Automatic Detection of Obstructive Sleep Apnea Using Wavelet Transform and Entropy-Based Features From Single-Lead ECG Signal

Diagnostic accuracy of machine learning algorithms in electrocardiogram-based sleep apnea detection: A systematic review and meta-analysis

Sleep apnea is a prevalent disorder affecting 10 % of middle-aged individuals, yet it remains underdiagnosed due to the limitations of polysomnography (PSG), the current diagnostic gold standard. Single-lead electrocardiography (ECG) has been proposed as a potential alternative diagnostic tool, but interpretation challenges remain. Recent advances in machine learning and deep learning technologies offer promising approaches for enhancing the detection of sleep apnea through automated analysis of ECG signals. This meta-analysis aims to evaluate the diagnostic accuracy of machine learning (ML) and deep learning (DL) algorithms in detecting sleep apnea patterns from single-lead ECG data. A comprehensive literature search across multiple databases was conducted through November 2023, adhering to PRISMA-DTA guidelines. Studies that included sensitivity and specificity data for ECG-based sleep apnea detection using (machine learning/deep learning) ML/DL were selected. The analysis included 84 studies, demonstrating high diagnostic accuracy for ML/DL algorithms, with pooled sensitivity and specificity of over 90 % in per-segment analysis and close to 97 % in per-record analysis. Despite strong diagnostic performance, variations in algorithm effectiveness and methodological biases were noted. This meta-analysis highlights the potential of ML and DL in improving sleep apnea diagnosis and outlines areas for future research to address current limitations.

Explainable AI-driven scalogram analysis and optimized transfer learning for sleep apnea detection with single-lead electrocardiograms

Sleep apnea, a fatal sleep disorder causing repetitive respiratory cessation, requires immediate intervention due to neuropsychological issues. However, existing approaches such as polysomnography, considered the most reliable and accurate test to detect sleep apnea, frequently require multichannel ECG recordings and advanced feature extraction algorithms, significantly restricting their wider application. Deep learning has recently emerged as a viable method for detecting sleep apnea. Our study describes a unique method for detecting sleep apnea utilizing single-lead ECG signals and deep learning techniques. In our proposed method, we have employed the continuous wavelet transform to convert electrocardiogram (ECG) signals into scalograms, which allows us to capture both the time and frequency domains. To enhance the classification performance, we have implemented an optimized pre-trained GoogLeNet architecture as a transfer learning model. In this study, we have analyzed the PhysioNet Apnea ECG dataset, UCDDB dataset and the MIT-BIH polysomnographic dataset for training and evaluation for per-segment classification, to demonstrate the effectiveness of our approach. In our experiments, the proposed model achieves remarkable results, with an accuracy of 93.85%, sensitivity of 93.42%, specificity of 94.30%, and F1 score of 93.83% for the Apnea ECG dataset in per-segment classification. Our model excels on the UCDDB dataset with 87.20% accuracy, 80.99% sensitivity, 93.39% specificity, and an 86.34% F1-score. Furthermore, the model obtains 88.58% accuracy, 88.78% sensitivity, 88.38% specificity, and 88.61% F1 score on the MIT BIH polysomnographic dataset, showing its robust performance and balanced precision-recall trade-off. Afterwards, LIME, an explainable AI method, has been implemented to illustrate the insights responsible for predicting apnea or non apnea.

Screening major depressive disorder in patients with obstructive sleep apnea using single-lead ECG recording during sleep

Objective: A large number of people with obstructive sleep apnea (OSA) also suffer from major depressive disorder (MDD), leading to underdiagnosis due to overlapping symptoms. Polysomnography has been considered to identify MDD. However, limited access to sleep clinics makes this challenging. In this study, we propose a model to detect MDD in people with OSA using an electrocardiogram (ECG) during sleep. Methods: The single-lead ECG data of 32 people with OSA (OSAD-) and 23 with OSA and MDD (OSAD+) were investigated. The first 60 min of their recordings after sleep were segmented into 30-s segments and 13 parameters were extracted: PR, QT, ST, QRS, PP, and RR; mean heart rate; two time-domain HRV parameters: SDNN, RMSSD; and four frequency heart rate variability parameters: LF_power, HF_power, total power, and the ratio of LF_power/HF_power. The mean and standard deviation of these parameters were the input to a support vector machine which was trained to separate OSAD- and OSAD+. Results: The proposed model distinguished between OSAD+ and OSAD- groups with an accuracy of 78.18%, a sensitivity of 73.91%, a specificity of 81.25%, and a precision of 73.91%. Conclusion: This study shows the potential of using only ECG for detecting depression in OSA patients.

