scholarly journals Short-Term HRV Analysis Using Nonparametric Sample Entropy for Obstructive Sleep Apnea

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 267
Author(s):  
Duan Liang ◽  
Shan Wu ◽  
Lan Tang ◽  
Kaicheng Feng ◽  
Guanzheng Liu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sample Entropy ◽  
Biomedical Signal Processing ◽  
Apnea Hypopnea Index ◽  
Short Term ◽  
Autonomic Nervous System Dysfunction ◽  
Obstructive Sleep ◽  
Hrv Analysis ◽  
Frequency Power

Obstructive sleep apnea (OSA) is associated with reduced heart rate variability (HRV) and autonomic nervous system dysfunction. Sample entropy (SampEn) is commonly used for regularity analysis. However, it has limitations in processing short-term segments of HRV signals due to the extreme dependence of its functional parameters. We used the nonparametric sample entropy (NPSampEn) as a novel index for short-term HRV analysis in the case of OSA. The manuscript included 60 6-h electrocardiogram recordings (20 healthy, 14 mild-moderate OSA, and 26 severe OSA) from the PhysioNet database. The NPSampEn value was compared with the SampEn value and frequency domain indices. The empirical results showed that NPSampEn could better differentiate the three groups (p < 0.01) than the ratio of low frequency power to high frequency power (LF/HF) and SampEn. Moreover, NPSampEn (83.3%) approached a higher OSA screening accuracy than the LF/HF (73.3%) and SampEn (68.3%). Compared with SampEn (|r| = 0.602, p < 0.05), NPSampEn (|r| = 0.756, p < 0.05) had a significantly stronger association with the apnea-hypopnea index (AHI). Hence, NPSampEn can fully overcome the influence of individual differences that are prevalent in biomedical signal processing, and might be useful in processing short-term segments of HRV signal.

scholarly journals Efficacy and adherence of auto-CPAP therapy in patients with obstructive sleep apnea: a prospective study

2020 ◽  
Vol 15 ◽  
Author(s):  
Hang Dinh-Thi-Dieu ◽  
Anh Vo-Thi-Kim ◽  
Huong Tran-Van ◽  
Sy Duong-Quy
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Congestion ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Short Term ◽  
Arousal Index ◽  
Obstructive Sleep ◽  
A Prospective Study

Introduction: The use of auto-continuous positive airway pressure (auto-CPAP) therapy has been recommended for subjects with moderate-to-severe obstructive sleep apnea (OSA) without significant comorbidities. This study is aimed at evaluating the efficacy and adherence of auto-CPAP therapy in subjects with OSA. Methods: It was a perspective and descriptive study. All study subjects who had apnea-hypopnea index (AHI) >30/h, measured by polysomnography, were included. They were treated with auto-CPAP and followed-up for 6 months for evaluating the effect of CPAP-therapy on clinical and biological features and treatment adherence. Results: One hundred and thirty-nine subjects with severe OSA were accepted for auto-CPAP therapy at inclusion. BMI was 28.4±3.8 kg/m2; neck and abdomen circumferences were 38.2±6.4 and 85.7±11.6. Epworth and Pichot scores were 18.4±6.3 and 28.3±4.5, respectively; AHI was 39±7/h and arousal index was 39±13/hour. At 6th month, 96.4% of study subjects continued to use auto-CPAP-therapy within 6.5±2.4 hours/night. There was a significant correlation between the modification (Δ) of Epworth scores and (Δ) AHI after 3 and 6 months of auto-CPAP-therapy (R=0.568 and P=0.003; R=0.745 and P=0.002; respectively). At 6th month follow-up, the main side effects of auto-CPAP were difficult sleeping, dry mouth or nose, skin marks or rashes, discomfortable breathing, and nasal congestion (36.1%, 32.0%, 20.8%, 16.0%, and 11.9%; respectively). Conclusion: Auto-CPAP is effective in treatment of Vietnamese patients with severe OSA in short-term follow-up.

