Pulse Photopletismography Amplitude Decrease Detector for Sleep Apnea Evaluation in Children

A method for automatic detection of sleep apnea using pulse photoplethysmography signal (PPG) is proposed. This method is based on a detection of decreases on PPG amplitude fluctuations. The proposed detector is composed of three stages: pre-processing, envelope detection, based on root mean square series or Hilbert transform, and decision algorithm based on an adaptive threshold. The detector has been evaluated using simulated and real signals. Sensibility and positive predictive value of the detector where 76% and 73% for real signals. A clinical study to sleep apnea diagnosis in children based on this detector has been carried out. PPG attenuation events per hour ratio E h has statistical significance (p < 0.05) to classify children as normal 13.5 plusmn 6.35 Eh (mean plusmn SD) or pathologic 21.1 plusmn 8.93 Eh

[1]  F. Abboud,et al.  Sympathetic neural mechanisms in obstructive sleep apnea. , 1995, The Journal of clinical investigation.

[2]  P Lavie,et al.  Periodic, profound peripheral vasoconstriction--a new marker of obstructive sleep apnea. , 1999, Sleep.

[3]  J. Tank,et al.  Hypoxia augments apnea-induced peripheral vasoconstriction in humans. , 2001, Journal of applied physiology.

[4]  Y. Shimada,et al.  Spectrophotometric monitoring of arterial oxygen saturation in the fingertip , 2006, Medical and Biological Engineering and Computing.

[5]  ColinE. Sullivan,et al.  REVERSAL OF OBSTRUCTIVE SLEEP APNOEA BY CONTINUOUS POSITIVE AIRWAY PRESSURE APPLIED THROUGH THE NARES , 1981, The Lancet.

[6]  W C Dement,et al.  The sleep apnea syndromes. , 1976, Annual review of medicine.

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

[8]  S. Launois,et al.  Peripheral vascular resistance increases after termination of obstructive apneas. , 2001, Journal of applied physiology.

[9]  J. Farber,et al.  Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. , 2002, Pediatrics.

[10]  Bonnie K. Lind,et al.  Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study , 2000 .

[11]  K. Clark,et al.  Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community- Based Study , 2000 .

[12]  T. Young,et al.  The occurrence of sleep-disordered breathing among middle-aged adults. , 1993, The New England journal of medicine.

[13]  A. Sandler,et al.  Inattention, hyperactivity, and symptoms of sleep-disordered breathing , 2002 .

[14]  J. Farber.  Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. , 2002, Pediatrics.

[15]  Itsik Dvir,et al.  Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies. , 2003, Chest.

[16]  Paul Atkinson,et al.  The effect of upper airway obstruction and arousal on peripheral arterial tonometry in obstructive sleep apnea. , 2002, American journal of respiratory and critical care medicine.

[17]  P. L. Smith,et al.  Neural and local effects of hypoxia on cardiovascular responses to obstructive apnea. , 2000, Journal of applied physiology.

[18]  S. Connolly,et al.  CYCLICAL VARIATION OF THE HEART RATE IN SLEEP APNOEA SYNDROME Mechanisms, and Usefulness of 24 h Electrocardiography as a Screening Technique , 1984, The Lancet.

[19]  Pablo Laguna,et al.  Bioelectrical Signal Processing in Cardiac and Neurological Applications , 2005 .

[20]  Debra E Weese-Mayer,et al.  Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. , 2003, Pediatrics.

[21]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .