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Naptics: Convenient and Continuous Blood Pressure Monitoring during Sleep

Published: 18 September 2018 Publication History

Abstract

Normal circadian rhythm mediates blood pressure during sleep, decreasing in value in healthy subjects. Current methods to monitor nocturnal blood pressure use an active blood pressure cuff that repeatedly auto-inflates while the subject sleeps. Since these inflations happen in intervals of thirty minutes to one hour, they cause considerable sleep disturbances that lead to false measurements and impact the person's quality of sleep. These blood pressure samples are also just spot checks and rarely exceed 10-15 values per night.
We present Naptics, a wearable device woven into shorts. Naptics passively monitors the wearer's blood pressure throughout the night---continuously and unobtrusively---without disturbing the user during sleep. Naptics detects the micro-vibrations of the wearer's body that stem from the heartbeat and senses the optical reflections from the pulse wave as it propagates down the wearer's leg. From the timing between these two events, Naptics computes the pulse transit time, which correlates strongly with the user's blood pressure.
Naptics' key novelty is its unobtrusive approach in tracking blood pressure during the night. Our controlled evaluation of six subjects showed a high correlation (r = 0.89) between Naptics' calibrated mean arterial pressure and cuff-based blood pressure. Our in-the-wild evaluation validates Naptics in tracking five participants' blood pressure patterns throughout four nights and compares them to before and after cuff measurements. In a majority of the nights, Naptics correctly followed the trend of the cuff measurements while providing insights into the behavior and the patterns of participants' nocturnal blood pressure. Participants reported high sleep quality in sleep diaries after each night, validating Naptics as a convenient monitoring apparatus.

