WO2009074955A1 - Sleep position detection - Google Patents

Sleep position detection Download PDF

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Publication number
WO2009074955A1
WO2009074955A1 PCT/IB2008/055164 IB2008055164W WO2009074955A1 WO 2009074955 A1 WO2009074955 A1 WO 2009074955A1 IB 2008055164 W IB2008055164 W IB 2008055164W WO 2009074955 A1 WO2009074955 A1 WO 2009074955A1
Authority
WO
WIPO (PCT)
Prior art keywords
sensors
electrocardiogram
electrocardiogram signal
body position
bed
Prior art date
Application number
PCT/IB2008/055164
Other languages
French (fr)
Inventor
Mohammed Meftah
Andreas Brauers
Original Assignee
Koninklijke Philips Electronics N.V.
Philips Intellectual Property & Standards Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Koninklijke Philips Electronics N.V., Philips Intellectual Property & Standards Gmbh filed Critical Koninklijke Philips Electronics N.V.
Priority to CN2008801201443A priority Critical patent/CN101896120B/en
Priority to EP08860136A priority patent/EP2229101B1/en
Priority to US12/747,176 priority patent/US9649043B2/en
Publication of WO2009074955A1 publication Critical patent/WO2009074955A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/282—Holders for multiple electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1113—Local tracking of patients, e.g. in a hospital or private home
    • A61B5/1114—Tracking parts of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1116—Determining posture transitions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/339—Displays specially adapted therefor
    • A61B5/341—Vectorcardiography [VCG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6887—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient mounted on external non-worn devices, e.g. non-medical devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6887—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient mounted on external non-worn devices, e.g. non-medical devices
    • A61B5/6892—Mats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/04—Arrangements of multiple sensors of the same type
    • A61B2562/046—Arrangements of multiple sensors of the same type in a matrix array

Definitions

  • the invention relates to a method and apparatus for measuring body position.
  • sleep disorder is a very widespread phenomenon. About 40% of American adults suffer from some kind of sleep disorder while about 70 million Americans are chronically sleep deprived (source: www.snorenet.com/education statistics. htm). Accordingly, measurement of sleeping quality and sleep disturbances is required. As well as vital parameters such as heart rate, respiration rate and body temperature, body position is an important parameter in such measurements. The measurement of body position can also be important to detect changes in body position where this is needed for medical reasons, for example for people who are at risk of developing a decubitus sore or ulcer.
  • ECG electrocardiogram
  • the inventors have realized that by measuring the ECG traces with a plurality of sensors arranged in a position not fixed with respect to the body but fixed with respect to a support the sensors can use the variation in the body surface potential caused by the electrical activity of the heart at different positions on the body to measure the body position.
  • prior art sensors attached to the body measure the body surface potential at constant locations on the body.
  • the variation of ECG signal over the body means that the use of sensors fixed with respect to the support results in much greater differences in ECG traces as the body moves than using sensors attached to the body.
  • the sensors are capacitive sensors which do not need to be in direct contact with the skin. This enables conventional nightwear to be worn.
  • the sensors may be arranged in an array across the body support. This allows measurements to be taken with the body in different positions above different sensors in the array.
  • Fig. 1 shows a first embodiment of the invention
  • Fig. 2 shows a plurality of body positions
  • Fig. 3 shows a results measured in the plurality of body positions; and Fig. 4 shows an alternative embodiment of the invention.
  • the Figs, are schematic and not to scale.
  • apparatus includes a bed 10 with a mattress acting as a body support 121 having an upper sleeping surface 14, which acts in use as a body support.
  • a plurality of sensors 18 are arranged as an array 16 over the upper sleeping surface 14.
  • the sensors are connected to processor 30 which in turn is connected to memory 32 including code 34 for carrying out the method as set out below.
  • the sensors 18 are capacitive sensors of the type described in WO 2007/060609 (Philips). Such sensors are able to detect electrocardiogram signals without being in physical contact with the patient, leading to the distinct advantage that the patient can wear normal clothing, pyjamas, in bed.
  • a capacitively coupled return path may be used, for example capacitive plate 19 at the foot of the bed. This is used to reject common mode interference, especially at mains electricity frequencies (50Hz/60Hz).
  • Fig. 2 illustrates four sleeping positions of a patient, lying over four sensors 18.
  • these sensors are labeled Tl, T2, Bl and B2. It will be appreciated that these represent the four sensors on the upper surface over which a patient happens to be lying.
  • the four positions are prone (lying on the front), supine (lying on the back), right side (lying facing the right side) and left side (lying facing the left side). Note that in the latter two positions the patient is only lying on two sensors, Tl and Bl, in view of the smaller area of contact with the upper sleeping surface in these positions.
  • the body surface potential mapping of the electrical activity of the heart is the mapping of potential over the body.
  • the sensors fixed at known locations measure this potential and so give a measure of the body orientation.
  • sensors attached to the patient always pick up the body surface potential from the same point on the body. This would give much smaller changes with different body position.
  • the polarity of the QRS complex gives significant data. In the case that this is positive (see the right side data measured between sensors Tl and Bl), this indicates that the electrical axis of the heart is parallel to the line of sensors Tl to Bl. In contrast, if the polarity is negative (see the left side data measured between sensors Tl and Bl) this indicates that the electrical axis of the heart is antiparallel to the line of sensors Tl to Bl.
  • the electrical axis of the heart is roughly perpendicular to the line of sensors (here Bl to T2).
  • calibration measurements can be obtained by a calibration procedure, which may be done at regular intervals or at user demand. During such a calibration procedure the user is asked to lie in the four different positions, and the measured signals are recorded for each position as calibration signals.
  • the measured signals are analyzed for similarity to the calibration signals and the closest match used to determine body position.
  • the alternative approach is to use the identification of the polarity of the QRS complex from at least one and preferably more pairs of sensors. This can then be used to determine the angle of the electrical axis of the heart depending on this polarity, and hence obtain a measure of the user's position.
  • both of these approaches are used by the processor to obtain an estimate of the sleeping position.
  • only one or the other might be used.
  • the sleep position can be determined without the need for additional electronics, mechanics and alike, since it is being extracted from the ECG signal. Moreover, the comfort for the patient is not impaired by additional electrodes attached to the patient.
  • the use of more than two sensors allows for the apparatus to measure body position even if the body is not located over a particular pair of sensors.
  • information regarding which sensors are able to detect ECG measurements may be combined with the orientation information to determine body position.
  • the sensors used are electrically conductive electrodes integrated in a bed sheet as a conductive textile electrode array 40 (Fig. 4).
  • a foot region 42 of conductive textile serves as a ground plate meant for the reduction of common-mode interference.
  • a conductive pillow 44 may be used as the return path for electricity, or a conventional leg electrode.
  • the conductive electrodes need to be in electrical contact with the patient during measurement so that the patient should sleep with a naked trunk, and not in pyjamas.
  • the sensors need not be arranged in a bed but in another kind of body support, such as a chair for example.
  • the body support could simply be the floor of a room or fixed to the floor of the room and the sensors could be fixed in the room.
  • the sensors need not be fixed to the body support but simply fixed in position with respect to that support, for example by being fixed to a frame or cover.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Physiology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

