A wearable, flexible sensor for real-time, home monitoring of sleep apnea

Innovative biosensing smart masks: unveiling the future of respiratory monitoring

Real-time monitoring of respiratory health is increasingly critical, particularly in addressing global health challenges such as Corona Virus Disease 2019 (COVID-19). Smart masks equipped with biosensing mechanisms revolutionize respiratory health monitoring by enabling real-time detection of respiratory parameters and biomarkers. In recent years, significant advancements have been achieved in the development of smart masks based on different sensor types with high sensitivity and accuracy, flexible functionality, and portability, providing new approaches for remote and real-time monitoring of respiratory parameters and biomarkers. In this review, we aim to provide a comprehensive overview of the current state of development and future potential of biosensing smart masks in various domains. This review outlines a systematic categorization of smart masks according to diverse sensing principles, classifying them into six categories: electrochemical sensors, optical sensors, piezoelectric sensors, and others. This review discusses the basic sensing principles and mechanisms of smart masks and describes the existing research developments of their different biosensors. Additionally, it explores the innovative applications of smart masks in health monitoring, protective functions, and expanding application scenarios. This review also identifies the current challenges faced by smart masks, including issues with sensor accuracy, environmental interference, and the need for better integration of multifunctional features. Proposed solutions to these challenges are discussed, along with the anticipated role of smart masks in early disease detection, personalized medicine, and environmental protection.

Flexible, wearable mechano-acoustic sensors for body sound monitoring applications

Body sounds serve as a valuable source of health information, offering insights into systems such as the cardiovascular, pulmonary, and gastrointestinal systems. Additionally, body sound measurements are easily accessible, fast, and non-invasive, which has led to their widespread use in clinical auscultation for diagnosing health conditions. However, conventional devices like stethoscopes are constrained by rigid and bulky designs, limiting their potential for long-term monitoring and often leading to subjective diagnoses. Recently, flexible, wearable mechano-acoustic sensors have emerged as an innovative alternative for body sound auscultation, offering significant advantages over conventional rigid devices. This review explores these advanced sensors, delving into their sensing mechanisms, materials, configurations, and fabrication techniques. Furthermore, it highlights various health monitoring applications of flexible, wearable mechano-acoustic sensors based on body sound auscultation. Finally, the existing challenges and promising opportunities are addressed, providing a snapshot of the current picture and the strategies of future approaches in this rapidly evolving field.

Next-Generation Chemiresistive Wearable Breath Sensors for Non-Invasive Healthcare Monitoring: Advances in Composite and Hybrid Materials

Recently wearable breath sensors have received significant attention in personalized healthcare systems by offering new methods for remote, non-invasive, and continuous monitoring of various health indicators from breath samples without disrupting daily routines. The rising demand for rapid, personalized diagnostics has sparked concerns over electronic waste from short-lived silicon-based devices. To address this issue, the development of flexible and wearable sensors for breath sensing applications is a promising approach. Research highlights the development of different flexible, wearable sensors operating with different operating principles, such as chemiresistive sensors to detect specific target analytes due to their simple design, high sensitivity, selectivity, and reliability. Further, focusing on the non-invasive detection of biomarkers through exhaled breath, chemiresistive wearable sensors offer a comprehensive and environmentally friendly solution. This article presents a comprehensive discussion of the recent advancement in chemiresistive wearable breath sensors for the non-invasive detection of breath biomarkers. The article further emphasizes the intricate development and functioning of the sensor, including the selection criteria for both the flexible substrate and advanced functional materials, including their sensing mechanisms. The review then explores the potential applications of wearable gas sensing systems with specific disease detection, with modern challenges associated with non-invasive breath sensors.

A deep learning-enabled smart garment for accurate and versatile monitoring of sleep conditions in daily life

In wearable smart systems, continuous monitoring and accurate classification of different sleep-related conditions are critical for enhancing sleep quality and preventing sleep-related chronic conditions. However, the requirements for device-skin coupling quality in electrophysiological sleep monitoring systems hinder the comfort and reliability of night wearing. Here, we report a washable, skin-compatible smart garment sleep monitoring system that captures local skin strain signals under weak device-skin coupling conditions without positioning or skin preparation requirements. A printed textile-based strain sensor array responds to strain from 0.1 to 10% with a gauge factor as high as 100 and shows independence to extrinsic motion artifacts via strain-isolating printed pattern design. Through reversible starching treatment, ink penetration depth during direct printing on garments is controlled to achieve batch-to-batch performance variation <10%. Coupled with deep learning, explainable AI, and transfer learning data processing, the smart garment is capable of classifying six sleep states with an accuracy of 98.6%, maintaining excellent explainability (classification with low bias) and generalization (95% accuracy on new users with few-shot learning less than 15 samples per class) in practical applications, paving the way for next-generation daily sleep healthcare management.