Automatic detection of sleep apnea from a single-lead ECG signal based on spiking neural network model

BACKGROUND

Sleep apnea (SLA) is a commonly encountered sleep disorder characterized by repetitive cessation of respiration while sleeping. In the past few years, researchers have focused on developing less complex and more cost-effective diagnostic approaches for identifying SLA recipients, in contrast to the cumbersome, complicated, and expensive conventional methods.

METHOD

This study presents a biologically plausible learning approach of spiking neural networks (SNN) with temporal coding and a tempotron learning model for diagnosing SLA disorder using single-lead electrocardiogram (ECG) data information. The proposed framework utilizes temporal encoding and the leaky integrate and fire model to transform the ECG signal into spikes for capturing the signal's dynamic pattern nature and to simulate input response behaviors. The tempoton learning technique, a spike-based algorithm, trains the SNN model to identify SLA event patterns from encoded output spike trains. This study utilized ECG data to extract heart rate variability (HRV) and ECG-derived respiration (EDR) signals from 1-min segment data of ECG records for input to SNN model. Thirty-five recordings of both released and withheld data from the Apnea-ECG databases from Physionet have been applied to train the SNN model and validate the model's efficacy in identifying SLA occurrences.

RESULTS

The proposed method demonstrated substantial improvements compared to other SLA detection techniques, achieving a significant accuracy of 94.63 % for per-segment detection, along with specificity, sensitivity, F1-score and AUC values of 96.21 %, 92.04 %, 0.9285, and 0.9851 respectively. The accuracy for per-recording detection achieved 100 %, with a correlation coefficient value of 0.986. Additionally, the experiment used UCD data for validation methods, achieving an accuracy of 84.573 %.

CONCLUSIONS

These results suggest the effectiveness and accessibility of the presented approach for accurately identifying SLA cases. The suggested model enhances the performance of SLA detection when contrasted with various techniques based on feature engineering and feature learning.

An Automatic Coronary Microvascular Dysfunction Classification Method Based on Hybrid ECG Features and Expert Features

OBJECTIVE

In recent years, the early diagnosis and treatment of coronary microvascular dysfunction (CMD) have become crucial for preventing coronary heart disease. This paper aims to develop a computer-assisted autonomous diagnosis method for CMD by using ECG features and expert features.

APPROACH

Clinical electrocardiogram (ECG), myocardial contrast echocardiography (MCE), and coronary angiography (CAG) are used in our method. Firstly, morphological features, temporal features, and T-wave features of ECG are extracted by multi-channel residual network with BiLSTM (MCResnet-BiLSTM) model and the multi-source T-wave features (MTF) extraction model, respectively. And these features are fused to form ECG features. In addition, the CFR[Formula: see text] is calculated based on the parameters related to the MCE at rest and stress state, and the Angio-IMR is calculated based on CAG. The combination of CFR[Formula: see text] and Angio-IMR is termed as expert features. Furthermore, the hybrid features, fused from the ECG features and the expert features, are input into the multilayer perceptron to implement the identification of CMD. And the weighted sum of the softmax loss and center loss is used as the total loss function for training the classification model, which optimizes the classification ability of the model.

RESULT

The proposed method achieved 93.36% accuracy, 94.46% specificity, 92.10% sensitivity, 95.89% precision, and 93.95% F1 score on the clinical dataset of the Second Affiliated Hospital of Zhejiang University.

CONCLUSION

The proposed method accurately extracts global ECG features, combines them with expert features to obtain hybrid features, and uses weighted loss to significantly improve diagnostic accuracy. It provides a novel and practical method for the clinical diagnosis of CMD.

