title: Assessment of the suitability of using a forehead EEG electrode set and chin EMG electrodes for sleep staging in polysomnography.
abstract: Recently, a number of portable devices designed for full polysomnography at home have appeared. However, current scalp electrodes used for electroencephalograms are not practical for patient self-application. The aim of this study was to evaluate the suitability of recently introduced forehead electroencephalogram electrode set and supplementary chin electromyogram electrodes for sleep staging. From 31 subjects (10 male, 21 female; age 31.3 ± 11.8 years), sleep was recorded simultaneously with a forehead electroencephalogram electrode set and with a standard polysomnography setup consisting of six recommended electroencephalogram channels, two electrooculogram channels and chin electromyogram. Thereafter, two experienced specialists scored each recording twice, based on either standard polysomnography or forehead recordings. Sleep variables recorded with the forehead electroencephalogram electrode set and separate chin electromyogram electrodes were highly consistent with those obtained with the standard polysomnography. There were no statistically significant differences in total sleep time, sleep efficiency or sleep latencies. However, compared with the standard polysomnography, there was a significant increase in the amount of stage N1 and N2, and a significant reduction in stage N3 and rapid eye movement sleep. Overall, epoch-by-epoch agreement between the methods was 79.5%. Inter-scorer agreement for the forehead electroencephalogram was only slightly lower than that for standard polysomnography (76.1% versus 83.2%). Forehead electroencephalogram electrode set as supplemented with chin electromyogram electrodes may serve as a reliable and simple solution for recording total sleep time, and may be adequate for measuring sleep architecture. Because this electrode concept is well suited for patient's self-application, it may offer a significant advancement in home polysomnography.
authors.affiliation: Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.|Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.|Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sami
authors.initials: S
authors.lastname: Myllymaa
authors.affiliation: Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Muraja-Murro
authors.affiliation: Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Susanna
authors.initials: S
authors.lastname: Westeren-Punnonen
authors.affiliation: Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Hukkanen
authors.affiliation: Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
authors.forename: Reijo
authors.initials: R
authors.lastname: Lappalainen
authors.affiliation: Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.|Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Mervaala
authors.affiliation: Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.|Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Töyräs
authors.affiliation: Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.|Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland.|Institute of Dentistry, University of Oulu, Oulu, Finland.|Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Sipilä
authors.affiliation: Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Katja
authors.initials: K
authors.lastname: Myllymaa
mesh_terms: D000328:Adult; D002680:Chin; D004566:Electrodes; D004569:Electroencephalography / Q000295:instrumentation*; D004576:Electromyography / Q000295:instrumentation*; D004585:Electrooculography / Q000295:instrumentation; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000295:instrumentation* / Q000379:methods*; D012894:Sleep Stages / Q000502:physiology*; D012895:Sleep, REM / Q000502:physiology; D013997:Time Factors
keywords: portable monitoring; screen-printed electrode; self-applicable sensor; sleep disorders; sleep scoring