Screening of obstructive sleep apnea using Hilbert-Huang decomposition of oronasal airway pressure recordings.

Polysomnographic signals are usually recorded from patients exhibiting symptoms related to sleep disorders such as obstructive sleep apnea (OSA). Analysis of polysomnographic data allows for the determination of the type and severity of sleep apnea or other sleep-related disorders by a specialist or technician. The usual procedure entails an overnight recording several hours long. This paper presents a methodology to help with the screening of OSA using a 5-min oronasal airway pressure signal emanating from a polysomnographic recording during the awake period, eschewing the need for an overnight recording. The clinical sample consisted of a total of 41 subjects, 20 non-OSA individuals and 21 individuals with OSA. A signal analysis technique based on the Hilbert-Huang transform was used to extract intrinsic oscillatory modes from the signals. The frequency distribution of both the first mode and second mode and their sum were shown to differ significantly between non-OSA subjects and OSA patients. An index measure based on the distribution frequencies of the oscillatory modes yielded a sensitivity of 81.0% (for 95% specificity) for the detection of OSA. Two other index measures based on the relation between the area and the maximum of the 1st and 2nd halves of the frequency histogram both yielded a sensitivity of 76.2% (for 95% specificity). Although further tests will be needed to test the reproducibility of these results, the proposed measures seem to provide a fast method to screen OSA patients, thus reducing the costs and the waiting time for diagnosis.

[1]  Ying Sun,et al.  Rapid screening test for sleep apnea using a nonlinear and nonstationary signal processing technique. , 2007, Medical engineering & physics.

[2]  Xing Hongyan,et al.  A New QRS Detection Algorithm Based on Empirical Mode Decomposition , 2008, 2008 2nd International Conference on Bioinformatics and Biomedical Engineering.

[3]  V. Somers,et al.  Obstructive Sleep Apnea , 2005, Annals of Internal Medicine.

[4]  O. A. Rosso,et al.  EEG analysis using wavelet-based information tools , 2006, Journal of Neuroscience Methods.

[5]  S. Hong,et al.  Reduced cerebral blood flow during wakefulness in obstructive sleep apnea-hypopnea syndrome. , 2007, Sleep.

[6]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[7]  Amparo Alonso-Betanzos,et al.  A new method for sleep apnea classification using wavelets and feedforward neural networks , 2005, Artif. Intell. Medicine.

[8]  Shuren Qin,et al.  A new envelope algorithm of Hilbert-Huang Transform , 2006 .

[9]  B. Jammes,et al.  Alpha and Theta Wave Localisation using Hilbert-Huang Transform: Empirical Study of the Accuracy , 2006, 2006 2nd International Conference on Information & Communication Technologies.

[10]  K. Behbehani,et al.  A noninvasive technique for detecting obstructive and central sleep apnea , 1997, IEEE Transactions on Biomedical Engineering.

[11]  J. Wheatley,et al.  Oral airway resistance during wakefulness in patients with obstructive sleep apnoea , 1999, Thorax.

[12]  Mo H. Modarres,et al.  A measure of ventilatory variability at wake-sleep transition predicts sleep apnea severity. , 2008, Chest.

[13]  Leontios J Hadjileontiadis,et al.  Empirical mode decomposition and fractal dimension filter. A novel technique for denoising explosive lung sounds. , 2007, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[14]  R. Fonseca-Pinto,et al.  On the influence of time-series length in EMD to extract frequency content: simulations and models in biomedical signals. , 2009, Medical engineering & physics.

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

[16]  M. MacCallum,et al.  The Application of the Wavelet Transform to Polysomnographic Signals , 2003, Int. J. Wavelets Multiresolution Inf. Process..

[17]  Gabriel Rilling,et al.  On empirical mode decomposition and its algorithms , 2003 .

[18]  Ching-Chi Lin,et al.  Oral airway resistance during wakefulness in eucapnic and hypercapnic sleep apnea syndrome , 2004, Respiratory Physiology & Neurobiology.

[19]  Tang Jing-tian,et al.  Hilbert-Huang Transform for ECG De-Noising , 2007, 2007 1st International Conference on Bioinformatics and Biomedical Engineering.

[20]  C. Spengler,et al.  Endogenous circadian rhythm of pulmonary function in healthy humans. , 2000, American journal of respiratory and critical care medicine.

[21]  Ramón González-Camarena,et al.  Crackle sounds analysis by empirical mode decomposition. Nonlinear and nonstationary signal analysis for distinction of crackles in lung sounds. , 2007, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[22]  S. Cerutti,et al.  Automatic screening of obstructive sleep apnea from the ECG based on empirical mode decomposition and wavelet analysis , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[23]  H. V. van Houwelingen,et al.  Diurnal variation in lung function in subgroups from two Dutch populations: consequences for longitudinal analysis. , 1999, American journal of respiratory and critical care medicine.

[24]  Jens Timmer,et al.  Diagnosis of sleep apnea by automatic analysis of nasal pressure and forced oscillation impedance. , 2002, American journal of respiratory and critical care medicine.

[25]  Guo Xiao-jing,et al.  The EEG Signal Preprocessing Based on Empirical Mode Decomposition , 2008, 2008 2nd International Conference on Bioinformatics and Biomedical Engineering.

[26]  S C Villalobos,et al.  CRACKLE SOUNDS ANALYSIS BY EMPIRICAL MODE DECOMPOSITION , 2007 .

[27]  C. Que,et al.  Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation , 2008, Respiration.