Dr Kiran K G Ravindran

Abstract Background Increased daytime napping and excessive sleepiness are associated with cognitive decline in older adults, especially in people living with dementia (PLWD) [1]. Subjective assessments of naps are burdensome and maybe unreliable in PLWD and hence there is a need for technologies that provide objective longitudinal assessment of the incidence and duration of naps. Here we compare two contactless sleep technologies (CSTs) against sleep diary and actigraphy for monitoring daytime napping in community dwelling non‐demented older adults. Method Two under‐mattress CSTs (Withings Sleep Analyser [WSA] and Emfit QS [Emfit]) along with actigraphy (Actiwatch Spectrum [AWS]) were deployed in the home of 17 older adults for a period of 14 days ( = 65 years; Mean Age ± SD = 72 ± 4.49; 6 Women). The ground truth nap information was collected using an extended consensus sleep diary that included additional information about naps (timing, duration, and location). We analyzed the agreement of the napping events and duration estimated by WSA, Emfit and AWS against the sleep diary reported events. Result The CSTs only detected in‐bed naps whilst the AWS detected both in‐bed and not‐in‐bed naps. Although all the compared devices detected spurious naps unreported in the sleep diary, it was highest in AWS (81% of total naps detected) followed by Emfit (63%) and WSA (16%) as shown in Figure 1. Among the CSTs, WSA accurately detected more in bed naps while registering less spurious naps compared to Emfit but had lower duration agreement to sleep diary (Figure 2). Further, when the contribution of daytime naps to 24‐h total sleep time was computed, the WSA estimate (12.8±6.1%) was closest to the sleep diary estimate (12.9±9.1%) followed by AWS (15.6±9.9%) and Emfit (17.2±11.1%). Conclusion CSTs, with their ability to provide both contextual location information and objective measures of napping, such as timing and duration, offer a reliable and unobtrusive alternative to traditional methods such as sleep diary and actigraphy for long‐term round‐the‐clock monitoring of sleep in older adults. References: [1] Li, P, Gao, L, Yu, L, et al. Daytime napping, and Alzheimer’s dementia: A potential bidirectional relationship. Alzheimer’s Dement. 2023; 19: 158– 168. https://doi.org/10.1002/alz.12636

Objective: Sleep monitoring has extensively utilized electroencephalogram (EEG) data collected from the scalp, yielding very large data repositories and well-trained analysis models. Yet, this wealth of data is lacking for emerging, less intrusive modalities, such as ear-EEG.Methods and procedures: The current study seeks to harness the abundance of open-source scalp EEG datasets by applying models pre-trained on data, either directly or with minimal fine-tuning; this is achieved in the context of effective sleep analysis from ear-EEG data that was recorded using a single in-ear electrode, referenced to the ipsilateral mastoid, and developed in-house as described in our previous work. Unlike previous studies, our research uniquely focuses on an older cohort (17 subjects aged 65-83, mean age 71.8 years, some with health conditions), and employs LightGBM for transfer learning, diverging from previous deep learning approaches. Results: Results show that the initial accuracy of the pre-trained model on ear-EEG was 70.1%, but fine-tuning the model with ear-EEG data improved its classification accuracy to 73.7%. The fine-tuned model exhibited a statistically significant improvement (p < 0.05, dependent t-test) for 10 out of the 13 participants, as reflected by an enhanced average Cohen's kappa score (a statistical measure of inter-rater agreement for categorical items) of 0.639, indicating a stronger agreement between automated and expert classifications of sleep stages. Comparative SHAP value analysis revealed a shift in feature importance for the N3 sleep stage, underscoring the effectiveness of the fine-tuning process.Conclusion: Our findings underscore the potential of fine-tuning pre-trained scalp EEG models on ear-EEG data to enhance classification accuracy, particularly within an older population and using feature-based methods for transfer learning. This approach presents a promising avenue for ear-EEG analysis in sleep studies, offering new insights into the applicability of transfer learning across different populations and computational techniques.Clinical impact: An enhanced ear-EEG method could be pivotal in remote monitoring settings, allowing for continuous, non-invasive sleep quality assessment in elderly patients with conditions like dementia or sleep apnea.

