Obstructive sleep apnea (OSA) is among the most prevalent sleep disorders, which is estimated to affect 6 %−19 % of women and 13 %−33 % of men. Besides daytime sleepiness, impaired cognitive functioning and an increased risk for accidents, OSA may lead to obesity, diabetes and cardiovascular diseases (CVD) on the long term. Its prevalence is only expected to rise, as it is linked to aging and excessive body fat. Nevertheless, many patients remain undiagnosed and untreated due to the cumbersome clinical diagnostic procedures. For this, the patient is required to sleep with an extensive set of body attached sensors. In addition, the recordings only provide a single night perspective on the patient in an uncomfortable, and often unknown, environment. Thus, large scale monitoring at home is desired with comfortable sensors, which can stay in place for several nights. To ...

The fact that a third of a human life is spent in a bed indicates the essential character of sleep. While some people might opt voluntarily for sleep deprivation, others don’t get to choose. Their healthy pattern of sleep is disrupted due to sleep disorders such as sleep apnea, insomnia and restless legs syndrome. Most clinical diagnoses revolve around complaints of excessive daytime sleepiness. People usually wait quite long however before contacting professional help, and might only do so when complaints have gone from minor to serious. It can be argued that people with minor complaints will have negligible compliance to rather obtrusive therapies, and should not be treated with pharmaceuticals. However, cognitive and behavioral therapy has proven its effectiveness for clinically diagnosed patients in different domains, and might thus also enhance the quality of life for people with minor ...

This research focuses on the development of algorithms to extract diagnostic information from the ECG signal, which can be used to improve automatic detection systems and home monitoring solutions. In the first part of this work, a generically applicable algorithm for model selection in kernel principal component analysis is presented, which was inspired by the derivation of respiratory information from the ECG signal. This method not only solves a problem in biomedical signal processing, but more importantly offers a solution to a long-standing problem in the field of machine learning. Next, a methodology to quantify the level of contamination in a segment of ECG is proposed. This level is used to detect artifacts, and to improve the performance of different classifiers, by removing these artifacts from the training set. Furthermore, an evaluation of three different methodologies to compute the ECG-derived ...

The respiratory sinus arrhythmia (RSA) is a form of cardiorespiratory coupling in which the heart rate accelerates during inhalation and decelerates during exhalation. Its quantification has been suggested as a tool to assess different diseases and conditions. However, whilst the potential of the RSA estimation as a diagnostic tool is shown in research works, its use in clinical practice and mobile applications is rather limited. This can be attributed to the lack of understanding of the mechanisms generating the RSA. To try to explain the RSA, studies are done using noninvasive signals, namely, respiration and heart rate variability (HRV), which are combined using different algorithms. Nevertheless, the algorithms are not standardized, making it difficult to draw solid conclusions from these studies. Therefore, the first aim of this thesis was to develop a framework to evaluate algorithms for RSA estimation. To ...

Epilepsy is one of the most common neurological disorders, which affects almost 1% of the population worldwide. Anti-epileptic drugs provide adequate treatment for about 70% of epilepsy patients. The remaining 30% of the patients continue to have seizures, which drastically affects their quality of life. In order to obtain efficacy measures of therapeutic interventions for these patients, an objective way to count and document seizures is needed. However, in an outpatient setting, one of the major problems is that seizure diaries kept by patients are unreliable. Automated seizure detection systems could help to objectively quantify seizures. Those detection systems are typically based on full scalp Electroencephalography (EEG). In an outpatient setting, full scalp EEG is of limited use because patients will not tolerate wearing a full EEG cap for long time periods during daily life. There is a need for ...

Monitoring of vital signs is a key tool in medical diagnostics to asses the onset and the evolution of several diseases. Among fundamental vital parameters, such as the hearth rate, blood pressure and body temperature, the Respiratory Rate (RR) plays an important role. For this reason, respiration needs to be carefully monitored in order to detect potential signs or events indicating possible changes of health conditions. Monitoring of the respiration is generally carried out in hospital and clinical environments by the use of expensive devices with several sensors connected to the patient's body. A new research trend, in order to reduce healthcare service costs and make monitoring of vital signs more comfortable, is the development of low-cost systems which may allow remote and contactless monitoring; in such a context, an appealing method is to rely on video processing-based solutions. In ...

Epilepsy is one of the most common neurological diseases, especially in children. And although the majority of patients can be treated through medication or surgery (70%-75%), a significant group of patients cannot be treated. For this latter group of patients it is advisable to follow the evolution of the disease. This can be done through a long-term automatic monitoring, which gives an objective measure of the number of seizures that the patient has, for example during the night. On the other hand, there is a reduced social control overnight and the parents or caregivers can miss some seizures. In severe seizures, it is sometimes necessary, however, to avoid dangerous situations during or after the seizure (e.g. the danger of suffocation caused by vomiting or a position that obstructs breathing, or the risk of injury during violent movements), and to comfort ...

The electrocardiogram or ECG is a relatively easy-to-record signal that contains an enormous amount of potentially useful information. It is currently mostly being used for screening purposes. For example, pre-participation cardiovascular screening of young athletes has been endorsed by both scientific organisations and sporting governing bodies. A typical cardiac examination is taken in a hospital environment and lasts 10 seconds. This is often sufficient to detect major pathologies, yet this small sample size of the heart’s functioning can be deceptive when used to evaluate one’s general condition. A solution for this problem is to monitor the patient outside of the hospital, during a longer period of time. Due to the extension of the analysis period, the detection rate of cardiac events can be highly increased, compared to the cardiac exam in the hospital. However, it also increases the likelihood of ...

