Polysomnography (PSG) is the current gold standard for the diagnosis of sleep disorders. However, this multiparametric sleep monitoring tool also has some drawbacks, e.g. it limits the patient's mobility during the night and it requires the patient to come to a specialized sleep clinic or hospital to attach the sensors. Unobtrusive techniques for the detection of sleep disorders such as sleep apnea are therefore gaining increasing interest. Remote photoplethysmography using video is a technique which enables contactless detection of hemodynamic information. Promising results in near-infrared have been reported for the monitoring of sleep-relevant physiological parameters pulse rate, respiration and blood oxygen saturation. In this study we validate a contactless monitoring system on eight patients with a high likelihood of relevant obstructive sleep apnea, which are enrolled for a sleep study at a specialized sleep center. The dataset includes 46.5 hours of video recordings, full polysomnography and metadata. The camera can detect pulse and respiratory rate within 2 beats/breaths per minute accuracy 92% and 91% of the time, respectively. Estimated blood oxygen values are within 4 percentage-points of the finger-oximeter 89% of the time. These results demonstrate the potential of a camera as a convenient diagnostic tool for sleep apnea, and sleep disorders in general.

Aiming at continuous unobtrusive respiration monitoring, motion robustness is paramount. However, some types of motion can completely hide the respiration information and the detection of these events is required to avoid incorrect rate estimations. Therefore, this work proposes a motion detector optimized to specifically detect severe motion of infants combined with a respiration rate detection strategy based on automatic pixels selection, which proved to be robust to motion of the infants involving head and limbs. A dataset including both thermal and RGB (Red Green Blue) videos was used amounting to a total of 43 h acquired on 17 infants. The method was successfully applied to both RGB and thermal videos and compared to the chest impedance signal. The Mean Absolute Error (MAE) in segments where some motion is present was $1.16$ and $1.97$ breaths/min higher than the MAE in the ideal moments where the infants were still for testing and validation set, respectively. Overall, the average MAE on the testing and validation set are $3.31$ breaths/min and $5.36$ breaths/min, using $64.00\%$ and $69.65\%$ of the included video segments (segments containing events such as interventions were excluded based on a manual annotation), respectively. Moreover, we highlight challenges that need to be overcome for continuous camera-based respiration monitoring. The method can be applied to different camera modalities, does not require skin visibility, and is robust to some motion of the infants.

Pulse-oximetry has become a core monitoring modality in most fields of medicine. Typical dual-wavelength pulse-oximeters estimate blood oxygen saturation (SpO₂) levels from a relationship between the amplitudes of red and infrared photoplethysmographic (PPG) waveforms. When captured with a camera, the PPG waveforms are much weaker and consequently the measurement is more sensitive to distortions and noises. Therefore, an indirect method has recently been proposed where, instead of extracting the relative amplitudes from the individual waveforms, the waveforms are linearly combined to construct a collection of pulse signals with different pulse signatures, each corresponding to a specific oxygen saturation level. This method has been shown to outperform the conventional ratio-of-ratios based methods, especially when adding a third wavelength. Adding wavelengths, however, complicates the calibration. Inaccuracies in the calibration model threaten the performance of the method. Opto-physiological models have been shown earlier to provide useful calibration parameter estimates. In this paper, we show that the accuracy can be improved using a data-driven approach. We performed 5-fold cross validation on recordings with variations in oxygen saturation and optimized for pulse quality. All evaluated wavelength combinations, also without visible red, meet the required ISO standard accuracy with the calibration from the proposed method. This scalable approach is not only helpful to fine-tune the calibration model, but even allows computation of the calibration model parameters from scratch without prior knowledge of the data acquisition details, i.e., the properties of camera and illumination.

Both Respiratory Flow (RF) and Respiratory Motion (RM) are visible in thermal recordings of infants. Monitoring these two signals usually requires landmark detection for the selection of a region of interest. Other approaches combine respiratory signals coming from both RF and RM, obtaining a Mixed Respiratory (MR) signal. The detection and classification of apneas, particularly common in preterm infants with low birth weight, would benefit from monitoring both RF and RM, or MR, signals. Therefore, we propose in this work an automatic RF pixel detector not based on facial/body landmarks. The method is based on the property of RF pixels in thermal videos, which are in areas with a smooth circular gradient. We defined 5 features combined with the use of a bank of Gabor filters that together allow selection of the RF pixels. The algorithm was tested on thermal recordings of 9 infants amounting to a total of 132 min acquired in a neonatal ward. On average the percentage of correctly identified RF pixels was $84\%$. Obstructive Apneas (OAs) were simulated as a proof of concept to prove the advantage in monitoring the RF signal compared to the MR signal. The sensitivity in the simulated OA detection improved for the RF signal reaching $73\%$ against the $23\%$ of the MR signal. Overall, the method yielded promising results, although the positioning and number of cameras used could be further optimized for optimal RF visibility.

Cameras have changed our way of life in many ways