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Not long ago, hearables paved the way for biosensing, fitness, and healthcare monitoring. Smart earbuds today are not only producing sound but also monitoring vital signs. Reliable determination of cardiovascular and pulmonary system information can explore the use of hearables for physiological monitoring. Recent research shows that photoplethysmography (PPG) signals not only contain details on oxygen saturation level (SPO2) but also carry more physiological information including pulse rate, respiration rate, blood pressure, and arterial-related information. The analysis of the PPG signal from the ear has proven to be reliable and accurate in the research setting. (1) Background: The present integrative review explores the existing literature on an in-ear PPG signal and its application. This review aims to identify the current technology and usage of in-ear PPG and existing evidence on in-ear PPG in physiological monitoring. This review also analyzes in-ear (PPG) measurement configuration and principle, waveform characteristics, processing technology, and feature extraction characteristics. (2) Methods: We performed a comprehensive search to discover relevant in-ear PPG articles published until December 2022. The following electronic databases: Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Scopus, Web of Science, and PubMed were utilized to conduct the studies addressing the evidence of in-ear PPG in physiological monitoring. (3) Results: Fourteen studies were identified but nine studies were finalized. Eight studies were on different principles and configurations of hearable PPG, and eight studies were on processing technology and feature extraction and its evidence in in-ear physiological monitoring. We also highlighted the limitations and challenges of using in-ear PPG in physiological monitoring. (4) Conclusions: The available evidence has revealed the future of in-ear PPG in physiological monitoring. We have also analyzed the potential limitation and challenges that in-ear PPG will face in processing the signal.
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http://dx.doi.org/10.3390/s23146484 | DOI Listing |
IEEE J Biomed Health Inform
August 2025
Automated emotion identification via physiological data from wearable devices is a growing field, yet traditional electroencephalography (EEG) and photoplethysmography (PPG) collection methods can be uncomfortable. This research introduces a novel structure of the in-ear wearable device that captures both PPG and EEG signals to enhance user comfort for emotion recognition. Data were collected from 21 individuals experiencing four emotional states (fear, happy, calm, sad) induced by video stimuli.
View Article and Find Full Text PDFSensors (Basel)
February 2025
Exsurgo Ltd., 45i William Pickering Drive, Rosedale, Auckland 0632, New Zealand.
This paper presents a study undertaken to evaluate the sensor systems that were shortlisted to be used in the development of a portable respiratory-gated transcutaneous auricular vagus nerve stimulation (taVNS) system. To date, all published studies assessing respiratory-gated taVNS have been performed in controlled laboratory environments. This limitation arises from the reliance on non-portable sensing equipment, which poses significant logistical challenges.
View Article and Find Full Text PDFIEEE Rev Biomed Eng
November 2024
The human ear has emerged as a bidirectional gateway to the brain's and body's signals. Recent advances in around-the-ear and in-ear sensors have enabled the assessment of biomarkers and physiomarkers derived from brain and cardiac activity using ear-electroencephalography (ear-EEG), photoplethysmography (ear-PPG), and chemical sensing of analytes from the ear, with ear-EEG having been taken beyond-the-lab to outer space. Parallel advances in non-invasive and minimally invasive brain stimulation techniques have leveraged the ear's access to two cranial nerves to modulate brain and body activity.
View Article and Find Full Text PDFSingapore Med J
September 2024
Duke-NUS Medical School, Singapore.
Introduction: This study aimed to evaluate a technique of using photoplethysmography (PPG) for detecting elevated blood glucose in individuals.
Method: This is a prospective, cross-sectional study in which 500 healthy volunteers were recruited at a tertiary hospital in Singapore from October 2021 to February 2023. Capillary glucose was measured concurrently with PPG signals acquired using the wrist-worn Actxa Tracker (Spark + Series 2) and the In-Ear Prototype model SVT, which were worn for a duration of 8 min.
Annu Int Conf IEEE Eng Med Biol Soc
July 2023
Accurate pulse-oximeter readings are critical for clinical decisions, especially when arterial blood-gas tests - the gold standard for determining oxygen saturation levels - are not available, such as when determining COVID-19 severity. Several studies demonstrate that pulse oxygen saturation estimated from photoplethysmography (PPG) introduces a racial bias due to the more profound scattering of light in subjects with darker skin due to the increased presence of melanin. This leads to an overestimation of blood oxygen saturation in those with darker skin that is increased for low blood oxygen levels and can result in a patient not receiving potentially life-saving supplemental oxygen.
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