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New Automated Detection Method of OSA Based on Artificial Neural Networks Using P-Wave Shape and Time Changes

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Abstract

This paper describes a new method for automatic detection of obstructive sleep apnea (OSA) based on artificial neural networks (ANN) using regular electrocardiogram (ECG) recordings. ECG signals were pre-processed and segmented to extract the P-waves; then three P-wave features were extracted: the P-wave duration (T p ), the P-wave dispersion (P d ), and the time interval from the peak of the P-wave to the R-wave (T pr ). Combinations of the three features were used as features for classification using ANN. For each feature combination studied, 70% of the input data was used for training the ANN, 15% for validating, and 15% for testing the results. Perfect agreement between expert’s scores and the ANN scores was achieved when the ANN was applied on T p , P d , and T pr taken together, while substantial agreements were achieved when applying the ANN on the feature combinations T p and P d , and T p and T pr .

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References

  1. Penzel, T., McNames, J., de Chazal, P., Raymond, B., Murray, A., and Moody, G., Systematic comparison of different algorithms for apnoea detection based on electrocardiogram recordings. Med. Biol. Eng. Comput. 40:402–407, 2002.

    Article  Google Scholar 

  2. de Chazal, P., Heneghan, C., Sheridan, E., Reilly, R., Nolan, P., and O’Malley, M., Automated processing of the single-lead electrocardiogram for the detection of obstructive sleep apnoea. IEEE Trans. Biomed. Eng. 50(6):686–696, 2003.

    Article  Google Scholar 

  3. Boudaoud, S., Rix, H., Meste, O., Heneghan, C., O’Brien, C., Corrected integral shape averaging applied to obstructive sleep apnea detection from the electrocardiogram. EURASIP J. Adv. Signal. Process. 2007:32570, (2007).

  4. Shamsuzzaman, A., Gersh, B., and Somers, V., Obstructive sleep apnea implications for cardiac and vascular disease. JAMA. 290(14):1906–1914, 2003.

    Article  Google Scholar 

  5. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., and Badr, S., The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 328:1230–1235, 1993.

    Article  Google Scholar 

  6. Young, T., Evans, L., Finn, L., and Palta, M., Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 20:705–706, 1997.

    Google Scholar 

  7. Boudaoud, S., Heneghan, C., Rix, H., Meste, O., and O’Brien, C., P-wave shape changes observed in the surface electrocardiogram of subjects with obstructive sleep apnoea. Comput. Cardiol. 32:359–362, 2005.

    Article  Google Scholar 

  8. Peker, Y., Kraiczi, H., Hedner, J., Loth, S., Johansson, A., and Bende, M., An independent association between obstructive sleep apnoea and coronary artery disease. Eur. Respir. J. 13:179–184, 1999.

    Article  Google Scholar 

  9. Peppard, P., Young, T., Palta, M., and Skatrud, J., Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 342:1378–1384, 2000.

    Article  Google Scholar 

  10. Yaggi, H., Concato, J., Kernan, W., Lichtman, J., Brass, L., and Mohsenin, V., Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 353:2034–2041, 2005.

    Article  Google Scholar 

  11. Yumino, D., Tsurumi, Y., Takagi, A., Suzuki, K., and Kasanuki, H., Impact of obstructive sleep apnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome. Am. J. Cardiol. 99(1):26–30, 2007.

    Article  Google Scholar 

  12. Boudaoud, S., Rix, H., Blanc, J., Cornilly, J., and Meste, O., Integrated shape averaging applied to AF detection. Comput. Cardiol. 30:125–128, 2003.

    Google Scholar 

  13. Boudaoud, S., Meste, O., and Rix, H., Curve registration for study of P-wave morphing during exercise. Comput. Cardiol. 31:125–128, 2004.

    Google Scholar 

  14. Carlson, J., Johansson, R., and Olsson, S., Classification of electrocardiographic P-Wave morphology. IEEE Trans. Biomed. Eng. 4:401–405, 2001.