scholarly journals Portable Sleep Apnea Syndrome Screening and Event Detection Using Long Short-Term Memory Recurrent Neural Network

Sensors ◽  
2020 ◽  
Vol 20 (21) ◽  
pp. 6067
Author(s):  
Hung-Chi Chang ◽  
Hau-Tieng Wu ◽  
Po-Chiun Huang ◽  
Hsi-Pin Ma ◽  
Yu-Lun Lo ◽  
...  
Keyword(s):  
Neural Network ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Recurrent Neural Network ◽  
Short Term Memory ◽  
Apnea Hypopnea Index ◽  
Short Term ◽  
Term Memory ◽  
Obstructive Sleep ◽  
Long Short Term Memory

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by repeated airflow partial reduction or complete cessation due to upper airway collapse during sleep. OSAHS can induce frequent awake and intermittent hypoxia that is associated with hypertension and cardiovascular events. Full-channel Polysomnography (PSG) is the gold standard for diagnosing OSAHS; however, this PSG evaluation process is unsuitable for home screening. To solve this problem, a measuring module integrating abdominal and thoracic triaxial accelerometers, a pulsed oximeter (SpO2) and an electrocardiogram sensor was devised in this study. Moreover, a long short-term memory recurrent neural network model is proposed to classify four types of sleep breathing patterns, namely obstructive sleep apnea (OSA), central sleep apnea (CSA), hypopnea (HYP) events and normal breathing (NOR). The proposed algorithm not only reports the apnea-hypopnea index (AHI) through the acquired overnight signals but also identifies the occurrences of OSA, CSA, HYP and NOR, which assists in OSAHS diagnosis. In the clinical experiment with 115 participants, the performances of the proposed system and algorithm were compared with those of traditional expert interpretation based on PSG signals. The accuracy of AHI severity group classification was 89.3%, and the AHI difference for PSG expert interpretation was 5.0±4.5. The overall accuracy of detecting abnormal OSA, CSA and HYP events was 92.3%.

scholarly journals Short-term efficacy of mandibular advancement splint in treatment of obstructive sleep apnea-hypopnea syndrome

2013 ◽  
Vol 18 (3) ◽  
pp. 118-123 ◽  
Author(s):  
Calliandra Moura Pereira de Lima ◽  
Laurindo Zanco Furquim ◽  
Adilson Luiz Ramos
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Mandibular Advancement ◽  
Apnea Hypopnea Index ◽  
Long Term Effects ◽  
Short Term ◽  
Term Efficacy ◽  
Mandibular Advancement Splint ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

OBJECTIVE: The aim of the present study was to determine the short-term efficacy of treatment for snoring and obstructive sleep apnea-hypopnea syndrome (OSAHS) using a mandibular advancement splint. METHODS: The sample comprised 20 patients (13 men and 7 women; mean age = 48 years; mean body mass index = 27.07) with OSAHS. Polysomnograms were performed before and 60 days after mandibular advancement splint therapy. RESULTS: There was a significant reduction in the apnea-hypopnea index (AHI) following treatment (mean pretreatment AHI = 20.89 ± 17.9 versus mean posttreatment AHI = 4.43 ± 3.09) (p < 0.05). The snoring reduced and the sleep efficiency improved, as registered by polysomnograms (p<0.05). CONCLUSIONS: The sleep quality improved in patients using mandibular advancement splint. Further studies evaluating long-term effects are needed.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

scholarly journals High Plasma Cystine Levels Are Associated with Blood Pressure and Reversed by CPAP in Patients with Obstructive Sleep Apnea