Transforming Sleep Monitoring: Review of Wearable and Remote Devices Advancing Home Polysomnography and Their Role in Predicting Neurological Disorders

This paper explores the progressive era of sleep monitoring, focusing on wearable and remote devices contributing to advances in the concept of home polysomnography. We begin by exploring the basic physiology of sleep, establishing a theoretical basis for understanding sleep stages and associated changes in physiological variables. The review then moves on to an analysis of specific cutting-edge devices and technologies, with an emphasis on their practical applications, user comfort, and accuracy. Attention is also given to the ability of these devices to predict neurological disorders, particularly Alzheimer's and Parkinson's disease. The paper highlights the integration of hardware innovations, targeted sleep parameters, and partially advanced algorithms, illustrating how these elements converge to provide reliable sleep health information. By bridging the gap between clinical diagnosis and real-world applicability, this review aims to elucidate the role of modern sleep monitoring tools in improving personalised healthcare and proactive disease management.

HfO2 Memristor-Based Flexible Radio Frequency Switches

Flexible and wearable electronics are experiencing rapid growth due to the increasing demand for multifunctional, lightweight, and portable devices. However, the growing demands of interactive applications driven by the rise of AI reveal the inadequate connectivity of current connection technologies. In this work, we successfully leverage memristive technology to develop a flexible radio frequency (RF) switch, optimized for 6G-compatible communication systems and adaptable to flexible applications. The flexible RF switch demonstrates a low insertion loss (2 dB) and a cutoff frequency exceeding 840 GHz, and performance metrics are maintained after 106 switching cycles and 2500 mechanical bending cycles, showing excellent reliability and robustness. Furthermore, the RF switch is fully integrable with a photolithography-processable polyimide (PSPI) substrate, enabling efficient 2.5D integration with other RF components, such as RF antennas and interconnects. This technology holds significant promise to advance 6G communications in flexible electronics, offering a scalable solution for high-speed data transmission in next-generation wearable devices.

Low-impedance tissue-device interface using homogeneously conductive hydrogels chemically bonded to stretchable bioelectronics

Stretchable bioelectronics has notably contributed to the advancement of continuous health monitoring and point-of-care type health care. However, microscale nonconformal contact and locally dehydrated interface limit performance, especially in dynamic environments. Therefore, hydrogels can be a promising interfacial material for the stretchable bioelectronics due to their unique advantages including tissue-like softness, water-rich property, and biocompatibility. However, there are still practical challenges in terms of their electrical performance, material homogeneity, and monolithic integration with stretchable devices. Here, we report the synthesis of a homogeneously conductive polyacrylamide hydrogel with an exceptionally low impedance (~21 ohms) and a reasonably high conductivity (~24 S/cm) by incorporating polyaniline-decorated poly(3,4-ethylenedioxythiophene:polystyrene). We also establish robust adhesion (interfacial toughness: ~296.7 J/m2) and reliable integration between the conductive hydrogel and the stretchable device through on-device polymerization as well as covalent and hydrogen bonding. These strategies enable the fabrication of a stretchable multichannel sensor array for the high-quality on-skin impedance and pH measurements under in vitro and in vivo circumstances.

Crosstalk-free graphene-liquid elastomer based printed sensors for unobtrusive respiratory monitoring

Flexible strain sensors have garnered attraction in the human healthcare domain. However, caveats like crosstalk and noise associated with the output signal of such a sensor often limit the accuracy. Hence, developing a strain sensor via frugal engineering is critical, thereby warranting its mass utility. A stencil printable graphene/liquid elastomeric crosstalk-free strain sensor for unobtrusive respiratory monitoring is reported herein. Printing supports the frugality of the process and avoids complex fabrication. The sensor was mounted on a wearable mask, and the sensor console was fabricated. The console demonstrated the capability to detect the respiratory profile at room and low temperature (-26 °C) with an SNR of -12.85 dB. Developed sensors could nullify the impact of temperature and humidity and generate respiratory signals due to strain induced by breathing. A model experiment was conducted to support the fidelity of the strain mechanism. The console demonstrated excellent stability (over 500 cycles) with a sensitivity of -196.56 (0-0.17% strain) and 117.49 (0.17-0.34% strain). The console could accurately determine conditions like eupnea, tachypnoea, etc., and transmit the data wirelessly via Bluetooth. These findings solve major caveats in flexible sensor development by focusing on selectivity, sensitivity, and stability.

