Piezoelectric Sensor-Based Continuous Monitoring of Respiratory Rate During Sleep



Respiration during sleep is one of the indicators of an individual’s health. However, many respiratory measurement devices need to be worn by the patient and can affect sleep. We introduce here a novel, easy-to-use, respiratory rate-monitoring sensor made of stretchable piezoelectric material that can be used conveniently at home as well as in a clinical setting.


We enrolled 6 members of a family as volunteers ranging in age from 9 months to 69 years. The sensor was used to continuously record respiratory rate data for all individuals during sleep.


The sensor could detect known breathing patterns such as stable, unstable, or deep breathing as well as apnea during sleep. We observed significant differences in the respiratory rates and respiratory stability between subjects during sleep.


The piezoelectric sensor was effective in people in all age groups, paving a way for future use as a convenient and reliable mode of respiratory assessment for adults as well as neonates at home and in a clinical setting.

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  1. 1.

    World Health Organization. (1984). A programme for controlling acute respiratory infections in children: Memorandum from a WHO meeting. Bulletin of the World Health Organization, 62, 47–58.

    Google Scholar 

  2. 2.

    Moon, R. Y., Darnall, R. A., Feldman-Winter, L., Goodstein, M. H., & Hauck, F. R. (2016). SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics, 138(5), e20162940. https://doi.org/10.1542/peds.2016-2940.

    Article  Google Scholar 

  3. 3.

    Kinney, H. C., & Thach, B. T. (2009). The sudden infant death syndrome. New England Journal of Medicine, 361, 795–805. https://doi.org/10.1056/NEJMra0803836.

    Article  Google Scholar 

  4. 4.

    Guilleminault, C., & Quo, S. D. (2001). Sleep-disordered breathing. A view at the beginning of the new Millennium. Dental Clinics of North America, 45, 643–656.

    Google Scholar 

  5. 5.

    Vaessen, T. J. A., Overeem, S., & Sitskoorn, M. M. (2015). Cognitive complaints in obstructive sleep apnea. Sleep Medicine Reviews. https://doi.org/10.1016/j.smrv.2014.03.008.

    Article  Google Scholar 

  6. 6.

    Berry, R. B., Budhiraja, R., Gottlieb, D. J., Gozal, D., Iber, C., Kapur, V. K., et al. (2012). Rules for scoring respiratory events in sleep: Update of the 2007 AASM manual for the scoring of sleep and associated events. Journal of Clinical Sleep Medicine, 8(5), 597–619. https://doi.org/10.5664/jcsm.2172.

    Article  Google Scholar 

  7. 7.

    Seymour, C. W., Liu, V. X., Iwashyna, T. J., Brunkhorst, F. M., Rea, T. D., Scherag, A., et al. (2016). Assessment of clinical criteria for sepsis for the third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - Journal of the American Medical Association, 315(8), 762–774. https://doi.org/10.1001/jama.2016.0288.

    Article  Google Scholar 

  8. 8.

    Al-Sayed, L. E., Schrank, W. I., & Thach, B. T. (1994). Ventilatory sparing strategies and swallowing pattern during bottle feeding in human infants. Journal of Applied Physiology, 77(1), 78–83. https://doi.org/10.1152/jappl.1994.77.1.78.

    Article  Google Scholar 

  9. 9.

    Gewolb, I. H., Vice, F. L., Schweitzer-Kenney, E. L., Taciak, V. L., & Bosma, J. F. (2001). Developmental patterns of rhythmic suck and swallow in preterm infants. Developmental Medicine and Child Neurology, 43(1), 22–27. https://doi.org/10.1017/S0012162201000044.

    Article  Google Scholar 

  10. 10.

    Gewolb, I. H., & Vice, F. L. (2006). Maturational changes in the rhythms, patterning, and coordination of respiration and swallow during feeding in preterm and term infants. Developmental Medicine and Child Neurology, 48(7), 589–594. https://doi.org/10.1017/S001216220600123X.

    Article  Google Scholar 

  11. 11.

    Butterworth, S. (1930). On the theory of filter amplifiers. Experimental Wireless and the Wireless Engineer, 7, 536–541.

    Google Scholar 

  12. 12.

    Barrett, K. E., Boitano, S., Barman, S. M., & Brooks, H. L. (2010). Respiratory physiology. In W. F. Ganong (Ed.), Ganong’s review of medical physiology (p. 588). Pennsylvania: The McGraw-Hill Companies Inc.

