We investigated plausible changes in spectral and higher order statistical properties of tracheal respiratory sounds from wakefulness to sleep in relation to obstructive sleep apnea (OSA). Data consisted of expiratory sounds of 30 participants suspected of OSA during wakefulness and sleep, both recorded in supine position. Participants were divided into two groups of mild and severe OSA (15 in each group) based on their apnea/hypopnea index (AHI) per hour. Three different frequency-based features of their power spectra in addition to Kurtosis and Katz fractal dimension (KFD) were estimated from each normalized expiratory sound; they were compared within and between the groups. During wakefulness, the sounds average power at low-frequency components in severe group was lesser than that of the mild group. However, during sleep, the average power of high-frequency components in severe subjects was more than that of the mild group. The kurtosis value of both mild and severe OSA groups increased significantly from wakefulness to sleep using both mouth and nasal breathing sounds during wakefulness. The KFD increased significantly from wakefulness to sleep for both mild and severe OSA group using only nasal breathing sounds during wakefulness. These changes are indicative that the upper airway of severe OSA show more compliance and thickness compare to that of the mild OSA during both wakefulness and sleep and represent an increased stiffness during sleep. This implies a regional narrowing which cause both more compliance and stiffness simultaneously in different regions of the upper airway.
Read full abstract