A robust deep learning system for screening of obstructive sleep apnea using T-F spectrum of ECG signals

Obstructive sleep apnea (OSA) is a non-communicable sleep-related medical condition marked by repeated disruptions in breathing during sleep. It may induce various cardiovascular and neurocognitive complications. Electrocardiography (ECG) is a useful method for detecting numerous health-related disorders. ECG signals provide a less complex and non-invasive solution for the screening of OSA. Automated and accurate detection of OSA may enhance diagnostic performance and reduce the clinician's workload. Traditional machine learning methods typically involve several labor-intensive manual procedures, including signal decomposition, feature evaluation, selection, and categorization. This article presents the time-frequency (T-F) spectrum classification of de-noised ECG data for the automatic screening of OSA patients using deep convolutional neural networks (DCNNs). At first, a filter-fusion algorithm is used to eliminate the artifacts from the raw ECG data. Stock-well transform (S-T) is employed to change filtered time-domain ECG into T-F spectrums. To discriminate between apnea and normal ECG signals, the obtained T-F spectrums are categorized using benchmark Alex-Net and Squeeze-Net, along with a less complex DCNN. The superiority of the presented system is measured by computing the sensitivity, specificity, accuracy, negative predicted value, precision, F1-score, and Fowlkes-Mallows index. The results of comparing all three utilized DCNNs reveal that the proposed DCNN requires fewer learning parameters and provides higher accuracy. An average accuracy of 95.31% is yielded using the proposed system. The presented deep learning system is lightweight and faster than Alex-Net and Squeeze-Net as it utilizes fewer learnable parameters, making it simple and reliable.

Dual-Teacher Feature Distillation: A Transfer Learning Method for Insomniac PSG Staging

Insomnia is the most common sleep disorder linked with adverse long-term medical and psychiatric outcomes. Automatic sleep staging plays a crucial role in aiding doctors to diagnose insomnia disorder. Only a few studies have been conducted to develop automatic sleep staging methods for insomniacs, and most of them have utilized transfer learning methods, which involve pre-training models on healthy individuals and then fine-tuning them on insomniacs. Unfortunately, significant differences in feature distribution between the two subject groups impede the transfer performance, highlighting the need to effectively integrate the features of healthy subjects and insomniacs. In this paper, we propose a dual-teacher cross-domain knowledge transfer method based on the feature-based knowledge distillation to improve the performance of sleep staging for insomniacs. Specifically, the insomnia teacher directly learns from insomniacs and feeds the corresponding domain-specific features into the student network, while the health domain teacher guide the student network to learn domain-generic features. During the training process, we adopt the OFD (Overhaul of Feature Distillation) method to build the health domain teacher. We conducted the experiments to validate the proposed method, using the Sleep-EDF database as the source domain and the CAP-Database as the target domain. The results demonstrate that our method surpasses advanced techniques, achieving an average sleep staging accuracy of 80.56% on the CAP-Database. Furthermore, our method exhibits promising performance on the private dataset.

Computational ensemble expert system classification for the recognition of bruxism using physiological signals

This study aimed to develop an automatic diagnostic scheme for bruxism, a sleep-related disorder characterized by teeth grinding and clenching. The aim was to improve on existing methods, which have been proven to be inefficient and challenging. We utilized a novel hybrid machine learning classifier, facilitated by the Weka tool, to diagnose bruxism from biological signals. The study processed and examined these biological signals by calculating the power spectral density. Data were categorized into normal or bruxism categories based on the EEG channel (C4-A1), and the sleeping phases were classified into wake (w) and rapid eye movement (REM) stages using the ECG channel (ECG1-ECG2). The classification resulted in a maximum specificity of 93% and an accuracy of 95% for the EEG-based diagnosis. The ECG-based classification yielded a supreme specificity of 87% and an accuracy of 96%. Furthermore, combining these phases using the EMG channel (EMG1-EMG2) achieved the highest specificity of 95% and accuracy of 98%. The ensemble Weka tool combined all three physiological signals EMG, ECG, and EEG, to classify the sleep stages and subjects. This integration increased the specificity and accuracy to 97% and 99%, respectively. This indicates that a more precise bruxism diagnosis can be obtained by including all three biological signals. The proposed method significantly improves bruxism diagnosis accuracy, potentially enhancing automatic home monitoring systems for this disorder. Future studies may expand this work by applying it to patients for practical use.

Application of LightGBM hybrid model based on TPE algorithm optimization in sleep apnea detection

Introduction

Sleep apnoea syndrome (SAS) is a serious sleep disorder and early detection of sleep apnoea not only reduces treatment costs but also saves lives. Conventional polysomnography (PSG) is widely regarded as the gold standard diagnostic tool for sleep apnoea. However, this method is expensive, time-consuming and inherently disruptive to sleep. Recent studies have pointed out that ECG analysis is a simple and effective diagnostic method for sleep apnea, which can effectively provide physicians with an aid to diagnosis and reduce patients' suffering.

Methods

To this end, in this paper proposes a LightGBM hybrid model based on ECG signals for efficient detection of sleep apnea. Firstly, the improved Isolated Forest algorithm is introduced to remove abnormal data and solve the data sample imbalance problem. Secondly, the parameters of LightGBM algorithm are optimised by the improved TPE (Tree-structured Parzen Estimator) algorithm to determine the best parameter configuration of the model. Finally, the fusion model TPE_OptGBM is used to detect sleep apnoea. In the experimental phase, we validated the model based on the sleep apnoea ECG database provided by Phillips-University of Marburg, Germany.

Results

The experimental results show that the model proposed in this paper achieves an accuracy of 95.08%, a precision of 94.80%, a recall of 97.51%, and an F1 value of 96.14%.

Discussion

All of these evaluation indicators are better than the current mainstream models, which is expected to assist the doctor's diagnostic process and provide a better medical experience for patients.

Spatiotemporal convolution sleep network based on graph attention mechanism with automatic feature extraction

BACKGROUND AND OBJECTIVE

Graph neural networks (GNNs) are widely used for automatic sleep staging. However, the majority of GNNs are based on spectral approaches, as far as we know, which heavily depend on the Laplacian eigenbasis determined by the graph structure with a large computing cost.

METHODS

We introduced a non-spectral approach named graph attention networks v2 (GATv2) as the core of our network to extract spatial information (S-GATv2 in our work), which is more flexible and intuitive than the routined spectral method. Meanwhile, to resolve the issue of weak generalization of using traditional feature extraction, the multi-convolutional layers are implemented to automatically extract features. In this work, the proposed spatiotemporal convolution sleep network (ST-GATv2) consists of multi-convolution layers and a GATv2 block. Of note, the graph attention technique to the time domain was applied to construct temporal GATv2 (T-GATv2), which intends to capture the connection between two channels in the adjacent sleep stages. Besides, the modified function is further proposed to capture the hidden changing trend information by the difference in the feature's value of the two adjacent stages.

RESULTS

In our experiment, we used the SS3 datasets in the MASS as our test datasets to compare with other advanced models. Our result reveals our model achieves the highest accuracy at 89.0 %. Besides, the proposed T-GATv2 block and modified function bring an approximate 0.5 % improvement in Kappa and F1-score.

CONCLUSIONS

Our results support the potential of graph attention mechanisms and creative blocks (T-GATv2 and modified function) in sleep classification. We suggest the proposed ST-GATv2 model as an effective tool in sleep staging in either healthy or diseased states.

Semi-Supervised Learning for Low-Cost Personalized Obstructive Sleep Apnea Detection Using Unsupervised Deep Learning and Single-Lead Electrocardiogram

OBJECTIVE

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that can lead to a wide range of health issues if left untreated. This study aims to address the lack of research on personalized models for single-lead electrocardiogram (ECG)-based OSA detection, by proposing an automatic semi-supervised algorithm for automated low-cost personalization fine-tuning.

METHODS

We utilize a convolutional neural network (CNN)-based auto-encoder (AE) with a modified training objective to detect anomalous region of OSA. An indicator based on model outputs is utilized as a benchmark measure to assign pseudo-labels with confidence to each sample. Finally, we perform validation of the semi-supervised algorithm on the same database and cross-database scenarios.

RESULTS

By introducing semi-supervised personalization, the accuracy, AUC, and mean absolute error (MAE) of the general model (GM) of 35 subjects from the same database are improved from 86.3%, 0.915, and 5.178 to 90.3%, 0.948, and 2.593. Simultaneously, in the validation of 25 subjects from a cross-database, the accuracy, AUC, and MAE of the GM are enhanced from 75.6%, 0.800, and 9.149 to 84.3%, 0.881, and 3.509.

CONCLUSION

The improved version of AE demonstrates excellent adaptability in identifying abnormal features in OSA, employing a data-driven approach to assign pseudo-labels for unknown data automatically. Additionally, leveraging the pseudo-labels through a semi-supervised fine-tuning strategy provides a solution to overcome the limitation of clinical annotations, facilitating low-cost implementation of personalized models.

SIGNIFICANCE

The semi-supervised approach proposed in this article provides a high-performance and annotation-free solution for personalized adjustment of automatic OSA detection.

Deep Learning Modeling of Cardiac Arrhythmia Classification on Information Feature Fusion Image with Attention Mechanism

The electrocardiogram (ECG) is a crucial tool for assessing cardiac health in humans. Aiming to enhance the accuracy of ECG signal classification, a novel approach is proposed based on relative position matrix and deep learning network information features for the classification task in this paper. The approach improves the feature extraction capability and classification accuracy via techniques of image conversion and attention mechanism. In terms of the recognition strategy, this paper presents an image conversion using relative position matrix information. This information is utilized to describe the relative spatial relationships between different waveforms, and the image identification is successfully applied to the Gam-Resnet18 deep learning network model with a transfer learning concept for classification. Ultimately, this model achieved a total accuracy of 99.30%, an average positive prediction rate of 98.76%, a sensitivity of 98.90%, and a specificity of 99.84% with the relative position matrix approach. To evaluate the effectiveness of the proposed method, different image conversion techniques are compared on the test set. The experimental results demonstrate that the relative position matrix information can better reflect the differences between various types of arrhythmias, thereby improving the accuracy and stability of classification.

Validity study of a multiscaled fusion network using single-lead electrocardiogram signals for obstructive sleep apnea diagnosis

STUDY OBJECTIVES

We evaluated the validity of a squeeze-and-excitation and multiscaled fusion network (SE-MSCNN) using single-lead electrocardiogram (ECG) signals for obstructive sleep apnea detection and classification.

METHODS

Overnight polysomnographic data from 436 participants at the Sleep Center of the First Affiliated Hospital of Sun Yat-sen University were used to generate a new FAH-ECG dataset comprising 260, 88, and 88 single-lead ECG signal recordings for training, validation, and testing, respectively. The SE-MSCNN was employed for detection of apnea-hypopnea events from the acquired ECG segments. Sensitivity, specificity, accuracy, and F1 scores were assigned to assess algorithm performance. We also used the SE-MSCNN to estimate the apnea-hypopnea index, classify obstructive sleep apnea severity, and compare the agreement between 2 sleep technicians.

RESULTS

The SE-MSCNN's accuracy, sensitivity, specificity, and F1 score on the FAH-ECG dataset were 86.6%, 83.3%, 89.1%, and 0.843, respectively. Although slightly inferior to previously reported results using public datasets, it is superior to state-of-the-art open-source models. Furthermore, the SE-MSCNN had good agreement with manual scoring, such that the Spearman's correlations for the apnea-hypopnea index between the SE-MSCNN and 2 technicians were 0.93 and 0.94, respectively. Cohen's kappa scores in classifying the SE-MSCNN and the 2 sleep technicians were 0.72 and 0.78, respectively.

CONCLUSIONS

In this study, we validated the use of the SE-MSCNN in a clinical environment, and despite some limitations the network appeared to meet the performance standards for generalizability. Therefore, updating algorithms based on single-lead ECG signals can facilitate the development of novel wearable devices for efficient obstructive sleep apnea screening.

CITATION

Yue H, Li P, Li Y, et al. Validity study of a multiscaled fusion network using single-lead electrocardiogram signals for obstructive sleep apnea diagnosis. J Clin Sleep Med. 2023;19(6):1017-1025.

