Sleep apnea screening based on Photoplethysmography data from wearable bracelets using an information-based similarity approach

BACKGROUND AND OBJECTIVE Sleep apnea (SA) is a common sleep disorder in daily life and is also an aggravating factor for various diseases. Having the potential to replace traditional but complicated diagnostic equipment, portable medical devices are receiving increasing attention, and thus, the demand for supporting algorithms is growing. This study aims to identify SA with wearable devices. METHODS Static information-based similarity (sIBS) and dynamic information-based similarity (dIBS) were proposed to analyze short-term fluctuations in heart rate (HR) with wearable devices. This study included overnight photoplethysmography (PPG) signals from 92 subjects obtained from wearable bracelets. RESULTS The results showed that sIBS achieved the highest correlation coefficient with the apnea-hypopnea index (R=-0.653, p=0). dIBS showed a good balance in sensitivity and specificity (75.0% and 72.1%, respectively). Combining sIBS and dIBS with other classical time-frequency domain indices could simultaneously achieve good accuracy and balance (84.7% accuracy, 76.7% sensitivity and 89.6% specificity). CONCLUSIONS This research showed that both classic time-frequency domain indices and IBS indices changed significantly only in the severe SA group. This novel method could serve as an effective way to assess SA and provide new insight into its pathophysiology.

[1]  Bachir Boucheham Reduced data similarity-based matching for time series patterns alignment , 2010, Pattern Recognit. Lett..

[2]  Chung-Kang Peng,et al.  Multiscale Analysis of Heart Rate Dynamics: Entropy and Time Irreversibility Measures , 2008, Cardiovascular engineering.

[3]  J. Prasko,et al.  Depression and obstructive sleep apnea. , 2017, Neuro endocrinology letters.

[4]  Madalena Costa,et al.  Multiscale entropy analysis of complex physiologic time series. , 2002, Physical review letters.

[5]  John Allen Photoplethysmography and its application in clinical physiological measurement , 2007, Physiological measurement.

[6]  Mario Chica-Olmo,et al.  An assessment of the effectiveness of a random forest classifier for land-cover classification , 2012 .

[7]  G. Parati,et al.  Obstructive sleep apnea syndrome and autonomic dysfunction , 2019, Autonomic Neuroscience.

[8]  C. Shapiro,et al.  Proportion of surgical patients with undiagnosed obstructive sleep apnoea. , 2013, British journal of anaesthesia.

[9]  B. Grant,et al.  Prediction of the apnea-hypopnea index from overnight pulse oximetry. , 2003, Chest.

[10]  Hsien-Tsai Wu,et al.  Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing , 2015, Entropy.

[11]  Chung-Kang Peng,et al.  Clustering Heart Rate Dynamics Is Associated with β-Adrenergic Receptor Polymorphisms: Analysis by Information-Based Similarity Index , 2011, PloS one.

[12]  J. Hayano,et al.  Quantitative detection of sleep apnea with wearable watch device , 2020, PloS one.

[13]  T. Laitinen,et al.  Mild obstructive sleep apnea does not modulate baroreflex sensitivity in adult patients , 2015, Nature and science of sleep.

[14]  Guy Albert Dumont,et al.  Correntropy-Based Pulse Rate Variability Analysis in Children with Sleep Disordered Breathing , 2017, Entropy.

[15]  Patricia A Deuster,et al.  Heart rate variability as a predictor of negative mood symptoms induced by exercise withdrawal. , 2007, Medicine and science in sports and exercise.

[16]  J. Juang,et al.  Screening of Obstructive Sleep Apnea in Snoring Patients Using a Patch-Type Device With Electrocardiogram and 3-Axis Accelerometer. , 2020, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[17]  Douglas G Altman,et al.  Standard deviations and standard errors , 2005, BMJ : British Medical Journal.

[18]  Muhammad Aslam Radar data analysis in the presence of uncertainty , 2021, European Journal of Remote Sensing.

[19]  Yifan Li,et al.  Application of the Variance Delay Fuzzy Approximate Entropy for Autonomic Nervous System Fluctuation Analysis in Obstructive Sleep Apnea Patients , 2020, Entropy.

[20]  Zedong Nie,et al.  Gait Rhythm Dynamics for Neuro-Degenerative Disease Classification via Persistence Landscape- Based Topological Representation , 2020, Sensors.

[21]  H. Nazeran,et al.  Comparison of Heart Rate Variability Signal Features Derived from Electrocardiography and Photoplethysmography in Healthy Individuals , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[22]  L. Raffo,et al.  A sleep apnoea keeper in a wearable device for Continuous detection and screening during daily life , 2008, 2008 Computers in Cardiology.

[23]  Muhammad Aslam,et al.  Analyzing the Solar Energy Data Using a New Anderson-Darling Test under Indeterminacy , 2020 .

[24]  Bachir Boucheham,et al.  Efficient matching of very complex time series , 2013, Int. J. Mach. Learn. Cybern..

[25]  U Rajendra Acharya,et al.  Automated sleep apnea detection from cardio-pulmonary signal using bivariate fast and adaptive EMD coupled with cross time-frequency analysis , 2020, Comput. Biol. Medicine.

[26]  Shoushui Wei,et al.  Comparison between heart rate variability and pulse rate variability during different sleep stages for sleep apnea patients. , 2017, Technology and health care : official journal of the European Society for Engineering and Medicine.

[27]  Florent Baty,et al.  Classification of Sleep Apnea Severity by Electrocardiogram Monitoring Using a Novel Wearable Device , 2020, Sensors.

[28]  J. Pépin,et al.  Sleep deprivation, sleep apnea and cardiovascular diseases. , 2012, Frontiers in bioscience.

[29]  Rashad A. Bantan,et al.  A study on measurement system analysis in the presence of indeterminacy , 2020 .

[30]  Gabriele B. Papini,et al.  Respiratory activity extracted from wrist-worn reflective photoplethysmography in a sleep-disordered population , 2020, Physiological measurement.

[31]  Chung-Kang Peng,et al.  Genomic Classification Using an Information-Based Similarity Index: Application to the SARS Coronavirus , 2005, J. Comput. Biol..

[32]  Guanzheng Liu,et al.  Robustness evaluation of heart rate variability measures for age gender related autonomic changes in healthy volunteers , 2014, Australasian Physical & Engineering Sciences in Medicine.

[33]  Neutrosophic D’Agostino Test of Normality: An Application to Water Data , 2021, Journal of Mathematics.

[34]  Saswata Sahoo,et al.  Wearable PPG sensor based alertness scoring system , 2017, 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[35]  I. Ringqvist,et al.  A Prospective Randomized Study Comparing Two Different Degrees of Mandibular Advancement with a Dental Appliance in Treatment of Severe Obstructive Sleep Apnea , 2003, Sleep and Breathing.

[36]  Cinna Soltanpur,et al.  A review on wearable photoplethysmography sensors and their potential future applications in health care , 2018, International journal of biosensors & bioelectronics.

[37]  Bernard C. Jiang,et al.  Automated Detection of Paroxysmal Atrial Fibrillation Using an Information-Based Similarity Approach , 2017, Entropy.

[38]  Geoffrey H. Tison,et al.  Abstract 21042: Cardiovascular Risk Stratification Using Off-the-Shelf Wearables and a Multi-Task Deep Learning Algorithm , 2017, Circulation.

[39]  Yifan Li,et al.  A method to detect sleep apnea based on deep neural network and hidden Markov model using single-lead ECG signal , 2018, Neurocomputing.

[40]  Atul Malhotra,et al.  Effect of mild, asymptomatic obstructive sleep apnea on daytime heart rate variability and impedance cardiography measurements. , 2012, The American journal of cardiology.

[41]  Vanessa Cristina Cunha Sequeira,et al.  Heart rate variability in adults with obstructive sleep apnea: a systematic review , 2019, Sleep Science.

[42]  Weifeng Pan,et al.  A Sleep Apnea Detection Method Based on Unsupervised Feature Learning and Single-Lead Electrocardiogram , 2021, IEEE Transactions on Instrumentation and Measurement.

[43]  M. Aslam A new goodness of fit test in the presence of uncertain parameters , 2020, Complex & Intelligent Systems.

[44]  Alexander J. Casson,et al.  Towards Photoplethysmography-Based Estimation of Instantaneous Heart Rate During Physical Activity , 2017, IEEE Transactions on Biomedical Engineering.

[45]  Qing Jiang,et al.  Sliding Trend Fuzzy Approximate Entropy as a Novel Descriptor of Heart Rate Variability in Obstructive Sleep Apnea , 2019, IEEE Journal of Biomedical and Health Informatics.

[46]  Bachir Boucheham,et al.  QP-DTW: Upgrading Dynamic Time Warping to Handle Quasi Periodic Time Series Alignment , 2018, J. Inf. Process. Syst..

[47]  J. Tuomilehto,et al.  Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. , 2009, American journal of respiratory and critical care medicine.

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

[49]  Gabriele B. Papini,et al.  Wearable monitoring of sleep-disordered breathing: estimation of the apnea–hypopnea index using wrist-worn reflective photoplethysmography , 2020, Scientific Reports.

[50]  Ting-Wei Lin,et al.  Sleeping detect using wearable device by PPG , 2016, 2016 International Conference on Advanced Materials for Science and Engineering (ICAMSE).