학술논문

A New Sleep Staging System for Type III Sleep Studies Equipped With a Tracheal Sound Sensor
Document Type
Periodical
Source
IEEE Transactions on Biomedical Engineering IEEE Trans. Biomed. Eng. Biomedical Engineering, IEEE Transactions on. 69(3):1225-1236 Mar, 2022
Subject
Bioengineering
Computing and Processing
Components, Circuits, Devices and Systems
Communication, Networking and Broadcast Technologies
Sleep
Sleep apnea
Belts
Testing
Performance evaluation
Manuals
Hidden Markov models
Automatic sleep staging
type III sleep study
cardio-respiratory channels
tracheal sound sensor
multilayer perceptron
viterbi HMM
Language
ISSN
0018-9294
1558-2531
Abstract
Type III sleep studies record cardio-respiratory channels only. Compared with polysomnography, which also records electrophysiological channels, they present many advantages: they are less expensive, less time-consuming, and more likely to be performed at home. However, their accuracy is limited by missing sleep information. That is why many studies present specific cardio-respiratory parameters to assess the causal effects of sleep stages upon cardiac or respiratory activities. For this paper, we gathered many parameters proposed in literature, leading to 1,111 features. The pulse oximeter, the PneaVoX sensor (recording tracheal sounds), respiratory inductance plethysmography belts, the nasal cannula and the actimeter provided the 112 worthiest ones for automatic sleep scoring. Then, a 3-step model was implemented: classification with a multi-layer perceptron, sleep transition rules corrections (from the AASM guidelines), and sequence corrections using a Viterbi hidden Markov model. The whole process was trained and tested using 300 and 100 independent recordings provided from patients suspected of having sleep breathing disorders. Results indicated that the system achieves substantial agreement with manual scoring for classifications into 2 stages (wake vs. sleep: mean Cohen’s Kappa $\kappa$ of 0.63 and accuracy rate $Acc$ of 87.8%) and 3 stages (wake vs. R stage vs. NREM stage: mean $\kappa$ of 0.60 and $Acc$ of 78.5%). It indicates that the method could provide information to help specialists while diagnosing sleep. The presented model had promising results and may enhance clinical diagnosis.