David Looney1, Valentin Goverdovsky1, Ivana Rosenzweig2,3,4,5, Mary J Morrell2,6,7, Danilo P Mandic1. 1. 1 Communications and Signal Processing Group, Electrical and Electronic Engineering Department. 2. 2 Imperial College London, London, United Kingdom. 3. 3 Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom. 4. 4 Danish Epilepsy Centre, Dianalund, Denmark. 5. 5 Sleep Disorders Centre, Guy's and St. Thomas' National Health Service Foundation Trust, London, United Kingdom. 6. 6 Academic Unit of Sleep and Ventilation, National Heart and Lung Institute, London, United Kingdom; and. 7. 7 National Institute for Health Research Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.
Abstract
RATIONALE: To date, EEG is the only quantifiable measure of the neural changes that define sleep. Although it is used widely for clinical testing, scalp-electrode EEG is costly and is poorly tolerated by sleeping patients. OBJECTIVES: This was a pilot study to assess the agreement between EEG recordings obtained from a new ear-EEG sensor and those obtained simultaneously from standard scalp electrodes. METHODS: Participants were four healthy men, 25 to 36 years of age. During naps, EEG tracings were recorded simultaneously from the ear sensor and from standard scalp electrodes. A clinical expert, blinded to the data collection, analyzed 30-second epochs of recordings from both devices, using standardized criteria. The agreement between scalp- and ear-recordings was assessed. MEASUREMENTS AND MAIN RESULTS: We scored 360 epochs (scalp-EEG and ear-EEG), of which 254 (70.6%) were scored as non-REM sleep using scalp-EEG. The ear-EEG sensor had a sensitivity of 0.88 (95% confidence interval [CI], 0.82-0.92) and a specificity of 0.78 (95% CI, 0.70-0.84) in detecting N2/N3 sleep. The kappa coefficient between the scalp- and the ear-EEG was 0.65 (95% CI, 0.58-0.73). As a sleep monitor (all non-REM sleep stages vs. wake), the in-ear sensor had a sensitivity of 0.91 (95% CI, 0.87-0.94) and a specificity of 0.66 (95% CI, 0.56-0.75). The kappa coefficient was 0.60 (95% CI, 0.50-0.69). CONCLUSIONS: Substantial agreement was observed between recordings derived from a new ear-EEG sensor and conventional scalp electrodes on four healthy volunteers during daytime naps.
RATIONALE: To date, EEG is the only quantifiable measure of the neural changes that define sleep. Although it is used widely for clinical testing, scalp-electrode EEG is costly and is poorly tolerated by sleeping patients. OBJECTIVES: This was a pilot study to assess the agreement between EEG recordings obtained from a new ear-EEG sensor and those obtained simultaneously from standard scalp electrodes. METHODS: Participants were four healthy men, 25 to 36 years of age. During naps, EEG tracings were recorded simultaneously from the ear sensor and from standard scalp electrodes. A clinical expert, blinded to the data collection, analyzed 30-second epochs of recordings from both devices, using standardized criteria. The agreement between scalp- and ear-recordings was assessed. MEASUREMENTS AND MAIN RESULTS: We scored 360 epochs (scalp-EEG and ear-EEG), of which 254 (70.6%) were scored as non-REM sleep using scalp-EEG. The ear-EEG sensor had a sensitivity of 0.88 (95% confidence interval [CI], 0.82-0.92) and a specificity of 0.78 (95% CI, 0.70-0.84) in detecting N2/N3 sleep. The kappa coefficient between the scalp- and the ear-EEG was 0.65 (95% CI, 0.58-0.73). As a sleep monitor (all non-REM sleep stages vs. wake), the in-ear sensor had a sensitivity of 0.91 (95% CI, 0.87-0.94) and a specificity of 0.66 (95% CI, 0.56-0.75). The kappa coefficient was 0.60 (95% CI, 0.50-0.69). CONCLUSIONS: Substantial agreement was observed between recordings derived from a new ear-EEG sensor and conventional scalp electrodes on four healthy volunteers during daytime naps.
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