Sleep Apnea Detection by Tracheal Motion and Sound, and Oximetry via Application of Deep Neural Networks

Abstract

Nasim Montazeri Ghahjaverestan,1,2 Cristiano Aguiar,3 Richard Hummel,3 Xiaoshu Cao,4,5 Jackson Yu,3 T Douglas Bradley2,3,5,6 1Sleep and Brain Health Laboratory, Sunnybrook Research Institute, Toronto, Ontario, Canada; 2Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; 3Bresotec Inc, Toronto, Ontario, Canada; 4Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; 5KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; 6Department of Medicine of the University Health Network, Toronto General Hospital, Toronto, Ontario, CanadaCorrespondence: T Douglas Bradley, University Health Network Toronto General Hospital, Room 9N-943, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada, Tel [phone], Fax [phone], Email [email protected]: Sleep apnea (SA) is highly prevalent, but under diagnosed due to inaccessibility of sleep testing. To address this issue, portable devices for home sleep testing have been developed to provide convenience with reasonable accuracy in diagnosing SA. The objective of this study was to test the validity a novel portable sleep apnea testing device, BresoDX1, in SA diagnosis, via recording of trachea-sternal motion, tracheal sound and oximetry.Patients and Methods: Adults with a suspected sleep disorder were recruited to undergo in-laboratory polysomnography (PSG) and a simultaneous BresoDX1 recording. Data from BresoDX1 were collected and features related to breathing sounds, body motions and oximetry were extracted. A deep neural network (DNN) model was trained with 61-second epochs of the extracted features to detect apneas and hypopneas from which an apnea-hypopnea index (AHI) was calculated. The AHI estimated by BresoDX1 (AHIbreso) was compared to the AHI determined from PSG (AHIPSG) and the sensitivity and specificity of SA diagnosis were assessed at an AHIPSG ≥ 15.Results: Two-hundred thirty-three participants (mean ± SD) 50 ± 16 years of age, with BMI of 29.8 ± 6.6 and AHI of 19.5 ± 22.7, were included. There was a strong relationship between AHIbreso and AHIPSG (r = 0.91, p < 0.001). SA detection for an AHIPSG ≥ 15 was highly sensitive (90.0%) and specific (85.9%).Conclusion: We conclude that the DNN model we developed via recording and analyses of trachea-sternal motion and sound along with oximetry provides an accurate estimate of the AHIPSG with high sensitivity and specificity. Therefore, BresoDX1 is a simple, convenient and accurate portable SA monitoring device that could be employed for home SA testing in the future.Keywords: sleep apnea, portable sleep testing, tracheal acoustics

Keywords

• sleep apnea
• portable sleep testing
• tracheal acoustics