References

[1]
Rajiv Agarwal, Jennifer E. Bills, Tyler J.W. Hecht, and Robert P. Light. 2011. Role of Home Blood Pressure Monitoring in Overcoming Therapeutic Inertia and Improving Hypertension Control. Hypertension 57, 1 (2011), 29--38.
[2]
Rajiv Agarwal and Robert Light. 2009. The Effect of Measuring Ambulatory Blood Pressure on Nighttime Sleep and Daytime Activity-Implications for Dipping. 5 (12 2009), 281--5.
[3]
John Allen. 2007. Photoplethysmography and its application in clinical physiological measurement. Physiological Measurement 28, 3 (2007), R1. http://stacks.iop.org/0967-3334/28/i=3/a=R01
[4]
A. Babchenko, E. Davidson, D. Adler, Y. Ginosar, V. Kurz, and M. Nitzan. 2000. Increase in pulse transit time to the foot after epidural anaesthesia treatment. Medical and Biological Engineering and Computing 38, 6 (01 Nov 2000), 674--679.
[5]
Lise Bankir, Murielle Bochud, Marc Maillard, Pascal Bovet, Anne Gabriel, and Michel Burnier. 2008. Nighttime Blood Pressure and Nocturnal Dipping Are Associated With Daytime Urinary Sodium Excretion in African Subjects. Hypertension 51, 4 (2008), 891--898.
[6]
Green BB, Cook AJ, Ralston JD, and et al. 2008. Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: A randomized controlled trial. JAMA 299, 24 (2008), 2857--2867.
[7]
Iddo Z. Ben-Dov, Jeremy D. Kark, Drori Ben-Ishay, Judith Mekler, Liora Ben-Arie, and Michael Bursztyn. 2007. Predictors of All-Cause Mortality in Clinical Ambulatory Monitoring. Hypertension 49, 6 (2007), 1235--1241.
[8]
José Boggia, Yan Li, Lutgarde Thijs, Tine W Hansen, Masahiro Kikuya, Kristina Björklund-Bodegård, Tom Richart, Takayoshi Ohkubo, Tatiana Kuznetsova, Christian Torp-Pedersen, Lars Lind, Hans Ibsen, Yutaka Imai, Jiguang Wang, Edgardo Sandoya, Eoin O'Brien, and Jan A Staessen. 2007. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. The Lancet 370, 9594 (2007), 1219 - 1229.
[9]
J. Crighton Bramwell and A. V. Hill. 1922. The Velocity of the Pulse Wave in Man. Proceedings of the Royal Society of London B: Biological Sciences 93, 652 (1922), 298--306.
[10]
Andrew M. Carek, Jordan Conant, Anirudh Joshi, Hyolim Kang, and Omer T. Inan. 2017. SeismoWatch: Wearable Cuffless Blood Pressure Monitoring Using Pulse Transit Time. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 1, 3, Article 40 (Sept. 2017), 16 pages.
[11]
Mary A Carskadon, William C Dement, et al. 2005. Normal human sleep: an overview. Principles and practice of sleep medicine 4 (2005), 13--23.
[12]
Yongjoon Chee, Jooman Han, Jaewoong Youn, and Kwangsuk Park. 2005. Air mattress sensor system with balancing tube for unconstrained measurement of respiration and heart beat movements. Physiological Measurement 26, 4 (2005), 413. http://stacks.iop.org/0967-3334/26/i=4/a=007
[13]
Byung Hun Choi, Gih Sung Chung, Jin-Seong Lee, Do-Un Jeong, and Kwang Suk Park. 2009. Slow-wave sleep estimation on a load-cell-installed bed: a non-constrained method. Physiological Measurement 30, 11 (2009), 1163. http://stacks.iop.org/0967-3334/30/i=11/a=002
[14]
Giorgio Coccagna and Elio Lugaresi. 1978. Arterial blood gases and pulmonary and systemic arterial pressure during sleep in chronic obstructive pulmonary disease. Sleep 1, 2 (1978), 117--124.
[15]
RJO Davies, NE Jenkins, and JR Stradling. 1994. Effect of measuring ambulatory blood pressure on sleep and on blood pressure during sleep. BMJ 308, 6932 (1994), 820--823.
[16]
R J O Davies, NE Jenkins, and J R Stradling. 1994. Effect of measuring ambulatory blood pressure on sleep and on blood pressure during sleep. BMJ 308, 6932 (1994), 820--823.
[17]
Artem Dementyev and Christian Holz. 2017. DualBlink: A Wearable Device to Continuously Detect, Track, and Actuate Blinking For Alleviating Dry Eyes and Computer Vision Syndrome. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 1, 1, Article 1 (March 2017), 19 pages.
[18]
Xiaorong Ding, Bryan P. Yan, Yuan-Ting Zhang, Jing Liu, Ni Zhao, and Hon Tsang. 2017. Pulse Transit Time Based Continuous Cuffless Blood Pressure Estimation: A New Extension and A Comprehensive Evaluation. 7 (12 2017).
[19]
