Detection of obstructive sleep apnea in pediatric subjects using surface lead electrocardiogram features.

STUDY OBJECTIVES: To investigate the feasibility of detecting obstructive sleep apnea (OSA) in children using an automated classification system based on analysis of overnight electrocardiogram (ECG) recordings. DESIGN: Retrospective observational study. SETTING: A pediatric sleep clinic. PARTICIPANTS: Fifty children underwent full overnight polysomnography. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: Expert polysomnography scoring was performed. The datasets were divided into a training set of 25 subjects (11 normal, 14 with OSA) and a withheld test set of 25 subjects (11 normal, 14 with OSA). Features, calculated from the ECG of the 25 training datasets, were empirically chosen to train a modified quadratic discriminant analysis classification system. The selected configuration used a segment length of 60 seconds and processed mean, SD, power spectral density, and serial correlation measures to classify segments as apneic or normal. By combining per-segment classifications and using receiver-operator characteristic analysis, a per-subject classifier was obtained that had a sensitivity of 85.7%, specificity of 90.9%, and accuracy of 88% on the training datasets. The same decision threshold was applied to the withheld datasets and yielded a sensitivity of 85.7%, specificity of 81.8%, and accuracy of 84%. The positive and negative predictive values were 85.7% and 81.8%, respectively, on the test dataset. CONCLUSIONS: The ability to correctly identify 12 out of 14 cases of OSA (with the 2 false negatives arising from subjects with an apnea-hypopnea index less than 10) indicates that the automated apnea classification system outlined may have clinical utility in pediatric patients.

Real time breathing rate estimation from a non contact biosensor.

An automated real time method for detecting human breathing rate from a non contact biosensor is considered in this paper. The method has low computational and RAM requirements making it well-suited to real-time, low power implementation on a microcontroller. Time and frequency domain methods are used to separate a 15s block of data into movement, breathing or absent states; a breathing rate estimate is then calculated. On a 1s basis, 96% of breaths were scored within 1 breath per minute of expert scored respiratory inductance plethysmography, while 99% of breaths were scored within 2 breaths per minute. When averaged over 30s, as is used in this respiration monitoring system, over 99% of breaths are within 1 breath per minute of the expert score.

Automated detection of paroxysmal atrial fibrillation from inter-heartbeat intervals.

An automated method for detecting episodes of probable paroxysmal atrial fibrillation based on processing blocks of inter-heartbeat intervals is considered. The method has very low computational requirements making it well-suited to near real-time, low power applications. A supervised linear discriminant classifier is used to estimate the likelihood of a block of inter-heartbeat intervals containing paroxysmal atrial fibrillation (PAF). Per block accuracies in separating normal from PAF were 92%, 94%, 100% and 100% when the method was used to process the Physionet MITDB, AFDB, NSRDB and NSR2DB databases respectively.

An evaluation of a non-contact biomotion sensor with actimetry.

Actimetry is a widely accepted technology for the diagnosis and monitoring of sleep disorders such as insomnia, circadian sleep/wake disturbance, and periodic leg movement. In this study we investigate a very sensitive non-contact biomotion sensor to measure actimetry and compare its performance to wrist-actimetry. A data corpus consisting of twenty subjects (ten normals, ten with sleep disorders) was collected in the unconstrained home environment with simultaneous non-contact sensor and ActiWatch actimetry recordings. The aggregated length of the data is 151 hours. The non-contact sensor signal was mapped to actimetry using 30 second epochs and the level of agreement with the ActiWatch actimetry determined. Across all twenty subjects, the sensitivity and specificity was 79% and 75% respectively. In addition, it was shown that the non-contact sensor can also measure breathing and breathing modulations. The results of this study indicate that the non-contact sensor may be a highly convenient alternative to wrist-actimetry as a diagnosis and screening tool for sleep studies. Furthermore, as the non-contact sensor measures breathing modulations, it can additionally be used to screen for respiratory disturbances in sleep caused by sleep apnea and COPD.