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Comparative Study
. 2013 May;17(2):747-52.
doi: 10.1007/s11325-012-0757-4. Epub 2012 Sep 21.

Assessment of a wireless headband for automatic sleep scoring

H Griessenberger  1 , D P J Heib, A B Kunz, K Hoedlmoser, M Schabus
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Comparative Study

Assessment of a wireless headband for automatic sleep scoring

H Griessenberger et al. Sleep Breath. .
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Abstract

Purpose: Classically, professional assessment of sleep is done in the sleep laboratory using whole-night polysomnography (PSG). However, given a misbalance between accredited sleep laboratories and the large amount of patients suffering from sleep disorders, only few receive appropriate diagnostic assessment. Recently, some low-cost home sleep scoring systems have been proposed, yet such systems are rarely tested scientifically. The aim of the present study was to evaluate the staging accuracy of the home sleep scoring system Zeo (Newton, MA, USA).

Methods: A final sample of 21 nights from ten subjects (aged 23-45) was digitally recorded with PSG as well as with the Zeo system. We compared scorings of Zeo (on an epoch-be-epoch basis) with the Somnolyzer 24 × 7 (an automatic staging algorithm), expert scorers as well as the freeware SleepExplorer.

Results: It was revealed that Zeo shows moderate overall agreement as compared to our study standard Somnolyzer 24 × 7 (κ = 0.56). The most obvious performance difference between Zeo and both other scoring approaches was stage wake (sleep onset latency + wake after sleep onset). While Zeo detected only 40.8 % of the study standard wake epochs, 70.1 % were detected by the expert scorers and 83.4 % by the SleepExplorer, respectively.

Conclusions: Data suggest that the Zeo system produces acceptable sleep scoring for stage REM, light and deep sleep, with a specific weakness in correctly detecting waking periods.

Figures

Fig. 1
Bland–Altman plots of sleep parameters SOL and WASO showing differences between Somnolyzer 24 × 7 and a Zeo, b expert c SleepExplorer scorings. The x-axes indicate the average from both the study standard and comparison scoring of wake after sleep onset and sleep onset latency. The difference is expressed as the comparison score minus the study standard score. The mean difference and the limits of agreement (±1.96 SD) are represented as dashed lines. Note that high variabilities are dominant for Zeo scorings
Fig. 2
Fig. 2
Scatter plots depicting the agreement of Somnolyzer 24 × 7 with Zeo for SOL, WASO and REM (top to bottom). Note that the SOL agreement for Zeo and study standard shows high deviations. Dots are scattered around the 45° line of identity
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