it arrived Participant maintained nightly logs Entry and exits times Sleep quality Sensor data access through portals for each sensor Subject Mattress Box Spring Gender B Age (yr) W E Height (m) Weight (kg) 1 M 55 1.85 85 2 F 50 1.65 60

Time in Bed Results Comparison of the results for the each sensors log Sensor B times very similar to logs. Sensor W shows less time than the log Cropping of the overnight period on some nights. Sensor E shows extra time compared to log Later rise time reported matching subject 2. Sensor Nights (count) Start Time Error (count) End Time Error (count) Mean Time in Bed (min) St. Dev. Time in Bed (min) Log 75 na na 562.4 39.6 W 75 7 9 550.9 44.2 E 75 4 19 580.2 36.9 B 54 0 1 566.2 39.4

Nocturnal Exits Bed Sensor B detected all of the bed exits during the study period with no errors Motion Sensors from the B system did have two errors that are directly attributable to a failed battery in a motion sensor. W sensor had 3 missed bed exits and reported three exits that did not occur Missed exits FN appear to also be associated with the cropping of the overnight period noted for this sensor. E sensor frequently misses bed exits. Doubling occupancy with 1 person remaining in bed Sensor Actual Exits (n) Exits Detected (TP) Exits Missed (FN) Extra Exits Reported (FP) W 92 89 3 3 E 92 30 62 0 B bed 73 73 0 0 B motion 73 71 2 0

Sleep Time Sensors (W and E) provide information regarding sleep state and time asleep The results show a large difference between the values reported for the two sensors. Causes: Inclusion of sleep within the score for sensor E from participant 2. Mean St. Dev. Mean Mean Mean Sensor Nights Time Time Light Deep REM (n) Asleep Asleep Sleep Sleep Sleep (min) (min) (min) (min) (min) W 75 437.1 50.5 350.7 64.8 21.5 E 75 520.8 47.3 291.4 92.9 136.6

Portal vs API Data Sensors (W and E) Summary data in web Portal API allows raw data access Cropping by Sensor W Upper image shows portal view of a night Lower image shows API data for same night. Portal data starts after bed exit 2 hours into the API data

Sleep Score Sensor E and W report a sleep score Neither sensor manufacturer provides details on the methodology or algorithm used for this assessment. Portal vs API score Sensor W: Identical data Sensor E: Web portal sleep score range of 73 100 API sleep score range of 73 124 Portal score capitated at 100 Score comparison E and W is shown Comparing score for each sensor by night Data shows no correlation in the two scores from the two sensors W score aligns more with subject logs

Summary Sensor B Provides accurate assessment of the time in bed for the specific subject. Limited to only the assessment of bed occupancy. Sensor E and W Have potential for significantly more knowledge to be obtained Sensor W Effective at detecting entry and exits from the bed Limitation: It reports a single sleep period in each day and the start and end of the period are not based on first bed entry and last exit. Sensor E sensor Reports multiple sleep periods per day period leading it to be better and more appropriate for use within a study where naps or multiple daily sleep periods Appears to have had more difficulties associated with confusion between the bed occupants. Future work Fusion based algorithm of the more accurate assessment of time in bed provided by the B sensor with the more detailed knowledge of sleep related measures provided by the W, E sensors or other sensors located through-out the home

Questions Acknowledgements The work was also supported in part by the CABHI Spark program and AGE-WELL NCE. BestBuy Canada Inc provided their Assured Living platform for the study. It was also supported in part by the Natural Sciences and Engineering Research Council (NSERC) Discovery Grant.