Acutely-ill hospitalised patients are at risk of clinical deteriorations in health leading to adverse events such as cardiac arrests. Deteriorations are currently detected by manually measuring physiological parameters every 4-6 hours. Consequently, deteriorations can remain unrecognised between assessments, delaying clinical intervention. It may be possible to provide earlier detection of deteriorations by using wearable sensors for continuous physiological monitoring. Respiratory rate (RR) is not commonly monitored by wearable sensors, despite being a sensitive marker of deteriorations. This thesis presents investigations to identify an algorithm suitable for estimating RR from two signals commonly acquired by wearable sensors: the electrocardiogram (ECG) and photoplethysmogram (PPG). A suitable algorithm was then used to estimate RRs retrospectively from a physiological dataset acquired from acutely-ill patients to assess the potential utility of wearable sensors for detecting deteriorations. Existing RR algorithms were identi ed through a systematic ...

This work has, as its objective, the development of non-invasive and low-cost systems for monitoring and automatic diagnosing specific neonatal diseases by means of the analysis of suitable video signals. We focus on monitoring infants potentially at risk of diseases characterized by the presence or absence of rhythmic movements of one or more body parts. Seizures and respiratory diseases are specifically considered, but the approach is general. Seizures are defined as sudden neurological and behavioural alterations. They are age-dependent phenomena and the most common sign of central nervous system dysfunction. Neonatal seizures have onset within the 28th day of life in newborns at term and within the 44th week of conceptional age in preterm infants. Their main causes are hypoxic-ischaemic encephalopathy, intracranial haemorrhage, and sepsis. Studies indicate an incidence rate of neonatal seizures of 2‰ live births, 11‰ for preterm ...

Advances in wearable electrocardiogram (ECG) monitoring devices have allowed for new cardiovascular applications to emerge beyond diagnostics, such as stress and fatigue detection, athletic performance assessment, sleep disorder characterization, mood recognition, activity surveillance, biometrics, and fitness tracking, to name a few. Such devices, however, are prone to artifacts, particularly due to movement, thus hampering heart rate and heart rate variability measurement and posing a serious threat to cardiac monitoring applications. To address these issues, this thesis proposes the use of a spectro-temporal signal representation called “modulation spectrum”, which is shown to accurately separate cardiac and noise components from the ECG signals, thus opening doors for noise-robust ECG signal processing tools and applications. First, an innovative ECG quality index based on the modulation spectral signal representation is proposed. The representation quantifies the rate-of-change of ECG spectral components, which are shown to ...

Cardiovascular diseases are a growing problem in today’s society. The World Health Organization (WHO) reported that these diseases make up about 30% of total global deaths and that heart diseases have no geographic, gender or socioeconomic boundaries. Therefore, detecting cardiac irregularities early-stage and a correct treatment are very important. However, this requires a good physiological understanding of the cardiovascular system. The heart is stimulated electrically by the brain via the autonomic nervous system, where sympathetic and vagal pathways are always interacting and modulating heart rate. Continuous monitoring of the heart activity is obtained by means of an ElectroCardioGram (ECG). Studying the fluctuations of heart beat intervals over time reveals a lot of information and is called heart rate variability (HRV) analysis. A reduction of HRV has been reported in several cardiological and noncardiological diseases. Moreover, HRV also has a prognostic ...

In this thesis, the power of Machine Learning (ML) algorithms is combined with brain connectivity patterns, using Magnetic Resonance Imaging (MRI), for classification and prediction of Multiple Sclerosis (MS). White Matter (WM) as well as Grey Matter (GM) graphs are studied as connectome data types. The thesis addresses three main research objectives. The first objective aims to generate realistic brain connectomes data for improving the classification of MS clinical profiles in cases of data scarcity and class imbalance. To solve the problem of limited and imbalanced data, a Generative Adversarial Network (GAN) was developed for the generation of realistic and biologically meaningful connec- tomes. This network achieved a 10% better MS classification performance compared to classical approaches. As second research objective, we aim to improve classification of MS clinical profiles us- ing morphological features only extracted from GM brain tissue. ...

The first part of the presented work is focused on measuring of QT intervals. QT interval can be an indicator of the cardiovascular health of the patient and detect any potential abnormalities. The QT interval is measured from the onset of the QRS complex to the end of the T wave. However, measurements for the end of the T wave are often highly subjective and the corresponding verification is difficult. Here we propose two methods of QT interval measuring – wavelet based and template matching method. Methods are compared with each other and tested on standard QT database. The second part of the presented work is focused on modelling of arrhythmias using McSharry’s model followed with classification using an artificial neural network. The proposed method uses pre-processing of signals with Linear Approximation Distance Thresholding method and Line Segment Clustering method ...

In this study, the respiratory system are modelled by three linear and one non-linear lumped parameter respiratory model, the equations of the models are driven and the parameters are estimated by using statistical signal processing methods. Linear RIC, Viscoelastic and Mead models and proposed basic non-linear RC model are used to resemble the respiratory system of the patient with Chronic Obstructive Pulmonary Disease (COPD) under non-invasive ventilation. Statistical signal processing methods such as Minimum Variance Unbiased Estimation (MVUE), Maximum Likelihood Estimation (MLE), Kalman Filter (KF), Unscented Kalman Filter (UKF) and Extended Kalman Filter (EKF) are very powerful methods to estimate the parameters of the systems embedded in the unknown noise. In the first part of this thesis, artificial respiratory signals (airway flow and airway pressure) are used for the performance measurement criteria. Posterior Cramer Rao Lower Bound (PCRLB) is computed ...