Introduction Disturbances of sleep/wake behaviour are amongst the most disabling symptoms of dementia, leading to increased carers’ burden and institutionalisation. The lack of unobtrusive, low- burden technologies validated to monitor sleep in patients living with dementia (PLWD) has prevented longitudinal studies of nocturnal disturbances and their correlates. Aims To examine the effect of medication changes and clinical status on the intraindividual variation in sleep/wake behaviour in PLWD. Methods Using under-mattress pressure-sensing mat in 46 PLWD, we monitored sleep/wake behavioural metrics for 13,711 nights between 2019-2021. Machine learning and >3.6million nightly summaries from 13,671 individuals from the general population were used to detect abnormalities in PLWD’s nightly sleep/wake metrics and convert them to risk scores. Additionally, GP records were reviewed for each patient to determine whether medication changes and clinical events affected sleep parameters. Results PLWD’s went to bed earlier and rose later than sex- and age-matched controls. They had more nocturnal awakenings with longer out-of-bed durations. Notably, at the individual patient level, increased metric-specific risk scores were temporally related to changes in antipsychotics and antidepressants, and acute illness, including UTI, cardiac events, and depressive episodes. Conclusions Passive monitoring of sleep/wake behaviours is a promising way to identify novel markers of disease progression and evaluate the effectiveness of pharmaceutical interventions in patients with dementia.

Background The incidence of sleep disturbances increases with normal aging and is highly prevalent among people living with dementia (PLWD). To facilitate management and improvement of sleep quality in PLWD, validated unintrusive contactless technologies for long term objective monitoring of sleep are needed. Here we evaluate the ability of a contactless sleep tracker to accurately determine Time in Bed (TIB), Wake vs Sleep and Sleep stages (wake, light, deep, and REM sleep). Method We deployed the Emfit (Emfit QS), a contactless sleep tracker placed under the mattress. The Emfit uses ballistography to estimate respiration and heart rate and sleep stages. We collected data from 16 participants (Age: Mean‐72.12; SD‐4.6 years [6F:10M]) at home for a 14‐day period followed by a single overnight laboratory polysomnography (PSG) sleep assessment. The Emfit outputs a) timeseries at 30 s intervals (four sleep stages) and b) overnight summary sleep parameters. Sleep staging and sleep parameter estimation by Emfit was compared to, a) in‐lab gold standard PSG, and b) at‐home wristworn accelerometer (Actiwatch spectrum (AWS)) and sleep diary (SD) data. The epoch‐to‐epoch sleep staging concordance of Emfit was estimated over the total recording interval (∼10hrs) of the PSG for the laboratory session and between 1800hrs and 1200hrs for each SD entry for the home recordings. The concordance analysis for the sleep parameters, bed entry and exit times were performed using the summary data automatically generated by Emfit. Result The concordance between the four‐class sleep staging of the Emfit and PSG was poor (Figure 1). The two class (sleep/wake) analysis (Table 1) showed high sleep classification accuracy (sensitivity) but poor wake classification accuracy (specificity) compared to PSG. The sleep parameter estimates of Emfit also showed poor agreement with PSG (Figure 2). The home analysis indicated excellent accuracy for Time in Bed (TIB) (i.e., the bed entry and exit times) as registered by the SD (Table 2) and total sleep time (TST) for both sleep diary and AWS (Figure 3). Conclusion : The contactless sleep tracker provides accurate information about Time in Bed (TIB), but there is a lack of consensus of the sleep state classification with the PSG.