A method of determining body position uses ECG sensors at fixed positions, not fixed to the patient. The ECG signals recorded from the sensors are used to detect body position, using the variation of ECG potential over the surface of the body. The results may be processed by measuring artefacts related to the angle between the sensors and the heart, in particular the polarity of the QRS complex. The sensors may be fixed on the upper surface of a bed and used to measure sleep position.

Description

Sleep position detection
FIELD OF THE INVENTION
The invention relates to a method and apparatus for measuring body position.
BACKGROUND OF THE INVENTION There has been an increasing interest in the monitoring of various vital body signs for a number of reasons.
There is an interest in monitoring the position of the human body for a number of reasons.
A particular issue is sleep disorder. Sleep disorder is a very widespread phenomenon. About 40% of American adults suffer from some kind of sleep disorder while about 70 million Americans are chronically sleep deprived (source: www.snorenet.com/education statistics. htm). Accordingly, measurement of sleeping quality and sleep disturbances is required. As well as vital parameters such as heart rate, respiration rate and body temperature, body position is an important parameter in such measurements. The measurement of body position can also be important to detect changes in body position where this is needed for medical reasons, for example for people who are at risk of developing a decubitus sore or ulcer.
It is further beneficial if the measurement of body position should be unobtrusive. Sensors should in particular be unobtrusive, unrestrictive and comfortable for the user.
A particular system for detecting changes in body posture using an electrocardiogram (ECG) is described in US 5,865,760. The ECG is analyzed to detect artefacts caused by changes in body posture.
SUMMARY OF THE INVENTION
According to the invention there is provided sleep position detection apparatus according to claim 1.
The inventors have realized that by measuring the ECG traces with a plurality of sensors arranged in a position not fixed with respect to the body but fixed with respect to a support the sensors can use the variation in the body surface potential caused by the electrical activity of the heart at different positions on the body to measure the body position. In contrast, prior art sensors attached to the body measure the body surface potential at constant locations on the body. The variation of ECG signal over the body means that the use of sensors fixed with respect to the support results in much greater differences in ECG traces as the body moves than using sensors attached to the body.
Preferably, the sensors are capacitive sensors which do not need to be in direct contact with the skin. This enables conventional nightwear to be worn.
The sensors may be arranged in an array across the body support. This allows measurements to be taken with the body in different positions above different sensors in the array.
In another aspect, there is provided a method of measuring body position according to claim 9.
BRIEF DESCRIPTION OF THE DRAWINGS
For a better understanding of the invention, embodiments will now be described, purely by way of example, with reference to the accompanying drawings, in which:
Fig. 1 shows a first embodiment of the invention; Fig. 2 shows a plurality of body positions;
Fig. 3 shows a results measured in the plurality of body positions; and Fig. 4 shows an alternative embodiment of the invention. The Figs, are schematic and not to scale.
DETAILED DESCRIPTION OF THE EMBODIMENTS
Referring to Fig. 1, apparatus according to an embodiment of the invention includes a bed 10 with a mattress acting as a body support 121 having an upper sleeping surface 14, which acts in use as a body support.
A plurality of sensors 18 are arranged as an array 16 over the upper sleeping surface 14. The sensors are connected to processor 30 which in turn is connected to memory 32 including code 34 for carrying out the method as set out below.
The sensors 18 are capacitive sensors of the type described in WO 2007/060609 (Philips). Such sensors are able to detect electrocardiogram signals without being in physical contact with the patient, leading to the distinct advantage that the patient can wear normal clothing, pyjamas, in bed.
Note that a capacitively coupled return path may be used, for example capacitive plate 19 at the foot of the bed. This is used to reject common mode interference, especially at mains electricity frequencies (50Hz/60Hz).