    Google Scholar 

  13. 13.

    Bendixen, H. H., Smith, G. M., & Mead, J. (2017). Pattern of ventilation in young adults. Journal of Applied Physiology, 19(2), 195–198. https://doi.org/10.1152/jappl.1964.19.2.195.

    Article  Google Scholar 

  14. 14.

    Hathorn, M. K. S. (1974). The rate and depth of breathing in new-born infants in different sleep states. The Journal of Physiology, 243(1), 101–113. https://doi.org/10.1113/jphysiol.1974.sp010744.

    Article  Google Scholar 

  15. 15.

    Rodríguez-Molinero, A., Narvaiza, L., Ruiz, J., & Gálvez-Barrõn, C. (2013). Normal respiratory rate and peripheral blood oxygen saturation in the elderly population. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.12580.

    Article  Google Scholar 

  16. 16.

    Rusconi, F., Castagneto, M., Gagliardi, L., Leo, G., Pellegatta, A., Porta, N., et al. (1994). Reference values for respiratory rate in the first 3 years of life. Pediatrics, 94(3), 350–355.

    Google Scholar 

  17. 17.

    Douglas, N. J., White, D. P., Pickett, C. K., Weil, J. V., & Zwillich, C. W. (1982). Respiration during sleep in normal man. Thorax, 37(11), 840–844. https://doi.org/10.1136/thx.37.11.840.

    Article  Google Scholar 

  18. 18.

    Parmelee, A. H., Schulz, H. R., & Disbrow, M. A. (1961). Sleep patterns of the newborn. The Journal of Pediatrics, 58(2), 241–250. https://doi.org/10.1016/S0022-3476(61)80164-9.

    Article  Google Scholar 

  19. 19.

    Peng, M., Ding, Z., Wang, L., & Cheng, X. (2019). Detection of sleep biosignals using an intelligent mattress based on piezoelectric ceramic sensors†. Sensors (Switzerland), 19(18), 3843. https://doi.org/10.3390/s19183843.

    Article  Google Scholar 

  20. 20.

    Klap, T., & Shinar, Z. (2010). Using piezoelectric sensor for continuous-contact-free monitoring of heart and respiration rates in real-life hospital settings. Computing in Cardiology, 40(2013), 671–674.

    Google Scholar 

  21. 21.

    Bu, N., Ueno, N., & Fukuda, O. (2009). Respiration and heartbeat measurement for sleep monitoring using a flexible AlN piezoelectric film sensor. Sensors and Transducers Journal, 109(10), 131–142.

    Google Scholar 

  22. 22.

    Freundlich, J. J., & Erickson, J. C. (1974). Electrical impedance pneumography for simple nonrestrictive continuous monitoring of respiratory rate, rhythm and tidal volume for surgical patients. Chest, 65(2), 181–184. https://doi.org/10.1378/chest.65.2.181.

    Article  Google Scholar 

  23. 23.

    Al-Khalidi, F. Q., Saatchi, R., Burke, D., Elphick, H., & Tan, S. (2011). Respiration rate monitoring methods: A review. Pediatric Pulmonology. https://doi.org/10.1002/ppul.21416.

    Article  Google Scholar 

  24. 24.

    Daw, W. (2016). Medical devices for measuring respiratory rate in children: A review. Journal of Advances in Biomedical Engineering and Technology, 3(1), 21–27. https://doi.org/10.15379/2409-3394.2016.03.01.04.

    Article  Google Scholar 

  25. 25.

    Storck, K., Karlsson, M., Ask, P., & Loyd, D. (1996). Heat transfer evaluation of the nasal thermistor technique. IEEE Transactions on Biomedical Engineering, 43(12), 1187–1191. https://doi.org/10.1109/10.544342.

    Article  Google Scholar 

  26. 26.

    Helfenbein, E., Firoozabadi, R., Chien, S., Carlson, E., & Babaeizadeh, S. (2014). Development of three methods for extracting respiration from the surface ECG: A review. Journal of Electrocardiology, 47(6), 819–825. https://doi.org/10.1016/j.jelectrocard.2014.07.020.

    Article  Google Scholar 

  27. 27.

    Moody, G., Mark, R., Bump, M., Weinstein, J., Berman, A., Mietus, J., & Goldberger, A. (1986). Clinical validation of the ECG-derived respiration (EDR) technique. Computers in Cardiology, 13, 507–510.

    Google Scholar 

  28. 28.