In this study, a novel orthonormalized partial least squares (OPLS) spatial filter is proposed for the extraction of the steady-state visual evoked potential (SSVEP) components buried in the electroencephalogram (EEG) data. The proposed method avoids over-fitting of the EEG data to the ideal SSVEP reference signals by reducing the over-emphasis of the target (pure sine-cosine) space. The paper presents the comparison of the detection accuracy of the proposed method with other existing spatial filters and discusses the shortcomings of these algorithms. The OPLS was tested across ten healthy subjects and its classification performance was examined. Further, statistical tests were performed to show the significant improvements in obtained detection accuracies. The result shows that the OPLS provides a significant improvement in detection accuracy across subjects compared to spatial filters under comparison. Hence, OPLS would act as a reliable and efficient spatial filter for separation of SSVEP components in brain-computer interface (BCI) applications.

Nocturnal disturbance is frequently observed in dementia and is a major contributor to institutionalisation. Unobtrusive technology that can quantify sleep/wake and determine bed occupancy during the major nocturnal sleep episode may be beneficial for long-term clinical monitoring and the carer. Such technologies have, however, not been validated in older people. Here we assessed the performance of the Withings Sleep Mattress (WSM) in a heterogenous older population to ensure external validity.

Wearable heart rate monitors offer a cost-effective way of non-invasive, long-term monitoring of cardiac health. Validation of wearable technologies in an older populations is essential for evaluating their effectiveness during deployment in healthcare settings. To this end, we evaluated the validity of heart rate measures from a wearable device, Empatica E4, and compared them to the electrocardiography (ECG). We collected E4 data simultaneously with ECG in thirty-five older men and women during an overnight sleep recording in the laboratory. We propose a robust approach to resolve the missing inter-beat interval (IBI) data and improve the quality of E4 derived measures. We also evaluated the concordance of heart rate (HR) and heart rate variability (HRV) measures with ECG. The results demonstrate that the automatic E4 heart rate measures capture long-term HRV whilst the short-term metrics are affected by missing IBIs. Our approach provides an effective way to resolve the missing IBI issue of E4 and extracts reliable heart rate measures that are concordant with ECG. Clinical Relevance— This work discusses data quality challenges in heart rate data acquired by wearables and provides an efficient and reliable approach for extracting heart rate measures from the E4 wearable device and validates the metrics in older adults

This study introduces a novel, high accuracy, calibration less spatial filter for reliable steady-state visual evoked potential (SSVEP) extraction from noisy electroencephalogram (EEG) data. The proposed method, exactly periodic subspace decomposition (EPSD), utilises the periodic properties of the SSVEP components to achieve a robust spatial filter for SSVEP extraction. It tries to extract the SSVEP components by projecting the EEG data onto a subspace where only the target signal components are retained. The performance of the method was tested on an SSVEP dataset obtained from ten subjects and compared with common SSVEP spatial filtering and detection techniques. The results obtained from the study shows that EPSD consistently provides a significant improvement in detection performance than other SSVEP spatial filters used in brain-computer interface (BCI) applications.

Study Objective: To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults. Methods: We collected 7 to 14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n=29), Emfit-QS (Emfit, n=17), a standard actigraphy device (Actiwatch Spectrum [AWS, n=34]) and a sleep diary. We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep diary assisted actigraphy (AWS|SD). Results: Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (ICC: going to bed, getting out of bed, time in bed > 0.75) whereas the accuracy of AWSA was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71±81.16 min; Emfit: +101.47±75.95 min) as did AWS-A (+46.95±67.26 min). The CSTs overestimated sleep efficiency (WSA: +9.19±14.26 %; Emfit: +9.41±11.05 %) whereas AWS-A estimate (-2.38±10.06 %) was accurate. About 65% (n=23) of participants reported daytime naps either in-bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-h sleep duration with an error of ≈10% compared to the sleep diary. Conclusions: CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency and naps before these CSTs can be fully utilized in field settings. Statement of Significance: Contactless sleep technologies that do not pose a burden on participants are promising tools for longitudinal monitoring of sleep in the community. In a comparison with sleep diary assisted actigraphy, we show that two under-mattress devices used without sleep diary information, provide accurate information on nocturnal sleep timing and 24-hr bed presence. The study population comprised community-dwelling older adults, several of whom had medical conditions such as sleep apnea, arthritis, and type-2 diabetes, which adds to the relevance of these data. With further improvements in their performance, these unobtrusive sleep technologies have significant potential for at scale and longitudinal monitoring of 24-h sleep-wake patterns in older adults without the burden of completing sleep diaries.

