3D detection of periodic limb movements in sleep.

The standard polysomnographic method for detecting periodic limb movements in sleep (PLMS) includes measuring the electromyography (EMG) signals from electrodes at the left and right tibialis anterior muscles. This procedure has disadvantages as the cabling affects the patients quality of sleep and the electrodes tend to come off during the night, deteriorating data quality. We used contactless monitoring of body movements by a 3D time-of-flight camera mounted above the bed. Changes in the 3D silhouette indicate motion. Contactless detection of PLMS has several substantial advantages over the EMG and provides more complete and more specific diagnostic data: (1) Motor events caused by other leg muscles than tibialis anterior muscles are fully captured by the 3D method, but missed by EMG. (2) 3D does not react to tonic muscle contractions, where such contractions cause strong deflections in EMG which are annotated as limb movements by most PSG apparatus. Another aspect turned out to be of high practical relevance: Deflections in EMG traces are frequently caused by poor electrode contacts, potentially causing false movement annotations. This can lead to substantial overestimation of the automatically computed PLM index. Contactless sensing completely avoids such problems.