Academia.eduAcademia.edu

Outline

Sleep Quality Estimation by Cardiopulmonary Coupling Analysis

2018, IEEE Transactions on Neural Systems and Rehabilitation Engineering

https://doi.org/10.1109/TNSRE.2018.2881361

Abstract

The gold standard for assessment of sleep quality is the polysomnography where physiological signals are used to generate both quantitative and qualitative measurements. Despite the production of highly accurate results, polysomnography is a complex, uncomfortable and expensive process, inaccessible to a large group of the population. Home monitoring devices were developed to address these issues, fitting the growing perspective of health care and focusing in prevention and wellness. The objective of this work was to develop an algorithm capable of estimating the quality of sleep, by analyzing the cyclic alternating pattern rate. The algorithm uses a single-lead electrocardiogram to produce a spectrographic measure of the cardiopulmonary coupling that in turn was fed to a classifier to estimate the nonrapid eye movement sleep and the presence of the cyclic alternating pattern. Two classifiers were tested, a feedforward neural network and a deep stacked autoencoder, with the second achieving better results, correctly classifying 77% of the subjects sleep quality (either good or bad). The developed method can be implemented in a home monitoring device to estimate the sleep quality in a non-invasive way and improve the detection of pathologies.

References (41)

  1. R. Berry, R. Brooks, C. Gamaldo, S. Harding, R. Lloyd, C. Marcus and B. Vaughn, The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Darien, Illinois, USA: American Academy of Sleep Medicine, 2017.
  2. M. Terzano, L. Parrino, A. Smerieri, R. Chervin, S. Chokroverty, C. Guilleminault, M. Hirshkowitz, M. Mahowald, H. Moldofsky, A. Rosa, R. Thomas and A. Walters, "Atlas, rules, and recording techniques for the scoring of cyclic alternating pattern (CAP) in human sleep," Sleep Medicine, vol. 2, no. 6, pp. 537-553, 2001.
  3. A. Smerieri, L. Parrino, M. Agosti, R. Ferri and M. Terzano, "Cyclic alternating pattern sequences and non-cyclic alternating pattern periods in human sleep," Clinical Neurophysiology, vol. 118, no. 10, pp. 2305- 2313, 2007.
  4. L. Parrino, G. Milioli, A. Melpignano and I. Trippi, "The Cyclic Alternating Pattern and the Brain-Body-Coupling During Sleep," Epileptologie, vol. 33, pp. 150-160, 2016.
  5. J. Gaines, A. Vgontzas, J. Fernandez-Mendoza, M. Basta, S. Pejovic, F. He and E. Bixler, "Short-and Long-Term Sleep Stability in Insomniacs and Healthy Controls," Sleep, vol. 38, no. 11, pp. 1727-1734, 2015.
  6. D. Reed and W. Sacco, "Measuring Sleep Efficiency: What Should the Denominator Be?," Journal of Clinical Sleep Medicine, vol. 12, no. 2, pp. 263-266, 2016.
  7. A. Krystal and J. Edinger, "Measuring sleep quality," Sleep Medicine, vol. 9, no. 1, pp. S10-S17, 2008.
  8. P. Schramm, R. Thomas, B. Feige, K. Spiegelhalder and D. Riemann, "Quantitative measurement of sleep quality using cardiopulmonary coupling analysis: a retrospective comparison of individuals with and without primary insomnia," Sleep and Breathing, vol. 17, no. 2, pp. 713- 721, 2013.
  9. L. Chen, C. Liu, Z. Ye, B. Wang and S. He, "Assessment of sleep quality using cardiopulmonary coupling analysis in patients with Parkinson's disease," Brain and Behavior, pp. 1-6, 2018.