2021 ◽  
Vol 10 (7) ◽  
pp. 1387
Author(s):  
Raphael Boneberg ◽  
Anita Pardun ◽  
Lena Hannemann ◽  
Olaf Hildebrandt ◽  
Ulrich Koehler ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Mononuclear Cells ◽  
Vascular Risk Factor ◽  
High Plasma ◽  
Apnea Hypopnea Index ◽  
Hypoxic Stress ◽  
Peripheral Blood Mononuclear ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) independent of obesity (OBS) imposes severe cardiovascular risk. To what extent plasma cystine concentration (CySS), a novel pro-oxidative vascular risk factor, is increased in OSA with or without OBS is presently unknown. We therefore studied CySS together with the redox state and precursor amino acids of glutathione (GSH) in peripheral blood mononuclear cells (PBMC) in untreated male patients with OSA (apnea-hypopnea-index (AHI) > 15 h−1, n = 28) compared to healthy male controls (n = 25) stratifying for BMI ≥ or < 30 kg m−2. Fifteen OSA patients were reassessed after 3–5-months CPAP. CySS correlated with cumulative time at an O2-saturation <90% (Tu90%) (r = 0.34, p < 0.05) beside BMI (r = 0.58, p < 0.001) and was higher in subjects with “hypoxic stress” (59.4 ± 2.0 vs. 50.1 ± 2.7 µM, p < 0.01) defined as Tu90% ≥ 15.2 min (corresponding to AHI ≥ 15 h−1). Moreover, CySS significantly correlated with systolic (r = 0.32, p < 0.05) and diastolic (r = 0.31, p < 0.05) blood pressure. CPAP significantly lowered CySS along with blood pressure at unchanged BMI. Unexpectedly, GSH antioxidant capacity in PBMC was increased with OSA and reversed with CPAP. Plasma CySS levels are increased with OSA-related hypoxic stress and associated with higher blood pressure. CPAP decreases both CySS and blood pressure. The role of CySS in OSA-related vascular endpoints and their prevention by CPAP warrants further studies.

scholarly journals Altered K-complex morphology during sustained inspiratory airflow limitation is associated with next-day lapses in vigilance in obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Ankit Parekh ◽  
Korey Kam ◽  
Anna E Mullins ◽  
Bresne Castillo ◽  
Asem Berkalieva ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Spectral Characteristics ◽  
Sleep Time ◽  
Airflow Limitation ◽  
Apnea Hypopnea Index ◽  
Complex Morphology ◽  
Obstructive Sleep ◽  
Inspiratory Airflow Limitation ◽  
Psychomotor Vigilance

Abstract Study Objectives Determine if changes in K-complexes associated with sustained inspiratory airflow limitation (SIFL) during N2 sleep are associated with next-day vigilance and objective sleepiness. Methods Data from thirty subjects with moderate-to-severe obstructive sleep apnea who completed three in-lab polysomnograms: diagnostic, on therapeutic continuous positive airway pressure (CPAP), and on suboptimal CPAP (4 cmH2O below optimal titrated CPAP level) were analyzed. Four 20-min psychomotor vigilance tests (PVT) were performed after each PSG, every 2 h. Changes in the proportion of spontaneous K-complexes and spectral characteristics surrounding K-complexes were evaluated for K-complexes associated with both delta (∆SWAK), alpha (∆αK) frequencies. Results Suboptimal CPAP induced SIFL (14.7 (20.9) vs 2.9 (9.2); %total sleep time, p &lt; 0.001) with a small increase in apnea–hypopnea index (AHI3A: 6.5 (7.7) vs 1.9 (2.3); p &lt; 0.01) versus optimal CPAP. K-complex density (num./min of stage N2) was higher on suboptimal CPAP (0.97 ± 0.7 vs 0.65±0.5, #/min, mean ± SD, p &lt; 0.01) above and beyond the effect of age, sex, AHI3A, and duration of SIFL. A decrease in ∆SWAK with suboptimal CPAP was associated with increased PVT lapses and explained 17% of additional variance in PVT lapses. Within-night during suboptimal CPAP K-complexes appeared to alternate between promoting sleep and as arousal surrogates. Electroencephalographic changes were not associated with objective sleepiness. Conclusions Sustained inspiratory airflow limitation is associated with altered K-complex morphology including the increased occurrence of K-complexes with bursts of alpha as arousal surrogates. These findings suggest that sustained inspiratory flow limitation may be associated with nonvisible sleep fragmentation and contribute to increased lapses in vigilance.

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