    Mahbub, I., Pullano, S. A., Wang, H., Islam, S. K., Fiorillo, A. S., To, G., et al. (2017). A low-power wireless piezoelectric sensor-based respiration monitoring system realized in CMOS process. IEEE Sensors Journal, 17, 1858–1864. https://doi.org/10.1109/JSEN.2017.2651073.

    Article  Google Scholar 

  29. 29.

    Villarroel, M., Guazzi, A., Jorge, J., Davis, S., Watkinson, P., Green, G., et al. (2014). Continuous non-contact vital sign monitoring in neonatal intensive care unit. Healthcare Technology Letters, 1(3), 87–91. https://doi.org/10.1049/htl.2014.0077.

    Article  Google Scholar 

  30. 30.

    Johansson, A., Oberg, P. A., & Sedin, G. (1999). Monitoring of heart and respiratory rates in newborn infants using a new photoplethysmographic technique. Journal of Clinical Monitoring and Computing, 15(7–8), 461–467.

    Article  Google Scholar 

  31. 31.

    Olsson, E., Ugnell, H., Oberg, P. A., & Sedin, G. (2000). Photoplethysmography for simultaneous recording of heart and respiratory rates in newborn infants. Acta Paediatrica, 89(7), 853–861. https://doi.org/10.1080/080352500750043774.

    Article  Google Scholar 

  32. 32.

    Wertheim, D., Olden, C., Savage, E., & Seddon, P. (2009). Extracting respiratory data from pulse oximeter plethysmogram traces in newborn infants. Archives of Disease in Childhood: Fetal and Neonatal Edition, 94(4), F301–F303. https://doi.org/10.1136/adc.2008.145342.

    Article  Google Scholar 

  33. 33.

    Castaneda, D., Esparza, A., Ghamari, M., Soltanpur, C., & Nazeran, H. (2018). A review on wearable photoplethysmography sensors and their potential future applications in health care. International Journal of Biosensors & Bioelectronics, 4(4), 195. https://doi.org/10.15406/ijbsbe.2018.04.00125.

    Article  Google Scholar 

  34. 34.

    Poets, C. F., Stebbens, V. A., Alexander, J. R., & Southall, D. P. (1991). Breathing patterns and heart rates at ages 6 weeks and 2 years. American Journal of Diseases of Children, 145(12), 1393–1396. https://doi.org/10.1001/archpedi.1991.02160120061020.

    Article  Google Scholar 

  35. 35.

    Weese-Mayer, D. E., Morrow, A. S., Conway, L. P., Brouillette, R. T., & Silvestri, J. M. (1990). Assessing clinical significance of apnea exceeding fifteen seconds with event recording. The Journal of Pediatrics, 117(4), 568–574. https://doi.org/10.1016/S0022-3476(05)80690-0.

    Article  Google Scholar 

  36. 36.

    Sridhar, R., Thach, B. T., Kelly, D. H., & Henslee, J. A. (2003). Characterization of successful and failed autoresuscitation in human infants, including those dying of SIDS. Pediatric Pulmonology, 36(2), 113–122. https://doi.org/10.1002/ppul.10287.

    Article  Google Scholar 

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The authors would like to thank Sumitomo Riko Company Limited (Japan) for providing the TaidoSensor® for the study. The authors would also like to thank Mr. Ritwik Handa, MBA (Intel Corp., Phoenix, AZ, USA), for providing technical guidance and assistance in this study.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information




SS contributed to the study design and analysis and interpretation of the data and co-wrote the manuscript. DJ contributed to the analysis and interpretation of the data and co-wrote the manuscript. NK is the lead investigator and contributed to the implementation of this study and edited the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Shuhei So.

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Conflict of interest

The authors have no conflicts of interest to declare. S.S. belongs to the funded laboratory of the Tawara IVF clinic.

Ethical Approval

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments. The protocol for this study was approved by the Institutional Review Board at Tawara IVF clinic (No. 2019_0024).

Informed Consent

Written informed consent was obtained from all the participants of this study (or their parent or legal guardian in the case of children under 16 years of age) for participation and publication of their data.

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So, S., Jain, D. & Kanayama, N. Piezoelectric Sensor-Based Continuous Monitoring of Respiratory Rate During Sleep. J. Med. Biol. Eng. (2021). https://doi.org/10.1007/s40846-021-00602-6

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  • Respiratory rate monitoring
  • Sensor
  • Piezoelectric
  • Sleep
  • Stable-unstable breathing
  • Apnea