  10. L. Parrino, R. Ferri, O. Bruni and M. Terzano, "Cyclic alternating pattern (CAP): the marker of sleep instability," Sleep Medicine Reviews, vol. 16, no. 1, pp. 27-45, 2012.
  11. F. Mendonça, A. Fred, S. Mostafa, F. Morgado-Dias and A. Ravelo- García, "Automatic detection of cyclic alternating pattern," Neural Computing and Applications, pp. 1-11, 2018.
  12. L. Ibrahim, F. Jacono, S. Patel, R. Thomas, E. Larkin, J. Mietus, C. Peng, A. Goldberger and S. Redline, "Heritability of abnormalities in cardiopulmonary coupling in sleep apnea: use of an electrocardiogram- based technique," Sleep, vol. 33, no. 5, pp. 643-646, 2010.
  13. J. Bronzino, The biomedical engineering handbook, 3º ed., Connecticut: CRC Press, 2006.
  14. J. Pan and W. Tompkins, "A real-time QRS detection algorithm," IEEE Transactions on Biomedical Engineering, vol. 32, no. 3, pp. 230-236, 1985.
  15. E. Helfenbein, R. Firoozabadi, S. Chien, E. Carlson and S. Babaeizadeh, "Development of three methods for extracting respiration from the surface ECG: a review," Journal of Electrocardiology, vol. 47, no. 6, pp. 819-825, 2014.
  16. S. Arunachalam and L. Brown, "Real-Time Estimation of the ECG- Derived Respiration (EDR) Signal using a New Algorithm for Baseline Wander Noise Removal," in Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2009, Minnesota, USA, 3-6, September, 2009.
  17. R. Thomas, J. Mietus, C. Peng and A. Goldberger, "An electrocardiogram-based technique to assess cardiopulmonary coupling during sleep," Sleep, vol. 28, no. 9, pp. 1151-1161, 2005.
  18. I. Santamaria and J. Via, "Estimation of the Magnitude Squared Coherence Spectrum Based on Reduced-Rank Canonical Coordinates," in IEEE International Conference on Acoustics, Speech and Signal Processing, 2007, Honolulu, Hawaii, USA, 15-20, April, 2007.
  19. M. Moller, "A scaled conjugate gradient algorithm for fast supervised learning," Neural Networks, vol. 6, nº 4, pp. 525-533, 1993.
  20. I. Goodfellow, Y. Bengio and A. Courville, Deep Learning, Massachusetts: The MIT Press, 2016.
  21. R. Kohavi, "A study of cross-validation and bootstrap for accuracy estimation and model selection," in 14th international joint conference on Artificial intelligence, Quebec, Canada, 20-25, August, 1995.
  22. K. Aboalayon, M. Faezipour, W. Almuhammadi and S. Moslehpour, "Sleep Stage Classification Using EEG Signal Analysis: A Comprehensive Survey and New Investigation," Entropy, vol. 18, no. 9, pp. 1-31, 2016.
  23. U. Scholz, A. Bianchi, S. Cerutti and S. Kubicki, "Vegetative Background of Sleep: Spectral Analysis of the Heart Rate Variability," Physiology & Behavior, vol. 62, no. 5, pp. 1037-1043, 1997.
  24. M. Xiao, H. Yan, J. Song, Y. Yang and X. Yang, "Sleep stages classification based on heart rate variability and random forest," Biomedical Signal Processing and Control, vol. 8, no. 6, pp. 624-633, 2013.
  25. F. Ebrahimi, S. Setarehdan, J. Ayala-Moyeda e H. Nazeran, "Automatic sleep staging using empirical mode decomposition, discrete wavelet transform, time-domain, and nonlinear dynamics features of heart rate variability signals," Computer Methods and Programs in Biomedicine, vol. 112, nº 1, pp. 47-57, 2013.
  26. M. Mendez, M. Matteucci, V. Castronovo, L. Ferini-Strambi, S. Cerutti and A. Bianchi, "Sleep staging from Heart Rate Variability: time-varying spectral features and Hidden Markov Models," International Journal of Biomedical Engineering and Technology, vol. 3, no. 3, pp. 246-263, 2010.