Fig. 2 illustrates four sleeping positions of a patient, lying over four sensors 18. In Fig. 2, these sensors are labeled Tl, T2, Bl and B2. It will be appreciated that these represent the four sensors on the upper surface over which a patient happens to be lying. The four positions are prone (lying on the front), supine (lying on the back), right side (lying facing the right side) and left side (lying facing the left side). Note that in the latter two positions the patient is only lying on two sensors, Tl and Bl, in view of the smaller area of contact with the upper sleeping surface in these positions.
The different body positions lead to clearly different waveforms as shown in Fig. 3. For the two positions in which only the Tl and Bl sensors are covered by the patient, only the ECG measurement between these two sensors is recorded; for the other two positions, four measurements are recorded.
The body surface potential mapping of the electrical activity of the heart is the mapping of potential over the body. The sensors fixed at known locations measure this potential and so give a measure of the body orientation. In contrast, sensors attached to the patient always pick up the body surface potential from the same point on the body. This would give much smaller changes with different body position.
In particular, note that the polarity of the QRS complex gives significant data. In the case that this is positive (see the right side data measured between sensors Tl and Bl), this indicates that the electrical axis of the heart is parallel to the line of sensors Tl to Bl. In contrast, if the polarity is negative (see the left side data measured between sensors Tl and Bl) this indicates that the electrical axis of the heart is antiparallel to the line of sensors Tl to Bl.
If the polarity is zero, or if the positive branch of the QRS complex is roughly the size of the negative branch of the QRS complex (see for example the measurement prone B1-T2), then the electrical axis of the heart is roughly perpendicular to the line of sensors (here Bl to T2).
In order to automatically determine the position, the effects of variation in the measured waveform due to interpersonal variation or changes in the health status of the person must be taken into account. In the embodiment, two different approaches are taken to determining body position. Both of these are used in tandem to determine the position.
Firstly, calibration measurements can be obtained by a calibration procedure, which may be done at regular intervals or at user demand. During such a calibration procedure the user is asked to lie in the four different positions, and the measured signals are recorded for each position as calibration signals.
Then, in use, the measured signals are analyzed for similarity to the calibration signals and the closest match used to determine body position.
The alternative approach is to use the identification of the polarity of the QRS complex from at least one and preferably more pairs of sensors. This can then be used to determine the angle of the electrical axis of the heart depending on this polarity, and hence obtain a measure of the user's position.
In the embodiment described, both of these approaches are used by the processor to obtain an estimate of the sleeping position. However, in alternative embodiments, only one or the other might be used.
The sleep position can be determined without the need for additional electronics, mechanics and alike, since it is being extracted from the ECG signal. Moreover, the comfort for the patient is not impaired by additional electrodes attached to the patient.
Note that the use of more than two sensors allows for the apparatus to measure body position even if the body is not located over a particular pair of sensors. In embodiments, information regarding which sensors are able to detect ECG measurements may be combined with the orientation information to determine body position.
In an alternative embodiment, the sensors used are electrically conductive electrodes integrated in a bed sheet as a conductive textile electrode array 40 (Fig. 4). In this case, a foot region 42 of conductive textile serves as a ground plate meant for the reduction of common-mode interference. Alternatively, a conductive pillow 44 may be used as the return path for electricity, or a conventional leg electrode.
In this case, the conductive electrodes need to be in electrical contact with the patient during measurement so that the patient should sleep with a naked trunk, and not in pyjamas.
Further, the sensors need not be arranged in a bed but in another kind of body support, such as a chair for example. Alternatively, the body support could simply be the floor of a room or fixed to the floor of the room and the sensors could be fixed in the room. The sensors need not be fixed to the body support but simply fixed in position with respect to that support, for example by being fixed to a frame or cover.
Although the above description relates to the human body a similar approach can be used for measuring the body position of animals, especially mammals.

