Multimodal detection of sleep apnoea using electrocardiogram and oximetry signals

• Published in: Philosophical transactions of the Royal Society of London. Series A: Mathematical, physical, and engineering sciences Vol. 367; no. 1887; pp. 369 - 389
• Main Authors: de Chazal, Philip, Heneghan, Conor, McNicholas, Walter T
• Format: Journal Article
• Language: English
• Published: London The Royal Society 28.01.2009
• Subjects: Adult; Automatic Data Processing; Breathing; Chemical desaturation; Electrocardiography; Electrocardiography - methods; Estimate reliability; Female; Heart rate; Holter Electrocardiogram; Home Care Services; Home Testing; Humans; Interval estimators; Male; Middle Aged; Monitoring, Physiologic - methods; Oximetry; Pattern Recognition, Automated; Polysomnography; Pulse oximetry; Reproducibility of Results; Respiration; Screening; Signal detection; Signal Processing, Computer-Assisted; Sleep - physiology; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - physiopathology; Sleep Apnoea
• ISSN: 1364-503X; 1471-2962
• DOI: 10.1098/rsta.2008.0156

A method for the detection of sleep apnoea, suitable for use in the home environment, is presented. The method automatically analyses night-time electrocardiogram (ECG) and oximetry recordings and identifies periods of normal and sleep-disordered breathing (SDB). The SDB is classified into one of six classes: obstructive, mixed and central apnoeas, and obstructive, mixed and central hypopnoeas. It also provides an estimated apnoea, hypopnoea and apnoea-hypopnoea index. The basis of the method is a pattern recognition system that identifies episodes of apnoea by analysing the heart variability, an ECG-derived respiration signal and blood oximetry values. The method has been tested on 183 subjects with a range of apnoea severities who have undergone a full overnight polysomnogram study. The results show that the method separates control subjects from subjects with clinically significant sleep apnoea with a specificity of 83 per cent and sensitivity of 95 per cent. These results demonstrate that home-based screening for sleep apnoea is a viable alternative to hospital-based tests with the added benefit of low cost and minimal waiting times.