Faculty of Medicine, Kyoto University, Kyoto, Japan.
Department of Systems Science, Kyoto University, Kyoto, Japan.
Sleep Breath. 2021 Dec;25(4):1821-1829. doi: 10.1007/s11325-020-02249-0. Epub 2021 Jan 10.
Sleep apnea syndrome (SAS) is a prevalent sleep disorder in which apnea and hypopnea occur frequently during sleep and result in increase of the risk of lifestyle-related disease development as well as daytime sleepiness. Although SAS is a common sleep disorder, most patients remain undiagnosed because the gold standard test polysomnography (PSG), is high-cost and unavailable in many hospitals. Thus, an SAS screening system that can be used easily at home is needed.
Apnea during sleep affects changes in the autonomic nervous function, which causes fluctuation of the heart rate. In this study, we propose a new SAS screening method that combines heart rate measurement and long short-term memory (LSTM) which is a type of recurrent neural network (RNN). We analyzed the data of intervals between adjacent R waves (R-R interval; RRI) on the electrocardiogram (ECG) records, and used an LSTM model whose inputs are the RRI data is trained to discriminate the respiratory condition during sleep.
The application of the proposed method to clinical data showed that it distinguished between patients with moderate-to-severe SAS with a sensitivity of 100% and specificity of 100%, results which are superior to any other existing SAS screening methods.
Since the RRI data can be easily measured by means of wearable heart rate sensors, our method may prove to be useful as an SAS screening system at home.
睡眠呼吸暂停综合征(SAS)是一种常见的睡眠障碍,在睡眠中经常发生呼吸暂停和呼吸不足,导致与生活方式相关的疾病发展风险增加以及白天嗜睡。尽管 SAS 是一种常见的睡眠障碍,但由于金标准测试多导睡眠图(PSG)成本高且许多医院都无法进行,因此大多数患者仍未被诊断出来。因此,需要一种可以在家中轻松使用的 SAS 筛查系统。
睡眠期间的呼吸暂停会影响自主神经系统功能的变化,从而导致心率波动。在这项研究中,我们提出了一种新的 SAS 筛查方法,该方法结合了心率测量和长短期记忆(LSTM),这是一种递归神经网络(RNN)。我们分析了心电图(ECG)记录中相邻 R 波(RR 间隔;RRI)之间的间隔数据,并使用输入为 RRI 数据的 LSTM 模型来训练该模型,以区分睡眠期间的呼吸状况。
将该方法应用于临床数据表明,它能够以 100%的灵敏度和 100%的特异性区分中重度 SAS 患者,其结果优于任何其他现有的 SAS 筛查方法。
由于 RRI 数据可以通过可穿戴心率传感器轻松测量,因此我们的方法可能被证明是一种有用的家用 SAS 筛查系统。