Claims

CLAIMS:
1. Apparatus for measuring body position, comprising at least two bio metric sensors (18) arranged in a fixed position with respect to a body support (12), for measuring at least one electrocardiogram signal from a body, wherein the at least one electrocardiogram signal changes with body position as a result of the variation of electrocardiogram potential over the surface of the body; and a processing means (30) arranged to capture at least one electrocardiogram signal from the sensors (18), and to determine the body position from the captured at least one electrocardiogram signal using the variation of electrocardiogram potential over the surface of the body.
2. Apparatus according to claim 1, wherein a plurality of the bio metric sensors (18) are arranged in an array (16) distributed across the bed (10).
3. Apparatus according to claim 1 or 2, comprising: a bed (10), wherein the bed (12) comprises the body support (12) and the biometric sensors (18) are arranged fixed in the bed (10).
4. Apparatus according to claim 3, wherein the biometric sensors (18) are arranged on an upper sleeping surface (14) of the bed (10).
5. Apparatus according to any preceding claim wherein the processing means (30) is arranged to capture a plurality of electrocardiogram signals measured from a respective plurality of the biometric sensors and to determine the body position from the plurality of electrocardiogram signals.
6. Apparatus according to any preceding claim, wherein the processing means (30) is adapted to determine the polarity of the QRS complex of the electrocardiogram signal or signals to determine the orientation of the heart with respect to the respective pair of sensors.
7. Apparatus according to any preceding claim wherein the processing means (30) is adapted to compare the QRS complex of the electrocardiogram signal or signals with a plurality of prerecorded electrocardiogram signals in respective body positions and to identify the closest match.
8. Apparatus according to any preceding claim wherein the sensors (18) are capacitive electrodes.
9. Apparatus according to any of claims 1 to 7 wherein the electrocardiogram sensors are contact electrodes (40), the apparatus further comprising a conductive foot contact (42) and/or conductive pillow (44) on the upper surface (14) of the bed to serve as a return path for electrical current.
10. A method of measuring body position, comprising : supporting the body on a body support (14) having electrocardiogram sensors (18) fixed with respect to the body support; capturing at least one electrocardiogram signal from respective electrocardiogram sensors (18), the at least one electrocardiogram signal changing with body position as a result of the variation of electrocardiogram potential over the surface of the body; and determining the body position from the at least one electrocardiogram signal using the variation of electrocardiogram potential over the surface of the body.
11. A method according to claim 10, wherein the step of determining the body position from the at least one electrocardiogram signal includes determining the polarity of the QRS complex of the at least one electrocardiogram signal.
12. A method according to claim 11 wherein the step of determining the body position from the at least one electrocardiogram signal includes determining the angle between the electrical axis of the heart and the orientation of the respective pair of biometric sensors from the polarity of the QRS complex.
13. A method according to claim 11 or 12, wherein the step of determining the body position from the at least one electrocardiogram signal compares the QRS complex of each electrocardiogram signal with a plurality of prerecorded electrocardiogram signals in respective body positions and identifies the closest match.
14. A method according to any of claims 10 to 13 wherein the sensors are arranged as an array over the surface of a bed and the step of measuring body position determines which sensors of the array can detect an electrocardiogram signal and measures the body position from the electrocardiogram signals from those sensors.
PCT/IB2008/055164 2007-12-12 2008-12-09 Sleep position detection WO2009074955A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CN2008801201443A CN101896120B (en) 2007-12-12 2008-12-09 Sleep position detection
EP08860136A EP2229101B1 (en) 2007-12-12 2008-12-09 Sleep position detection
US12/747,176 US9649043B2 (en) 2007-12-12 2008-12-09 Sleep position detection

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EP07122981.9 2007-12-12
EP07122981 2007-12-12

Publications (1)

Publication Number Publication Date
WO2009074955A1 true WO2009074955A1 (en) 2009-06-18

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Country Status (4)

Country Link
US (1) US9649043B2 (en)
EP (1) EP2229101B1 (en)
CN (1) CN101896120B (en)
WO (1) WO2009074955A1 (en)

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US9649043B2 (en) 2017-05-16
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