Sleep and circadian rhythm disturbance are predictors of poor physical and mental health, including dementia. Long-term digital technology-enabled monitoring of sleep and circadian rhythms in the community has great potential for early diagnosis, monitoring of disease progression, and assessing the effectiveness of interventions. Before novel digital technology-based monitoring can be implemented at scale, its performance and acceptability need to be evaluated and compared to gold-standard methodology in relevant populations. Here, we describe our protocol for the evaluation of novel sleep and circadian technology which we have applied in cognitively intact older adults and are currently using in people living with dementia (PLWD). In this protocol, we test a range of technologies simultaneously at home (7-14 days) and subsequently in a clinical research facility in which gold standard methodology for assessing sleep and circadian physiology is implemented. We emphasize the importance of assessing both nocturnal and diurnal sleep (naps), valid markers of circadian physiology, and that evaluation of technology is best achieved in protocols in which sleep is mildly disturbed and in populations that are relevant to the intended use-case. We provide details on the design, implementation, challenges, and advantages of this protocol, along with examples of datasets.

[This corrects the article DOI: 10.2196/46338.].

Introduction Longitudinal monitoring of vital signs provides a method for identifying changes to general health in an individual and particularly so in older adults. The nocturnal sleep period provides a convenient opportunity to assess vital signs. Contactless technologies that can be embedded into the bedroom environment are unintrusive and burdenless and have the potential to enable seamless monitoring of vital signs. To realise this potential, these technologies need to be evaluated against gold standard measures and in relevant populations. Methods We evaluated the accuracy of heart rate and breathing rate measurements of three contactless technologies (two under-mattress trackers: Withings sleep analyser (WSA) and Emfit QS (Emfit) and a bedside radar: Somnofy) in a sleep laboratory environment and assessed their potential to capture vital signs (heart rate and breathing rate) in a real-world setting. Data were collected in 35 community dwelling older adults aged between 65 and 83 years (mean ± SD: 70.8 ± 4.9; 21 men) during a one-night clinical polysomnography (PSG) in a sleep laboratory, preceded by 7 to 14 days of data collection at-home. Several of the participants had health conditions including type-2 diabetes, hypertension, obesity, and arthritis and ≈49% (n = 17) had moderate to severe sleep apnea while ≈29% (n = 10) had periodic leg movement disorder. The under-mattress trackers provided estimates of both heart rate and breathing rate while the bedside radar provided only breathing rate. The accuracy of the heart rate and breathing rate estimated by the devices was compared to PSG electrocardiogram (ECG) derived heart rate (beats per minute, bpm) and respiratory inductance plethysmography thorax (RIP thorax) derived breathing rate (cycles per minute, cpm). We also evaluated breathing disturbance indices of snoring and the apnea-hypopnea index (AHI) available from the WSA. Results All three contactless technologies provided acceptable accuracy in estimating heart rate [mean absolute error (MAE) < 2.2 bpm and mean absolute percentage error (MAPE) < 5%] and breathing rate (MAE ≤ 1.6 cpm and MAPE < 12%) at 1 minute resolution. All three contactless technologies were able to capture changes in heart rate and breathing rate across the sleep period. The WSA snoring and breathing disturbance estimates were also accurate compared to PSG estimates (R-squared: WSA Snore: 0.76, p < 0.001; WSA AHI: 0.59, p < 0.001). Conclusion Contactless technologies offer an unintrusive alternative to conventional wearable technologies for reliable monitoring of heart rate, breathing rate, and sleep apnea in community dwelling older adults at scale. They enable assessment of night-to-night variation in these vital signs, which may allow the identification of acute changes in health, and longitudinal monitoring which may provide insight into health trajectories.