  27. M. Aktaruzzaman, M. Migliorini, M. Tenhunen, S. Himanen, A. Bianchi and R. Sassi, "The addition of entropy-based regularity parameters improves sleep stage classification based on heart rate variability," Medical & Biological Engineering & Computing, vol. 53, no. 5, pp. 415- 425, 2015.
  28. G. Nason, T. Sapatinas and A. Sawczenko, "Wavelet Packet Modelling of Infant Sleep State Using Heart Rate Data," Sankhya B, vol. 63, no. 1, pp. 199-217, 2001.
  29. WerteniH., S. Yacoub and N. Ellouze, "An Automatic Sleep-Wake Classifier Using ECG Signals," International Journal of Computer Science Issues, vol. 11, no. 4, pp. 84-93, 2014.
  30. M. Adnane, Z. Jiang and Z. Yan, "Sleep-wake stages classification and sleep efficiency estimation using single-lead electrocardiogram," Expert Systems with Applications, vol. 39, no. 1, pp. 1401-1413, 2012.
  31. J. Kim, J. Lee and M. Shin, "Sleep stage classification based on noise- reduced fractal property of heart rate variability," in 2nd International Conference on Computer Science and Computational Intelligence 2017, Bali, Indonesia, 13-14, October, 2017.
  32. X. Zhang, W. Kou, E. Chang, H. Gao, Y. Fan and Y. Xu, "Sleep Stage Classification Based on Multi-level Feature Learning and Recurrent Neural Networks via Wearable Device," Clinical Orthopaedics and Related Research, vol. abs/1711.00629, pp. 1-11, 2017.
  33. P. Fonseca, X. Long, M. Radha, R. Haakma, R. Aarts and J. Rolink, "Sleep stage classification with ECG and respiratory effort," Physiological Measurement, vol. 36, no. 10, pp. 2027-2040, 2015.
  34. J. Harrington, P. Schramm, C. Davies and T. Lee-Chiong, "An electrocardiogram-based analysis evaluating sleep quality in patients with obstructive sleep apnea," Sleep Breath, vol. 17, no. 3, pp. 1071- 1078, 2013.
  35. R. Thomas, C. Wood and M. Bianchi, "Cardiopulmonary coupling spectrogram as an ambulatory clinical biomarker of sleep stability and quality in health, sleep apnea, and insomnia," Sleep, vol. 41, no. 2, 2018.
  36. R. Thomas, C. Shin, M. Bianchi, C. Kushida and C. Yun, "Distinct polysomnographic and ECGspectrographic phenotypes embedded within obstructive sleep apnea," Sleep Science and Practice, vol. 1, no. 11, pp. 1-13, 2017.
  37. S. Magnusdottir and H. Hilmisson, "Ambulatory screening tool for sleep apnea: analyzing a single-lead electrocardiogram signal (ECG)," Sleep and Breathing, vol. 22, no. 2, pp. 421-429, 2018.
  38. L. Piwek, D. Ellis, S. Andrews and A. Joinson, "The Rise of Consumer Health Wearables: Promises and Barriers," PLOS Medicine, vol. 13, no. 2, pp. 1-9, 2016.
  39. A. Rosa, G. Alves, M. Brito, M. Lopes and S. Tufik, "Visual and automatic cyclic alternating pattern (CAP) scoring: inter-rater reliability study," Arquivos de Neuro-Psiquiatria, vol. 64, no. 3A, pp. 578-581, 2006.
  40. J. Park, E. Urtnasan, E. Joo and K. Lee, "Cardiopulmonary Coupling Analysis Using Home Sleep Monitoring System Based on Air Mattress," Journal of Medical Systems, vol. 41, no. 11, pp. 1-3, 2017.
  41. A. Moriguchi, A. Otsuka, K. Kohara, H. Mikami, K. Katahira, T. Tsunetoshi, K. Higashimori, M. Ohishi, Y. Yo and T. Ogihara, "Spectral change in heart rate variability in response to mental arithmetic before and after the beta-adrenoceptor blocker, carteolol," Clinical Autonomic Research, vol. 2, no. 4, pp. 267-270, 1992.