Eugene C Fletcher and David C Levin. 1984. Cardiopulmonary hemodynamics during sleep in subjects with chronic obstructive pulmonary disease: the effect of short-and long-term oxygen. Chest 85, 1 (1984), 6--14.
[20]
N. R. Gaddum, J. Alastruey, P. Beerbaum, P. Chowienczyk, and T. Schaeffter. 2013. A Technical Assessment of Pulse Wave Velocity Algorithms Applied to Non-invasive Arterial Waveforms. Annals of Biomedical Engineering 41, 12 (01 Dec 2013), 2617--2629.
[21]
Mingwu Gao, N Bari Olivier, and Ramakrishna Mukkamala. 2016. Comparison of non-invasive pulse transit time estimates as markers of blood pressure using invasive pulse transit time measurements as a reference. Physiological reports 4, 10 (2016).
[22]
Alexandros S. Haralabidis, Konstantina Dimakopoulou, Federica Vigna-Taglianti, Matteo Giampaolo, Alessandro Borgini, Marie-Louise Dudley, Göran Pershagen, Gösta Bluhm, Danny Houthuijs, Wolfgang Babisch, Manolis Velonakis, Klea Katsouyanni, Lars Jarup, and 2008. Acute effects of night-time noise exposure on blood pressure in populations living near airports. European Heart Journal 29, 5 (2008), 658--664.
[23]
E Heude, P Bourgin, P Feigel, and P Escourrou. 1996. Ambulatory monitoring of blood pressure disturbs sleep and raises systolic pressure at night in patients suspected of suffering from sleep-disordered breathing. Clinical science 91, 1 (1996), 45--50.
[24]
Christian Holz and Edward J. Wang. 2017. Glabella: Continuously Sensing Blood Pressure Behavior Using an Unobtrusive Wearable Device. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 1, 3, Article 58 (Sept. 2017), 23 pages.
[25]
Christopher Idzikowski. 2003. Beating Insomnia: How to Get a Good Night's Sleep. Gill 8 Macmillan Ltd.
[26]
B P Imholz, G J Langewouters, G A van Montfrans, G Parati, J van Goudoever, K H Wesseling, W Wieling, and G Mancia. 1993. Feasibility of ambulatory, continuous 24-hour finger arterial pressure recording. Hypertension 21, 1 (1993), 65--73.
[27]
O. T. Inan, P. F. Migeotte, K. S. Park, M. Etemadi, K. Tavakolian, R. Casanella, J. Zanetti, J. Tank, I. Funtova, G. K. Prisk, and M. Di Rienzo. 2015. Ballistocardiography and Seismocardiography: A Review of Recent Advances. IEEE Journal of Biomedical and Health Informatics 19, 4 (July 2015), 1414--1427.
[28]
Staessen JA, Thijs L, Fagard R, and et al. 1999. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. JAMA 282, 6 (1999), 539--546.
[29]
Mehmet Kanbay, Faruk Turgut, Mehtap Erkmen Uyar, Ali Akcay, and Adrian Covic. 2008. Causes and Mechanisms of Nondipping Hypertension. Clinical and Experimental Hypertension 30, 7 (2008), 585--597. 18855262.
[30]
C. S. Kim, A. M. Carek, R. Mukkamala, O. T. Inan, and J. O. Hahn. 2015. Ballistocardiogram as Proximal Timing Reference for Pulse Transit Time Measurement: Potential for Cuffless Blood Pressure Monitoring. IEEE Transactions on Biomedical Engineering 62, 11 (Nov 2015), 2657--2664.
[31]
J. M. Kortelainen, M. O. Mendez, A. M. Bianchi, M. Matteucci, and S. Cerutti. 2010. Sleep Staging Based on Signals Acquired Through Bed Sensor. IEEE Transactions on Information Technology in Biomedicine 14, 3 (May 2010), 776--785.
[32]
Stephanie L.-O. Martin, Andrew M. Carek, Chang-Sei Kim, Hazar Ashouri, Omer Inan, Jin-Oh Hahn, and Ramakrishna Mukkamala. 2016. Weighing Scale-Based Pulse Transit Time is a Superior Marker of Blood Pressure than Conventional Pulse Arrival Time. 6 (12 2016), 39273.
[33]
Yan Li and Ji-Guang Wang. 2013. Isolated Nocturnal Hypertension. Hypertension 61, 2 (2013), 278--283.
[34]
WA Littler, AJ Honour, RD Carter, and P Sleight. 1975. Sleep and blood pressure. British Medical Journal 3, 5979 (August 1975), 346--348.
[35]
Jing Liu, Bryan Ping-Yen Yan, Wen-Xuan Dai, Xiao-Rong Ding, Yuan-Ting Zhang, and Ni Zhao. 2016. Multi-wavelength photoplethysmography method for skin arterial pulse extraction. Biomed. Opt. Express 7, 10 (Oct 2016), 4313--4326.
[36]
Timothy H. Monk, Charles F. Reynolds, David J. Kupfer, Daniel J. Buysse, Patricia A. Coble, Amy J. Hayes, Mary Ann Machen, Susan R. Petrie, and Angela M. Ritenour. 1994. The Pittsburgh Sleep Diary. Journal of Sleep Research 3, 2 (1994), 111--120.
[37]
