The scoring of sleep stages is one of the essential tasks in sleep analysis. Since a manual procedure requires considerable human and financial resources, and incorporates some subjectivity, an automated approach could result in several advantages. There have been many developments in this area, and in order to provide a comprehensive overview, it is essential to review relevant recent works and summarise the characteristics of the approaches, which is the main aim of this article. To achieve it, we examined articles published between 2018 and 2022 that dealt with the automated scoring of sleep stages. In the final selection for in-depth analysis, 125 articles were included after reviewing a total of 515 publications. The results revealed that automatic scoring demonstrates good quality (with Cohen's kappa up to over 0.80 and accuracy up to over 90%) in analysing EEG/EEG + EOG + EMG signals. At the same time, it should be noted that there has been no breakthrough in the quality of results using these signals in recent years. Systems involving other signals that could potentially be acquired more conveniently for the user (e.g. respiratory, cardiac or movement signals) remain more challenging in the implementation with a high level of reliability but have considerable innovation capability. In general, automatic sleep stage scoring has excellent potential to assist medical professionals while providing an objective assessment.

Objective : This paper presents an algorithm for non-invasive sleep stage identification using respiratory, heart rate and movement signals. The algorithm is part of a system suitable for long-term monitoring in a home environment, which should support experts analysing sleep. Approach : As there is a strong correlation between bio-vital signals and sleep stages, multinomial logistic regression was chosen for categorical distribution of sleep stages. Several derived parameters of three signals (respiratory, heart rate and movement) are input for the proposed method. Sleep recordings of five subjects were used for the training of a machine learning model and 30 overnight recordings collected from 30 individuals with about 27 000 epochs of 30 s intervals each were evaluated. Main results : The achieved rate of accuracy is 72% for Wake, NREM, REM (with Cohen’s kappa value 0.67) and 58% for Wake, Light (N1 and N2), Deep (N3) and REM stages (Cohen’s kappa is 0.50). Our approach has confirmed the potential of this method and disclosed several ways for its improvement. Significance : The results indicate that respiratory, heart rate and movement signals can be used for sleep studies with a reasonable level of accuracy. These inputs can be obtained in a non-invasive way applying it in a home environment. The proposed system introduces a convenient approach for a long-term monitoring system which could support sleep laboratories. The algorithm which was developed allows for an easy adjustment of input parameters that depend on available signals and for this reason could also be used with various hardware systems.

The scoring of sleep stages is an essential part of sleep studies. The main objective of this research is to provide an algorithm for the automatic classification of sleep stages using signals that may be obtained in a non-obtrusive way. After reviewing the relevant research, the authors selected a multinomial logistic regression as the basis for their approach. Several parameters were derived from movement and breathing signals, and their combinations were investigated to develop an accurate and stable algorithm. The algorithm was implemented to produce successful results: the accuracy of the recognition of Wake/NREM/REM stages is equal to 73%, with Cohen's kappa of 0.44 for the analyzed 19324 sleep epochs of 30 seconds each. This approach has the advantage of using the only movement and breathing signals, which can be recorded with less effort than heart or brainwave signals, and requiring only four derived parameters for the calculations. Therefore, the new system is a significant improvement for non-obtrusive sleep stage identification compared to existing approaches.

With the emergence of new sensor technologies, such as fiber optic sensors (FOSs), compared to traditional mechanical sensors, unobtrusive sleep monitoring has been a research focus for decades. This work aims to provide a guide to current bed-based sensor technologies with diverse applications in various settings. We conducted a retrospective literature review, summarizing the state-of-the-art research over the past decade on non-contact bed-based sensor technology in sleep monitoring. We developed a three-category terminology: unobtrusive sensor technology, application, and subject. A total of 263 unique articles were acquired from three databases and screened for relevance, resulting in 21 papers selected for in-depth analysis. The findings revealed eight types of sensors: six mechanical sensors (pressure, accelerometer, piezoelectric, load cell, electromechanical film (EMFI), and hydraulic) and two FOSs (fiber Bragg grating and microbend FOS) that are integrated with or positioned under the bed at three levels of unobtrusiveness. We identified 15 parameters, with heart rate (14) and respiratory rate (13) being the most frequently measured. These parameters are generally categorized into three applications: disease-related diagnosis (18), general sleep analysis (9), and general well-being (11). The results indicated that sleep apnea (5) and insomnia (2) were the most frequently detected sleep disorders. Additionally, 59.1% (13) of the systems were tested in a lab environment, with only one undergoing clinical trials. In summary, there is a clear lack of convincing proof of the systems’ effectiveness in continuous in-home sleep monitoring.

Sustainable technologies are being increasingly used in various areas of human life. While they have a multitude of benefits, they are especially useful in health monitoring, especially for certain groups of people, such as the elderly. However, there are still several issues that need to be addressed before its use becomes widespread. This work aims to clarify the aspects that are of great importance for increasing the acceptance of the use of this type of technology in the elderly. In addition, we aim to clarify whether the technologies that are already available are able to ensure acceptable accuracy and whether they could replace some of the manual approaches that are currently being used. A two-week study with people 65 years of age and over was conducted to address the questions posed here, and the results were evaluated. It was demonstrated that simplicity of use and automatic functioning play a crucial role. It was also concluded that technology cannot yet completely replace traditional methods such as questionnaires in some areas. Although the technologies that were tested were classified as being “easy to use”, the elderly population in the current study indicated that they were not sure that they would use these technologies regularly in the long term because the added value is not always clear, among other issues. Therefore, awareness-raising must take place in parallel with the development of technologies and services.