    Article  Google Scholar 

  15. Dogan, A., Acar, G., Gedikli, O., Ozaydin, M., Nazli, C., Altinbas, A., and Ergene, O., A comparison of P-wave duration and dispersion in patients with short-term and long-term atrial fibrillation. J. Electrocardiol. 36(3):251–255, 2003.

    Article  Google Scholar 

  16. Can, I., Aytemir, K., Demir Deniz, A., Ciftci, O., Tokgozoglu, L., Oto, A., and Sahin, A., P-wave duration and dispersion in patients with obstructive sleep apnea. Int. J. Cardiol. 133:e85–e89, 2009.

    Article  Google Scholar 

  17. Benzadón, M., Ortega, D., Thierer, J., Torcivia, R., Aldunate, L., de Lima, A., Navia, D., Dorsa, A., Rossi, A., and Trivi, M., Comparison of the amplitude of the P-wave from intracardiac electrocardiogram obtained by means of a central venous catheter filled with saline solution to that obtained via esophageal electrocardiogram. Am. J. Cardiol. 98:978–981, 2006.

    Article  Google Scholar 

  18. Turgut, O., Tandogan, I., Yilmaz, M., Yalta, K., Aydin, O., Association of P wave duration and dispersion with the risk for atrial, fibrillation: practical considerations in the setting, of coronary artery disease. Int. J. Cardiol. in press, 2009.

  19. Tsikouris, J., Kluger, J., Song, J., and White, C., Changes in P-wave dispersion and P-wave duration after open heart surgery are associated with the peak incidence of atrial fibrillation. Heart Lung. 30(6):466–471, 2001.

    Article  Google Scholar 

  20. Reynolds, E., Seda, G., Ware, J., Vinik, A., Risk, M., and Fishback, N., Autonomic function in sleep apnea patients: increased heart rate variability except during REM sleep in obese patients. Sleep Breath. 11:53–60, 2007.

    Article  Google Scholar 

  21. Svozil, D., Kvasnicka, V., and Pospichal, J., Introduction to multi-layer feed-forward neural networks. Chemometr. Intell. Lab. Sys. 39:43–62, 1997.

    Article  Google Scholar 

  22. Fausett, L., Fundamentals of neural networks: architectures, algorithms and applications. Prentice Hall, Upper Saddle River, 1994.

    MATH  Google Scholar 

  23. Kiymik, M., Akin, M., and Subasi, A., Automatic recognition of alertness level by using wavelet transform and artificial neural network. J. Neurosci. Methods. 139(2):231–240, 2004.

    Article  Google Scholar 

  24. Lalitha, V., and Eswaran, C., Automated detection of anesthetic depth levels using chaotic features with artificial neural networks. J. Med. Syst. 31(6):445–452, 2007.

    Article  Google Scholar 

  25. Yildiz, A., Akin, M., Poyraz, M., and Kirbas, G., Application of adaptive neuro-fuzzy inference system for vigilance level estimation by using wavelet-entropy feature extraction. Expert Syst. Appl. 36(4):7390–7399, 2009.

    Article  Google Scholar 

  26. Cohen, J., A coefficient of agreement for nominal scales. Edu. Physiol. Meas. 20:37–46, 1960.

    Google Scholar 

  27. Sim, J., and Wrigth, C., The Kappa statistics in reliability studies: use, interpretation, and sample size requirements. Phys. Ther. 85(3):257–268, 2005.

    Google Scholar 

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Acknowledgement

This work was supported by the German Research Foundation-DFG (Deutsche Forschungsgemeinschaft).

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Correspondence to Khaldon Lweesy.

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Lweesy, K., Fraiwan, L., Khasawneh, N. et al. New Automated Detection Method of OSA Based on Artificial Neural Networks Using P-Wave Shape and Time Changes. J Med Syst 35, 723–734 (2011). https://doi.org/10.1007/s10916-009-9409-z

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  • DOI: https://doi.org/10.1007/s10916-009-9409-z

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