Ramakrishna Mukkamala, Jin-Oh Hahn, Omer T Inan, Lalit Mestha, Chang-Sei Kim, Hakan Toreyin, and Snurvi Kyal. 2015. Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice. 62 (06 2015).
[38]
M Nitzan, B Khanokh, and Y Slovik. 2002. The difference in pulse transit time to the toe and finger measured by photoplethysmography. Physiological Measurement 23, 1 (2002), 85. http://stacks.iop.org/0967-3334/23/i=1/a=308
[39]
Eoin O'Brien, Roland Asmar, Lawrence Beilin, Yutaka Imai, Giuseppe Mancia, Thomas Mengden, Martin Myers, Paul Padfield, Paolo Palatini, Gianfranco Parati, Thomas Pickering, Josep Redon, Jan Staessen, George Stergiou, and Paolo Verdecchia. 2005. Practice Guidelines of the European Society of Hypertension for Clinic, Ambulatory, and Self Blood Pressure Measurement. 23 (05 2005), 697--701.
[40]
Eoin O'Brien, Neil Atkins, and Jan Staessen. 1995. State of the Market. Hypertension 26, 5 (1995), 835--842.
[41]
Eoin O'Brien, Gianfranco Parati, and George Stergiou. 2013. Ambulatory Blood Pressure Measurement. Hypertension 62, 6 (2013), 988--994.
[42]
J. Paalasmaa, M. Waris, H. Toivonen, L. Leppäkorpi, and M. Partinen. 2012. Unobtrusive online monitoring of sleep at home. In 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 3784--3788.
[43]
Gianfranco Parati, Juan Ochoa, Carolina Lombardi, and Grzegorz Bilo. 2013. Assessment and management of blood-pressure variability. 10 (03 2013), 143--55.
[44]
R. A. Payne, C. N. Symeonides, D. J. Webb, and S. R. J. Maxwell. 2006. Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure. Journal of Applied Physiology 100, 1 (2006), 136--141.
[45]
C. C. Y. Poon and Y. T. Zhang. 2005. Cuffless and Non-invasive Measurements of Arterial Blood Pressure by Pulse Transit Time. In 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. 5877--5880.
[46]
Philips Respironics. 2014. Actiwatch Spectrum. Website. (1 Jan 2014). Retrieved November 14, 2017 from http://www.actigraphy.respsironics.com/.
[47]
Eliot S Katz, Janita Lutz, Cheryl Black, and Carole L Marcus. 2003. Pulse Transit Time as a Measure of Arousal and Respiratory Effort in Children with Sleep-Disordered Breathing. 53 (04 2003), 580--8.
[48]
Roberto Sega, Rita Facchetti, Michele Bombelli, Giancarlo Cesana, Giovanni Corrao, Guido Grassi, and Giuseppe Mancia. 2005. Prognostic Value of Ambulatory and Home Blood Pressures Compared With Office Blood Pressure in the General Population. Circulation 111, 14 (2005), 1777--1783.
[49]
A. D. Wiens, A. Johnson, and O. T. Inan. 2017. Wearable Sensing of Cardiac Timing Intervals From Cardiogenic Limb Vibration Signals. IEEE Sensors Journal 17, 5 (March 2017), 1463--1470.
[50]
C. Yang and N. Tavassolian. 2017. Pulse Transit Time Measurement Using Seismocardiogram, Photoplethysmogram, and Acoustic Recordings: Evaluation and Comparison. IEEE Journal of Biomedical and Health Informatics PP, 99 (2017), 1--1.
[51]
Y. Zheng, B. P. Yan, Y. Zhang, C. M. Yu, and C. C. Y. Poon. 2013. Wearable cuffless PTT-based system for overnight blood pressure monitoring. In 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 6103--6106.

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cover image Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies
Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies  Volume 2, Issue 3
September 2018
1536 pages
EISSN:2474-9567
DOI:10.1145/3279953
Issue’s Table of Contents
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

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Publication History

Published: 18 September 2018
Accepted: 01 September 2018
Revised: 01 May 2018
Received: 01 November 2017
Published in IMWUT Volume 2, Issue 3

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Author Tags

  1. Blood pressure
  2. continuous physiological sensing
  3. nocturnal hypertension
  4. pulse transit time
  5. unobtrusive monitoring
  6. wearable device

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  • (2024)HearBP: Hear Your Blood Pressure via In-ear Acoustic Sensing Based on Heart SoundsIEEE INFOCOM 2024 - IEEE Conference on Computer Communications10.1109/INFOCOM52122.2024.10621249(991-1000)Online publication date: 20-May-2024
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