Department of Biomedical Engineering, Politecnico di Milano, Pzza. Leonardo da Vinci 32, 20131 Milano, Italy.
Physiol Meas. 2010 Mar;31(3):273-89. doi: 10.1088/0967-3334/31/3/001. Epub 2010 Jan 20.
This study analyses two different methods to detect obstructive sleep apnea (OSA) during sleep time based only on the ECG signal. OSA is a common sleep disorder caused by repetitive occlusions of the upper airways, which produces a characteristic pattern on the ECG. ECG features, such as the heart rate variability (HRV) and the QRS peak area, contain information suitable for making a fast, non-invasive and simple screening of sleep apnea. Fifty recordings freely available on Physionet have been included in this analysis, subdivided in a training and in a testing set. We investigated the possibility of using the recently proposed method of empirical mode decomposition (EMD) for this application, comparing the results with the ones obtained through the well-established wavelet analysis (WA). By these decomposition techniques, several features have been extracted from the ECG signal and complemented with a series of standard HRV time domain measures. The best performing feature subset, selected through a sequential feature selection (SFS) method, was used as the input of linear and quadratic discriminant classifiers. In this way we were able to classify the signals on a minute-by-minute basis as apneic or nonapneic with different best-subset sizes, obtaining an accuracy up to 89% with WA and 85% with EMD. Furthermore, 100% correct discrimination of apneic patients from normal subjects was achieved independently of the feature extractor. Finally, the same procedure was repeated by pooling features from standard HRV time domain, EMD and WA together in order to investigate if the two decomposition techniques could provide complementary features. The obtained accuracy was 89%, similarly to the one achieved using only Wavelet analysis as the feature extractor; however, some complementary features in EMD and WA are evident.
本研究分析了仅基于心电图信号检测睡眠时阻塞性睡眠呼吸暂停(OSA)的两种不同方法。OSA 是一种常见的睡眠障碍,由上呼吸道反复阻塞引起,在心电图上产生特征性模式。心电图特征,如心率变异性(HRV)和 QRS 峰值面积,包含适合快速、非侵入性和简单筛查睡眠呼吸暂停的信息。这项分析包括 Physionet 上提供的 50 份记录,分为训练集和测试集。我们研究了使用最近提出的经验模态分解(EMD)方法的可能性,将结果与通过成熟的小波分析(WA)获得的结果进行比较。通过这些分解技术,从心电图信号中提取了几个特征,并补充了一系列标准的 HRV 时域测量。通过顺序特征选择(SFS)方法选择的表现最佳的特征子集,作为线性和二次判别分类器的输入。通过这种方式,我们能够对信号进行逐分钟分类,分为呼吸暂停或非呼吸暂停,使用 WA 和 EMD 分别获得高达 89%和 85%的最佳子集大小的准确率。此外,无论使用哪种特征提取器,都可以 100%正确地区分呼吸暂停患者和正常受试者。最后,通过将标准 HRV 时域、EMD 和 WA 的特征组合在一起,重复相同的过程,以研究这两种分解技术是否可以提供互补的特征。获得的准确率为 89%,与仅使用小波分析作为特征提取器获得的准确率相似;然而,在 EMD 和 WA 中存在一些互补的特征。