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阻塞性睡眠呼吸暂停患者基于心肺功能的睡眠分期

Cardiorespiratory-based sleep staging in subjects with obstructive sleep apnea.

作者信息

Redmond Stephen J, Heneghan Conor

机构信息

Department of Electronic Engineering, University College Dublin, Belfield D4, Ireland.

出版信息

IEEE Trans Biomed Eng. 2006 Mar;53(3):485-96. doi: 10.1109/TBME.2005.869773.

Abstract

A cardiorespiratory-based automatic sleep staging system for subjects with sleep-disordered breathing is described. A simplified three-state system is used: Wakefulness (W), rapid eye movement (REM) sleep (R), and non-REM sleep (S). The system scores the sleep stages in standard 30-s epochs. A number of features associated with the epoch RR-intervals, an inductance plethysmography estimate of rib cage respiratory effort, and an electrocardiogram-derived respiration (EDR) signal were investigated. A subject-specific quadratic discriminant classifier was trained, randomly choosing 20% of the subject's epochs (in appropriate proportions of W, S and R) as the training data. The remaining 80% of epochs were presented to the classifier for testing. An estimated classification accuracy of 79% (Cohen's kappa value of 0.56) was achieved. When a similar subject-independent classifier was trained, using epochs from all other subjects as the training data, a drop in classification accuracy to 67% (kappa = 0.32) was observed. The subjects were further broken in groups of low apnoea-hypopnea index (AHI) and high AHI and the experiments repeated. The subject-specific classifier performed better on subjects with low AHI than high AHI; the performance of the subject-independent classifier is not correlated with AHI. For comparison an electroencephalograms (EEGs)-based classifier was trained utilizing several standard EEG features. The subject-specific classifier yielded an accuracy of 87% (kappa = 0.75), and an accuracy of 84% (kappa = 0.68) was obtained for the subject-independent classifier, indicating that EEG features are quite robust across subjects. We conclude that the cardiorespiratory signals provide moderate sleep-staging accuracy, however, features exhibit significant subject dependence which presents potential limits to the use of these signals in a general subject-independent sleep staging system.

摘要

本文描述了一种用于患有睡眠呼吸障碍的受试者的基于心肺功能的自动睡眠分期系统。该系统采用简化的三状态系统:清醒(W)、快速眼动(REM)睡眠(R)和非快速眼动睡眠(S)。系统以标准的30秒时段对睡眠阶段进行评分。研究了一些与时段RR间期、胸廓呼吸努力的电感体积描记估计值以及心电图衍生呼吸(EDR)信号相关的特征。训练了一个针对特定受试者的二次判别分类器,随机选择受试者20%的时段(W、S和R的比例适当)作为训练数据。其余80%的时段用于测试分类器。实现了估计分类准确率为79%(科恩kappa值为0.56)。当使用所有其他受试者的时段作为训练数据来训练类似的独立于受试者的分类器时,观察到分类准确率降至67%(kappa = 0.32)。受试者进一步被分为低呼吸暂停低通气指数(AHI)组和高AHI组,并重复实验。针对特定受试者训练的分类器在低AHI受试者上的表现优于高AHI受试者;独立于受试者的分类器的性能与AHI无关。为了进行比较,利用几个标准脑电图特征训练了基于脑电图(EEG)的分类器。针对特定受试者的分类器准确率为87%(kappa = 0.75),独立于受试者的分类器准确率为84%(kappa = 0.68),这表明脑电图特征在不同受试者之间相当稳健。我们得出结论,心肺信号提供了适度的睡眠分期准确率,然而,特征表现出显著的受试者依赖性,这给在一般的独立于受试者的睡眠分期系统中使用这些信号带来了潜在限制。

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