Abstract

Study ObjectivesTo develop and validate a novel non-contact system for whole-night sleep evaluation using breathing sounds analysis (BSA).DesignWhole-night breathing sounds (using ambient microphone) and polysomnography (PSG) were simultaneously collected at a sleep laboratory (mean recording time 7.1 hours). A set of acoustic features quantifying breathing pattern were developed to distinguish between sleep and wake epochs (30 sec segments). Epochs (n = 59,108 design study and n = 68,560 validation study) were classified using AdaBoost classifier and validated epoch-by-epoch for sensitivity, specificity, positive and negative predictive values, accuracy, and Cohen's kappa. Sleep quality parameters were calculated based on the sleep/wake classifications and compared with PSG for validity.SettingUniversity affiliated sleep-wake disorder center and biomedical signal processing laboratory.PatientsOne hundred and fifty patients (age 54.0±14.8 years, BMI 31.6±5.5 kg/m2, m/f 97/53) referred for PSG were prospectively and consecutively recruited. The system was trained (design study) on 80 subjects; validation study was blindly performed on the additional 70 subjects.Measurements and ResultsEpoch-by-epoch accuracy rate for the validation study was 83.3% with sensitivity of 92.2% (sleep as sleep), specificity of 56.6% (awake as awake), and Cohen's kappa of 0.508. Comparing sleep quality parameters of BSA and PSG demonstrate average error of sleep latency, total sleep time, wake after sleep onset, and sleep efficiency of 16.6 min, 35.8 min, and 29.6 min, and 8%, respectively.ConclusionsThis study provides evidence that sleep-wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis. This study highlights the potential of this innovative approach to measure sleep in research and clinical circumstances.

Highlights

  • Polysomnography (PSG) is currently considered the gold standard for sleep evaluation [1]

  • This study provides evidence that sleep-wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis

  • This study highlights the potential of this innovative approach to measure sleep in research and clinical circumstances

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Summary

Introduction

Polysomnography (PSG) is currently considered the gold standard for sleep evaluation [1]. Extensive effort has been devoted to seeking alternative simple cost-effective technologies for objective sleep-wake evaluation to increase accessibility in sleep disorders diagnosis. These new technologies are based on reducedchannels and sensors, and sophisticated computer-based algorithms [3,4,6,7,8,9]. Montgomery-Downs et al [13] recently reported that this new technology has specificity limitations similar to those of a traditional actigraphy device These devices consistently misidentify wake as sleep and overestimate both sleep time and quality

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