Spatial filters for steady-state visual evoked potential (SSVEP) detection rely on the purely periodic assumption of the signal components. In this study, we propose discriminative periodic component analysis (D pi CA) that takes advantage of the almost periodic nature of SSVEP without depending on ideal rigid templates. D pi CA tries to maximize the signal to noise ratio (SNR) of SSVEP components by utilizing the time structure of the stimulus frequencies embedded in the electroencephalogram (EEG) data. The performance of the proposed method was compared with standard canonical correlation analysis (CCA) using data collected from ten subjects. The results suggest that the D pi CA provides better detection accuracy compared to standard CCA across various window lengths and subjects. Furthermore, the statistical tests show that the D pi CA provides consistent and significant performance improvement than CCA even at short window lengths.

Background Nocturnal disturbance is frequently observed in dementia and is a major contributor to institutionalisation. Unobtrusive technology that can quantify sleep/wake and determine bed occupancy during the major nocturnal sleep episode may be beneficial for long-term clinical monitoring and the carer. Such technologies have, however, not been validated in older people. Here we assessed the performance of the Withings Sleep Mattress (WSM) in a heterogenous older population to ensure external validity. Method Eighteen participants (65 – 80 years, 10M:8F) completed 7-12 days of sleep/wake monitoring at home prior to an overnight laboratory session. WSM performance was compared to gold-standard (laboratory polysomnography [PSG] with video) and silver standard (actiwatch [AWS] and sleep diary at home). WSM data were downloaded from a third party API and the minute-to-minute sleep/wake timeseries extracted and time-ordered to create a sleep profile. Discontinuities in the timeseries were labelled as ‘missing data’ events. Results Participants contributed 107 nights with WSM and PSG or AWS data. In the laboratory, the overall epoch to epoch agreement (accuracy) of sleep/wake detection of WSM compared to PSG was 0.71 (sensitivity 0.8; specificity 0.45) and to AWS was 0.74 (sensitivity 0.77; specificity 0.53). Visual inspection of video recordings demonstrated that 20 of 21 ‘missing data’ events were true ‘out of bed’ events. These events were always associated with an increase in activity (AWS). At home, all 97 WSM ‘missing data’ events that occurred within the major nocturnal sleep episode defined by sleep diary data, were associated with an increase in activity levels in the AWS data and 36 of these events were also associated with an increase in light levels, indicating that the participant had left the bed. In several participants, data recorded by the WSM during daytime coincided with reported naps in the sleep diary. Conclusion Although WSM cannot reliably distinguish between sleep and wake, the presence/absence of data in WSM seem to be an accurate representation of whether older people are in or out of bed (bed occupancy). Thus, in dementia, this contactless, low-burden technology may be able to provide information about nocturnal disturbances and daytime naps in bed.

This study proposes and validates a novel steady-state visual evoked potential (SSVEP) detection approach, multiview MAX-VAR canonical correlation, that finds a common unique subspace that encompasses all the SSVEP responses pertaining to a specific subject. The method employs a generalized canonical correlation framework that efficiently computes a projection matrix that optimizes test data to achieve higher SSVEP identification performance. We used a SSVEP benchmark dataset using a 40 target BCI experiment to evaluate the proposed method. The results demonstrate that the multiview MAX-VAR canonical correlation approach outperforms the compared methods with respect to both accuracy and information transfer rates (ITRs). From the statistical significance tests, it is observed that the proposed approach effectively achieves superior performance at short window lengths making it a propitious algorithm for real time brain computer interfaces (BCI).

Traditional multichannel detection algorithms use reference signals that are a generalisation of the steady-state visual evoked potential (SSVEP) components. This leads to the suboptimal performance of the algorithms. For the first time, periodic component analysis (nCA) has been applied for the extraction of SSVEP components from background electroencephalogram (EEG). Data from six test subjects were used to evaluate the proposed method and compare it to standard canonical correlation analysis (CCA). The results demonstrate that the periodic component analysis acts as a reliable spatial filter for SSVEP extraction, and significantly outperforms traditional CCA even in low SNR conditions. The mean detection accuracy of nCA was higher than CCA across subjects, various window lengths and harmonics. The detection scores obtained from nCA provide reliable discrimination between control and idle states compared to CCA.

