ArticleBioelectronic medicine2026
A novel, wearable, in-ear EEG technology to assess sleep and daytime sleepiness.
Article in Bioelectronic medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
In-ear electroencephalography (EEG) has emerged as a promising alternative to traditional in-laboratory sleep studies, offering greater comfort and practicality. Here we present a novel in-ear EEG system, comparing in-ear recordings against scalp EEG channels acquired concurrently as part of polysomnography (PSG). The study enrolled 16 healthy control participants in a single-visit overnight-plus-daytime design, and 8 participants with central disorders of hypersomnolence (CDH) in a randomized crossover daytime design (medication vs. medication-holiday). For overnight sleep recordings, ear-EEG and scalp EEG sleep staging showed substantial agreement (Cohen's [Formula: see text]). For daytime MWT trials, agreement was moderate (Cohen's [Formula: see text]), reflecting the predominance of wake epochs in this paradigm. For the primary Maintenance of Wakefulness Test (MWT) endpoint of sleep onset latency (SOL), at the per-subject level ([Formula: see text])-averaging across trials as in standard clinical practice-agreement was good (ICC = 0.71, [Formula: see text], MAD = 5.1 min). Among the 37 of 126 trials where both devices detected sleep (approximately 30% of trials), agreement was strong (ICC = 0.82, MAD = 1.9 min), with excellent agreement in healthy controls (ICC = 0.95, MAD = 1.2 min). Overall trial-level agreement across all 126 trials was moderate (ICC = 0.55), reflecting 22 discordant trials in which scalp EEG detected sleep but in-ear EEG did not-predominantly brief, subtle N1 transitions, concentrated in a subset of CDH participants. For overnight sleep architecture ([Formula: see text] healthy controls), total sleep time ([Formula: see text], ICC = 0.85), sleep efficiency ([Formula: see text]), and wake after sleep onset ([Formula: see text]) showed strong agreement, with small systematic biases consistent with reduced N1 detection sensitivity. These findings support the feasibility of in-ear EEG for sleep staging and daytime sleepiness assessment in laboratory settings, and motivate larger confirmatory studies-including home-based longitudinal monitoring-to establish clinical utility, particularly in populations with altered sleep architecture.
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