Sleep Apnea Severity Estimation from Respiratory Related Movements Using Deep Learning

Sleep apnea is a common chronic respiratory disorder which occurs due to the repetitive complete or partial cessations of breathing during sleep. The gold standard assessment of sleep apnea requires full night polysomnography in a sleep laboratory which is expensive, time consuming, and inconvenient. Hence, there is an urgent need for a convenient, robust and wearable monitoring device for screening of sleep apnea. A simple and convenient accelerometer-based portable system is presented to estimate the severity of sleep apnea by analyzing tracheal movements. Respiratory related movements were recorded over the suprasternal notch using a 3D accelerometer. Twenty-one physiological features (7 features, 3 accelerometer channels) were extracted. Performance of three different deep learning models – convolutional neural network, recurrent neural network, and their combination – were evaluated for estimating the apnea hypopnea index (AHI). The estimated AHI is compared to the gold standard polysomnography. In 3-fold cross-validation experiments with 20 participants (9 female, age=47.8±18.0 years, BMI=30.8±4.8, AHI=22.2±21.8 events/hr), we achieved a correlation coefficient between gold standard and estimated values (r-value = 0.84). The proposed system is an accurate, convenient, and portable device suitable for home sleep apnea screening.

[1]  Rafael Golpe,et al.  Home sleep studies in the assessment of sleep apnea/hypopnea syndrome. , 2002, Chest.

[2]  Bradley V Vaughn,et al.  AASM Scoring Manual Version 2.2 Updates: New Chapters for Scoring Infant Sleep Staging and Home Sleep Apnea Testing. , 2015, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[3]  Jürgen Schmidhuber,et al.  Long Short-Term Memory , 1997, Neural Computation.

[4]  R. Rakel,et al.  Clinical and Societal Consequences of Obstructive Sleep Apnea and Excessive Daytime Sleepiness , 2009, Postgraduate medicine.

[5]  W. Flemons,et al.  Access to diagnosis and treatment of patients with suspected sleep apnea. , 2004, American journal of respiratory and critical care medicine.

[6]  Daniel J Buysse,et al.  Sleep–Related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Measurement Techniques in Clinical Research , 2000 .

[7]  Azadeh Yadollahi,et al.  Acoustic obstructive sleep apnea detection , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[8]  T. Young,et al.  Increased prevalence of sleep-disordered breathing in adults. , 2013, American journal of epidemiology.

[9]  A. Chesson,et al.  The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Techinical Specifications , 2007 .

[10]  Sergey Ioffe,et al.  Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift , 2015, ICML.

[11]  Yoshua Bengio,et al.  Understanding the difficulty of training deep feedforward neural networks , 2010, AISTATS.

[12]  Meir H. Kryger,et al.  Principles and practice of pediatric sleep medicine , 2005 .

[13]  Zahra Moussavi,et al.  Sleep apnea monitoring and diagnosis based on pulse oximetery and tracheal sound signals , 2010, Medical & Biological Engineering & Computing.

[14]  Daniel Sánchez Morillo,et al.  An Accelerometer-Based Device for Sleep Apnea Screening , 2010, IEEE Transactions on Information Technology in Biomedicine.

[15]  V. Somers,et al.  Obstructive sleep apnea and cardiovascular disease. , 2009, Circulation journal : official journal of the Japanese Circulation Society.

[16]  J. Fleetham,et al.  Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. , 1994, Sleep.

[17]  Bozena Kaminska,et al.  Validation of respiratory signal derived from suprasternal notch acceleration for sleep apnea detection , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[18]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[19]  M. Littner,et al.  Practice parameters for the indications for polysomnography and related procedures: an update for 2005. , 2005, Sleep.

[20]  M. Sackner,et al.  Validation of respiratory inductive plethysmography using different calibration procedures. , 2015, The American review of respiratory disease.

[21]  C. Hunt,et al.  Comparison of respiratory inductive plethysmography and thoracic impedance for apnea monitoring. , 1987, The Journal of pediatrics.