This study illustrates and evaluates a novel subject-specific target detection framework, sum of squared correlations (SSCOR), for improving the performance of steady-state visual evoked potential (SSVEP) based brain-computer interfaces (BCIs). The SSCOR spatial filter learns a common SSVEP representation space through the optimization of the individual SSVEP templates. The projection onto this SSVEP response subspace improves the signal to noise ratio (SNR) of the SSVEP components embedded in the recorded electroencephalographic (EEG) data. To demonstrate the effectiveness of the proposed framework, the target detection performance of the SSCOR method is compared with the state of the art task-related component analysis (TRCA). The evaluation is conducted on a 40 target SSVEP benchmark data collected from 35 subjects. The results of the extensive comparisons of the performance metrics show that the proposed SSCOR method outperforms the TRCA method. The ensemble version of the SSCOR framework provides an offline simulated information transfer rate (ITR) of 387 ± 9 bits/min which is much higher than that of the ensemble TRCA approach (max. ITR 216 ± 27 bits/min). The significant improvement in the detection accuracy and simulated ITR demonstrates the efficacy of the proposed framework for target detection in SSVEP based BCI applications.

Traditional spatial filters used for steady-state visual evoked potential (SSVEP) extraction such as minimum energy combination (MEC) require the estimation of the background electroencephalogram (EEG) noise components. Even though this leads to improved performance in low signal to noise ratio (SNR) conditions, it makes such algorithms slow compared to the standard detection methods like canonical correlation analysis (CCA) due to the additional computational cost. In this paper, Periodic component analysis (πCA) is presented as an alternative spatial filtering approach to extract the SSVEP component effectively without involving extensive modelling of the noise. The πCA can separate out components corresponding to a given frequency of interest from the background electroencephalogram (EEG) by capturing the temporal information and does not generalize SSVEP based on rigid templates. Data from ten test subjects were used to evaluate the proposed method and the results demonstrate that the periodic component analysis acts as a reliable spatial filter for SSVEP extraction. Statistical tests were performed to validate the results. The experimental results show that πCA provides significant improvement in accuracy compared to standard CCA and MEC in low SNR conditions. The results demonstrate that πCA provides better detection accuracy compared to CCA and on par with that of MEC at a lower computational cost. Hence πCA is a reliable and efficient alternative detection algorithm for SSVEP based brain-computer interface (BCI).

Background People living with dementia (PLWD) often exhibit marked sleep disturbances. These cause substantial care challenges and may be causally related to dementia progression. Collecting ecologically valid data on sleep disturbance in naturalistic settings has been difficult. As a result, sleep assessments in PLWD are generally limited to short studies in sleep laboratories or data collection from wearables, where compliance is problematic. Here, we demonstrate how passive internet of things (IoT) sensors can be used to monitor the effects of dementia on nocturnal behaviour and physiology. Method Using the Withings under‐mattress pressure sensor, we validated bed occupancy and physiological measures in 35 older adults tested both at home and in the laboratory. We then examined data collected between 2019 and 2021 from the general population (N=13,663) and from a cohort of PLWD taking part in the UK DRI study of home monitoring for PLWD (N=46). More than 4 million unique bed mat observations were analysed. Result Arise time across all subjects was negatively correlated with time to bed (Fig.1a, r(13,617)=‐0.5, p

Recently, filter bank analysis has been used in several detection methods to extract selective frequency features across multiple brain computer interface (BCI) modalities due to its effectiveness and simple structure. In this work, we propose filter bank technique as a standard preprocessing method for popular training free multi-channel steady-state visual evoked potential (SSVEP) detection methods to overcome subject-specific performance differences and a general improvement in detection accuracy. Our study validates the effectiveness of filter bank extensions by comparing performance differences of multichannel methods with their filter bank counterparts using a forty target SSVEP benchmark dataset collected across thirty five subjects. The results demonstrate that the proposed two stage (a filter bank stage followed by SSVEP detection) implementation of popular multichannel algorithms provide significant improvement in performance at short datalengths of < 2.75 s (p < 0.001) and can be viewed as a potential standard detection approach across all SSVEP identification problems.