Future Thread: Printing Electronics on Fibers

This article introduces a methodology to increase the integration density of functional electronic features on fibers/threads/wires through additive deposition of functional materials via printed electronics. It opens the possibility to create a multifunctional intelligent system on a single fiber/thread/wire while combining the advantages of existing approaches, i.e., the scalability of coating techniques and the microfeatures of semiconductor-based fabrication. By directly printing on threads (of diameters ranging from 90 to 1000 μm), micropatterned electronic devices and multifunctional electronic systems could be formed. Contact and noncontact printing methods were utilized to create various shapes from serpentines and meanders to planar coils and interdigitated electrodes, as well as complex multilayer structures for thermal and light actuators, humidity, and temperature sensors. We demonstrate the practicality of the method by integrating a multifunctional thread into a FFP mask for breath monitoring. Printing technologies provide virtually unrestricted choices for the types of threads, materials, and devices used. They are scalable via roll-to-roll processes and offer a resource-efficient way to democratize electronics across textile products.

Advances in Respiratory Monitoring: A Comprehensive Review of Wearable and Remote Technologies

This article explores the importance of wearable and remote technologies in healthcare. The focus highlights its potential in continuous monitoring, examines the specificity of the issue, and offers a view of proactive healthcare. Our research describes a wide range of device types and scientific methodologies, starting from traditional chest belts to their modern alternatives and cutting-edge bioamplifiers that distinguish breathing from chest impedance variations. We also investigated innovative technologies such as the monitoring of thorax micromovements based on the principles of seismocardiography, ballistocardiography, remote camera recordings, deployment of integrated optical fibers, or extraction of respiration from cardiovascular variables. Our review is extended to include acoustic methods and breath and blood gas analysis, providing a comprehensive overview of different approaches to respiratory monitoring. The topic of monitoring respiration with wearable and remote electronics is currently the center of attention of researchers, which is also reflected by the growing number of publications. In our manuscript, we offer an overview of the most interesting ones.

Reliable and Scalable Piezoresistive Sensors with an MXene/MoS2 Hierarchical Nanostructure for Health Signals Monitoring

The increased popularity of wearable electronic devices has led to a greater need for advanced sensors. However, fabricating pressure sensors that are flexible, highly sensitive, robust, and compatible with large-scale fabrication technology is challenging. This work investigates a piezoresistive sensor constructed from an MXene/MoS2 hierarchical nanostructure, which is obtained through an easy and inexpensive fabrication process. The sensor exhibits a high sensitivity of 0.42 kPa-1 (0-1.5 kPa), rapid response (∼36 ms), and remarkable mechanical durability (∼10,000 cycles at 13 kPa). The sensor has been demonstrated to be successful in detecting human motion, speech recognition, and physiological signals, particularly in analyzing human pulse. These data can be used to alert and identify irregularities in human health. Additionally, the sensing units are able to construct sensor arrays of various sizes and configurations, enabling pressure distribution imaging in a variety of application scenarios. This research proposes a cost-effective and scalable approach to fabricating piezoresistive sensors and sensor arrays, which can be utilized for monitoring human health and for use in human-machine interfaces.

Wearable Sensors for Respiration Monitoring: A Review

This paper provides an overview of flexible and wearable respiration sensors with emphasis on their significance in healthcare applications. The paper classifies these sensors based on their operating frequency distinguishing between high-frequency sensors, which operate above 10 MHz, and low-frequency sensors, which operate below this level. The operating principles of breathing sensors as well as the materials and fabrication techniques employed in their design are addressed. The existing research highlights the need for robust and flexible materials to enable the development of reliable and comfortable sensors. Finally, the paper presents potential research directions and proposes research challenges in the field of flexible and wearable respiration sensors. By identifying emerging trends and gaps in knowledge, this review can encourage further advancements and innovation in the rapidly evolving domain of flexible and wearable sensors.

Biomedical Applications of Electrets: Recent Advance and Future Perspectives

Recently, electrical stimulation, as a non-pharmacological physical stimulus, has been widely exploited in biomedical and clinical applications due to its ability to significantly enhance cell proliferation and differentiation. As a kind of dielectric material with permanent polarization characteristics, electrets have demonstrated tremendous potential in this field owing to their merits of low cost, stable performance, and excellent biocompatibility. This review provides a comprehensive summary of the recent advances in electrets and their biomedical applications. We first provide a brief introduction to the development of electrets, as well as typical materials and fabrication methods. Subsequently, we systematically describe the recent advances of electrets in biomedical applications, including bone regeneration, wound healing, nerve regeneration, drug delivery, and wearable electronics. Finally, the present challenges and opportunities have also been discussed in this emerging field. This review is anticipated to provide state-of-the-art insights on the electrical stimulation-related applications of electrets.

