Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review
Nocturnal sympathetic overdrive is an early indicator of cardiovascular (CV) disease, emphasizing the importance of reliable remote patient monitoring (RPM) for autonomic function during sleep. To be effective, RPM systems must be accurate, non-intrusive, and cost-effective. This review evaluates no...
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MDPI AG
2024-10-01
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| author | Valerie A. A. van Es Ignace L. J. de Lathauwer Hareld M. C. Kemps Giacomo Handjaras Monica Betta |
| author_facet | Valerie A. A. van Es Ignace L. J. de Lathauwer Hareld M. C. Kemps Giacomo Handjaras Monica Betta |
| author_sort | Valerie A. A. van Es |
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| description | Nocturnal sympathetic overdrive is an early indicator of cardiovascular (CV) disease, emphasizing the importance of reliable remote patient monitoring (RPM) for autonomic function during sleep. To be effective, RPM systems must be accurate, non-intrusive, and cost-effective. This review evaluates non-invasive technologies, metrics, and algorithms for tracking nocturnal autonomic nervous system (ANS) activity, assessing their CV relevance and feasibility for integration into RPM systems. A systematic search identified 18 relevant studies from an initial pool of 169 publications, with data extracted on study design, population characteristics, technology types, and CV implications. Modalities reviewed include electrodes (e.g., electroencephalography (EEG), electrocardiography (ECG), polysomnography (PSG)), optical sensors (e.g., photoplethysmography (PPG), peripheral arterial tone (PAT)), ballistocardiography (BCG), cameras, radars, and accelerometers. Heart rate variability (HRV) and blood pressure (BP) emerged as the most promising metrics for RPM, offering a comprehensive view of ANS function and vascular health during sleep. While electrodes provide precise HRV data, they remain intrusive, whereas optical sensors such as PPG demonstrate potential for multimodal monitoring, including HRV, SpO2, and estimates of arterial stiffness and BP. Non-intrusive methods like BCG and cameras are promising for heart and respiratory rate estimation, but less suitable for continuous HRV monitoring. In conclusion, HRV and BP are the most viable metrics for RPM, with PPG-based systems offering significant promise for non-intrusive, continuous monitoring of multiple modalities. Further research is needed to enhance accuracy, feasibility, and validation against direct measures of autonomic function, such as microneurography. |
| format | Article |
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| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
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| series | Bioengineering |
| spelling | doaj-art-4a9de744a3c54dd29692bdfff0ddd9e02025-08-20T02:11:12ZengMDPI AGBioengineering2306-53542024-10-011110104510.3390/bioengineering11101045Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic ReviewValerie A. A. van Es0Ignace L. J. de Lathauwer1Hareld M. C. Kemps2Giacomo Handjaras3Monica Betta4MoMiLab Research Unit, IMT School for Advanced Studies Lucca, 55100 Lucca, ItalyDepartment of Cardiology, Máxima Medical Centre, 5504 DB Veldhoven, The NetherlandsDepartment of Cardiology, Máxima Medical Centre, 5504 DB Veldhoven, The NetherlandsMoMiLab Research Unit, IMT School for Advanced Studies Lucca, 55100 Lucca, ItalyMoMiLab Research Unit, IMT School for Advanced Studies Lucca, 55100 Lucca, ItalyNocturnal sympathetic overdrive is an early indicator of cardiovascular (CV) disease, emphasizing the importance of reliable remote patient monitoring (RPM) for autonomic function during sleep. To be effective, RPM systems must be accurate, non-intrusive, and cost-effective. This review evaluates non-invasive technologies, metrics, and algorithms for tracking nocturnal autonomic nervous system (ANS) activity, assessing their CV relevance and feasibility for integration into RPM systems. A systematic search identified 18 relevant studies from an initial pool of 169 publications, with data extracted on study design, population characteristics, technology types, and CV implications. Modalities reviewed include electrodes (e.g., electroencephalography (EEG), electrocardiography (ECG), polysomnography (PSG)), optical sensors (e.g., photoplethysmography (PPG), peripheral arterial tone (PAT)), ballistocardiography (BCG), cameras, radars, and accelerometers. Heart rate variability (HRV) and blood pressure (BP) emerged as the most promising metrics for RPM, offering a comprehensive view of ANS function and vascular health during sleep. While electrodes provide precise HRV data, they remain intrusive, whereas optical sensors such as PPG demonstrate potential for multimodal monitoring, including HRV, SpO2, and estimates of arterial stiffness and BP. Non-intrusive methods like BCG and cameras are promising for heart and respiratory rate estimation, but less suitable for continuous HRV monitoring. In conclusion, HRV and BP are the most viable metrics for RPM, with PPG-based systems offering significant promise for non-intrusive, continuous monitoring of multiple modalities. Further research is needed to enhance accuracy, feasibility, and validation against direct measures of autonomic function, such as microneurography.https://www.mdpi.com/2306-5354/11/10/1045remotepatient monitoringnocturnal sympathetic overdrivesleepcardiovascular riskautonomic nervous systemcardiovascular health technologies |
| spellingShingle | Valerie A. A. van Es Ignace L. J. de Lathauwer Hareld M. C. Kemps Giacomo Handjaras Monica Betta Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review Bioengineering remotepatient monitoring nocturnal sympathetic overdrive sleep cardiovascular risk autonomic nervous system cardiovascular health technologies |
| title | Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review |
| title_full | Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review |
| title_fullStr | Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review |
| title_full_unstemmed | Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review |
| title_short | Remote Monitoring of Sympathovagal Imbalance During Sleep and Its Implications in Cardiovascular Risk Assessment: A Systematic Review |
| title_sort | remote monitoring of sympathovagal imbalance during sleep and its implications in cardiovascular risk assessment a systematic review |
| topic | remotepatient monitoring nocturnal sympathetic overdrive sleep cardiovascular risk autonomic nervous system cardiovascular health technologies |
| url | https://www.mdpi.com/2306-5354/11/10/1045 |
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