Objective. This study introduces and evaluates a novel target identification method, latent common source extraction (LCSE), that uses subject-specific training data for the enhancement of detection of steady-state visual evoked potential (SSVEP). Approach. LCSE seeks to construct a common latent representation of the SSVEP signal subspace that is stable across multiple trials of electroencephalographic (EEG) data. The spatial filter thus obtained improves the signal-to-noise ratio (SNR) of the SSVEP components by removing nuisance signals that are irrelevant to the generalized signal representation learnt from the given data. In this study a comparison of SSVEP identification performance between the proposed method, extended canonical correlation analysis (ExtCCA) and multiset canonical correlation analysis (MsetCCA) was conducted using SSVEP benchmark data of 40 targets recorded from 35 subjects to validate the effectiveness of the LCSE framework. Main results. The results indicate that the LCSE framework significantly outperforms the other two methods in terms of both classification accuracy and information transfer rates (ITRs). Significance. The significant improvement in the target identification performance demonstrates that the proposed LCSE method can be seen as a promising potential candidate for efficient SSVEP detection in brain-computer interface (BCI) systems.

Sleep timing varies between individuals and can be altered in mental and physical health conditions. Sleep and circadian sleep phenotypes, including circadian rhythm sleep-wake disorders, may be driven by endogenous physiological processes, exogeneous environmental light exposure along with social constraints and behavioural factors. Identifying the relative contributions of these driving factors to different phenotypes is essential for the design of personalised interventions. The timing of the human sleep-wake cycle has been modelled as an interaction of a relaxation oscillator (the sleep homeostat), a stable limit cycle oscillator with a near 24-hour period (the circadian process), man-made light exposure and the natural light-dark cycle generated by the Earth's rotation. However, these models have rarely been used to quantitatively describe sleep at the individual level. Here, we present a new Homeostatic-Circadian-Light model (HCL) which is simpler, more transparent and more computationally efficient than other available models and is designed to run using longitudinal sleep and light exposure data from wearable sensors. We carry out a systematic sensitivity analysis for all model parameters and discuss parameter identifiability. We demonstrate that individual sleep phenotypes in each of 34 older participants (65-83y) can be described by feeding individual participant light exposure patterns into the model and fitting two parameters that capture individual average sleep duration and timing. The fitted parameters describe endogenous drivers of sleep phenotypes. We then quantify exogenous drivers using a novel metric which encodes the circadian phase dependence of the response to light. Combining endogenous and exogeneous drivers better explains individual mean mid-sleep (adjusted R-squared 0.64) than either driver on its own (adjusted R-squared 0.08 and 0.17 respectively). Critically, our model and analysis highlights that different people exhibiting the same sleep phenotype may have different driving factors and opens the door to personalised interventions to regularize sleep-wake timing that are readily implementable with current digital health technology.

•A novel approach that maps EEG data onto an exactly periodic subspace is proposed.•EPSD employs the periodic characteristics of the SSVEP response to enhance its SNR.•EPSD exhibits robust performance compared to the other commonly used spatial filters.•The study confirms that EPSD is promising detection algorithm for SSVEP based BCI. A novel exactly periodic spatial filtering (EPSD) approach, that provides a robust detection performance, is introduced and evaluated in this study. The proposed method exploits the temporal properties of the steady-state visual evoked potential (SSVEP) response to construct an orthogonal and exactly periodic mapping that enhances the signal to noise ratio (SNR) of the SSVEP embedded in the electroencephalogram (EEG) data. The subspace of interest is constructed via the elimination of the signals spaces that does not constitute the exact period of the target frequency. The EPSD is evaluated on a 35 subject benchmark dataset collected using a 40 target SSVEP BCI system. The results reveal that the proposed EPSD spatial filter significantly enhances the performance of target detection. Further statistical tests also confirm that the EPSD is a potential alternative to the existing SSVEP spatial filters for realizing an efficient BCI system.