Novel SMD Component and Module Interconnection and Encapsulation Technique for Textile Substrates Using 3D Printed Polymer Materials

Nowadays, a range of sensors and actuators can be realized directly in the structure of textile substrates using metal-plated yarns, metal-filament yarns, or functionalized yarns with nanomaterials, such as nanowires, nanoparticles, or carbon materials. However, the evaluation or control circuits still depend upon the use of semiconductor components or integrated circuits, which cannot be currently implemented directly into the textiles or substituted by functionalized yarns. This study is focused on a novel thermo-compression interconnection technique intended for the realization of the electrical interconnection of SMD components or modules with textile substrates and their encapsulation in one single production step using commonly widespread cost-effective devices, such as 3D printers and heat-press machines, intended for textile applications. The realized specimens are characterized by low resistance (median 21 mΩ), linear voltage-current characteristics, and fluid-resistant encapsulation. The contact area is comprehensively analyzed and compared with the theoretical Holm's model.

Liquid metal integrated PU/CNT fibrous membrane for human health monitoring

Wearable flexible sensors are widely used in several applications such as physiological monitoring, electronic skin, and telemedicine. Typically, flexible sensors that are made of elastomeric thin-films lack sufficient permeability, which leads to skin inflammation, and more importantly, affects signal detection and consequently, reduces the sensitivity of the sensor. In this study, we designed a flexible nanofibrous membrane with a high air permeability (6.10 mm/s), which could be effectively used to monitor human motion signals and physiological signals. More specifically, a flexible membrane with a point (liquid metal nanoparticles)-line (carbon nanotubes)-plane (liquid metal thin-film) multiscale conductive structure was fabricated by combining liquid metal (LM) and carbon nanotubes (CNTs) with a polyurethane (PU) nanofibrous membrane. Interestingly, the excellent conductivity and fluidity of the liquid metal enhanced the sensitivity and stability of the membrane. More precisely, the gauge factor (GF) values of the membrane is 3.0 at 50% strain and 14.0 at 400% strain, which corresponds to a high strain sensitivity within the whole range of deformation. Additionally, the proposed membrane has good mechanical properties with an elongation at a break of 490% and a tensile strength of 12 MPa. Furthermore, the flexible membrane exhibits good biocompatibility and can efficiently monitor human health signals, thereby indicating potential for application in the field of wearable electronic devices.

SnO2-Based Ultra-Flexible Humidity/Respiratory Sensor for Analysis of Human Breath

Developing ultraflexible sensors using metal oxides is challenging due to the high-temperature annealing step in the fabrication process. Here, we demonstrate the ultraflexible relative humidity (RH) sensor on food plastic wrap by using 808 nm near-infrared (NIR) laser annealing for 1 min at a low temperature (26.2-40.8 °C). The wettability of plastic wraps coated with sol-gel solution is modulated to obtain uniform films. The surface morphology, local temperature, and electrical properties of the SnO₂ resistor under NIR laser irradiation with a power of 16, 33, and 84 W/cm² are investigated. The optimal device can detect wide-range RH from 15% to 70% with small incremental changes (0.1-2.2%). X-ray photoelectron spectroscopy reveals the relation between the surface binding condition and sensing response. Finally, the proposed sensor is attached onto the face mask to analyze the real-time human breath pattern in slow, normal, and fast modes, showing potential in wearable electronics or respiration monitoring.

Environmental Benefits of Sleep Apnoea Detection in the Home Environment

Sleep Apnoea (SA) is a common chronic illness that affects nearly 1 billion people around the world, and the number of patients is rising. SA causes a wide range of psychological and physiological ailments that have detrimental effects on a patient’s wellbeing. The high prevalence and negative health effects make SA a public health problem. Whilst the current gold standard diagnostic procedure, polysomnography (PSG), is reliable, it is resource-expensive and can have a negative impact on sleep quality, as well as the environment. With this study, we focus on the environmental impact that arises from resource utilisation during SA detection, and we propose remote monitoring (RM) as a potential solution that can improve the resource efficiency and reduce travel. By reusing infrastructure technology, such as mobile communication, cloud computing, and artificial intelligence (AI), RM establishes SA detection and diagnosis support services in the home environment. However, there are considerable barriers to a widespread adoption of this technology. To gain a better understanding of the available technology and its associated strength, as well as weaknesses, we reviewed scientific papers that used various strategies for RM-based SA detection. Our review focused on 113 studies that were conducted between 2018 and 2022 and that were listed in Google Scholar. We found that just over 50% of the proposed RM systems incorporated real time signal processing and around 20% of the studies did not report on this important aspect. From an environmental perspective, this is a significant shortcoming, because 30% of the studies were based on measurement devices that must travel whenever the internal buffer is full. The environmental impact of that travel might constitute an additional need for changing from offline to online SA detection in the home environment.