Background: Contactless sleep technologies (CSTs) hold promise for longitudinal, unobtrusive sleep monitoring in health and disease at scale, particularly in older people where the increased incidence of sleep abnormalities with aging is considered a risk factor for several neurodegenerative disorders. However, few CST have been evaluated in older people. Objective: To evaluate the performance of three contactless sleep technologies (a bedside radar [Somnofy] and two under-mattress devices [Withings Sleep Analyser and Emfit-QS]) compared to polysomnography (PSG) and actigraphy [Actiwatch Spectrum] recorded during a first night in a sleep laboratory, 10-hour time in bed protocol, which induced mild sleep disturbance. Methods: Thirty-five older men and women (70.8±4.9 years; 14 women) several of whom had comorbidities and/or sleep apnoea, participated in the study. Devices were evaluated by estimating a range of performance metrics for classification of sleep vs wake, and NREM and REM sleep stages (sleep summary and epoch by epoch concordance) and comparing to PSG metrics. Results: All three CSTs overestimated total sleep time (bias [mean]: > 90 min) and sleep efficiency (bias: > 13 %) with an associated underestimation of wake after sleep onset (bias: > 50 min). Sleep onset latency was accurately detected by the bedside radar (bias: 16 mins). CSTs did not perform as well as actigraphy in estimating the all-night sleep summary measures. The bedside radar performed better in discriminating sleep vs wake (MCC [mean and 95% CI]: 0.63 [0.57 0.69]) than the under-mattress devices (MCC: =0.41 [0.36 0.46]; Emfit-QS =0.35 [0.26 0.43]). Accuracy of identifying REM and Light sleep was poor across all CSTs while deep sleep was predicted with moderate accuracy (MCC: >0.45) by both Somnofy and Withings Sleep Analyser. The deep sleep duration estimates of Somnofy was found to be significantly correlated (r2=0.6, p

In the above paper [1], we proposed a novel framework that uses a constrained formulation of sum of squared correlation (SSCOR) approach as an alternative method for designing a spatial filter for steady-state visual evoked potential (SSVEP) based brain-computer interfaces (BCIs). To evaluate the target detection performance of the SSCOR method, the task-related component analyses (TRCA) were used as a benchmark [2]. The study used the SSVEP benchmark dataset containing 40 target data collected from 35 subjects [3]. During the evaluation of the proposed method, the SSCOR provided very high detection performance and outperformed the TRCA method and the results were reported.

Several cellular pathways contribute to neurodegenerative tauopathy-related disorders. Microglial activation, a major component of neuroinflammation, is an early pathological hallmark that correlates with cognitive decline, while the unfolded protein response (UPR) contributes to synaptic pathology. Sleep disturbances are prevalent in tauopathies and may also contribute to disease progression. Few studies have investigated whether manipulations of sleep influence cellular pathological and behavioural features of tauopathy. We investigated whether trazodone, a licensed antidepressant with hypnotic efficacy in dementia, can reduce disease-related cellular pathways and improve memory and sleep in male rTg4510 mice with a tauopathy-like phenotype. In a 9-week dosing regimen, trazodone decreased microglial NLRP3 inflammasome expression and phosphorylated p38mitogen-activated protein kinase levels which correlated with the NLRP3 inflammasome, the UPR effector ATF4, and total tau levels. Trazodone reduced theta oscillations during REM sleep and enhanced rapid eye movement (REM) sleep duration. Olfactory memory transiently improved, and memory performance correlated with REM sleep duration and theta oscillations. These findings on the effects of trazodone on the NLRP3 inflammasome, the unfolded protein response and behavioural hallmarks of dementia warrant further studies on the therapeutic value of sleep-modulating compounds for tauopathies.