Revised Tunable Q-Factor Wavelet Transform for EEG-Based Epileptic Seizure Detection

Electroencephalogram (EEG) signals are an essential tool for the detection of epilepsy. Because of the complex time series and frequency features of EEG signals, traditional feature extraction methods have difficulty meeting the requirements of recognition performance. The tunable Q-factor wavelet transform (TQWT), which is a constant-Q transform that is easily invertible and modestly oversampled, has been successfully used for feature extraction of EEG signals. Because the constant-Q is set in advance and cannot be optimized, further applications of the TQWT are restricted. To solve this problem, the revised tunable Q-factor wavelet transform (RTQWT) is proposed in this paper. RTQWT is based on the weighted normalized entropy and overcomes the problems of a nontunable Q-factor and the lack of an optimized tunable criterion. In contrast to the continuous wavelet transform and the raw tunable Q-factor wavelet transform, the wavelet transform corresponding to the revised Q-factor, i.e., RTQWT, is sufficiently better adapted to the nonstationary nature of EEG signals. Therefore, the precise and specific characteristic subspaces obtained can improve the classification accuracy of EEG signals. The classification of the extracted features was performed using the decision tree, linear discriminant, naive Bayes, SVM and KNN classifiers. The performance of the new approach was tested by evaluating the accuracies of five time-frequency distributions: FT, EMD, DWT, CWT and TQWT. The experiments showed that the RTQWT proposed in this paper can be used to extract detailed features more effectively and improve the classification accuracy of EEG signals.

RAFNet: Restricted attention fusion network for sleep apnea detection

Sleep apnea (SA) is a common sleep-related breathing disorder, which would lead to damage of multiple systemic organs or even sudden death. In clinical practice, portable device is an important tool to monitor sleep conditions and detect SA events by using physiological signals. However, SA detection performance is still limited due to physiological signals with time-variability and complexity. In this paper, we focus on SA detection with single lead ECG signals, which can be easily collected by a portable device. Under this context, we propose a restricted attention fusion network called RAFNet for sleep apnea detection. Specifically, RR intervals (RRI) and R-peak amplitudes (Rpeak) are generated from ECG signals and divided into one-minute-long segments. To alleviate the problem of insufficient feature information of the target segment, we combine the target segment with two pre- and post-adjacent segments in sequence, (i.e. a five-minute-long segment), as the input. Meanwhile, by leveraging the target segment as the query vector, we propose a new restricted attention mechanism with cascaded morphological and temporal attentions, which can effectively learn the feature information and depress redundant feature information from the adjacent segments with adaptive assigning weight importance. To further improve the SA detection performance, the target and adjacent segment features are fused together with the channel-wise stacking scheme. Experiment results on the public Apnea-ECG dataset and the real clinical FAH-ECG dataset with sleep apnea annotations show that the RAFNet greatly improves SA detection performance and achieves competitive results, which are superior to those achieved by the state-of-the-art baselines.

Sleep Apnea Detection Using Wavelet Scattering Transformation and Random Forest Classifier

Obstructive Sleep Apnea (OSA) is a common sleep-breathing disorder that highly reduces the quality of human life. The most powerful method for the detection and classification of sleep apnea is the Polysomnogram. However, this method is time-consuming and cost-inefficient. Therefore, several methods focus on using electrocardiogram (ECG) signals to detect sleep apnea. This paper proposed a novel automated approach to detect and classify apneic events from single-lead ECG signals. Wavelet Scattering Transformation (WST) was applied to the ECG signals to decompose the signal into smaller segments. Then, a set of features, including higher-order statistics and entropy-based features, was extracted from the WST coefficients to formulate a search space. The obtained features were fed to a random forest classifier to classify the ECG segments. The experiment was validated using the 10-fold and hold-out cross-validation methods, which resulted in an accuracy of 91.65% and 90.35%, respectively. The findings were compared with different classifiers to show the significance of the proposed approach. The proposed approach achieved better performance measures than most of the existing methodologies.

A novel approach to automatic sleep stage classification using forehead electrophysiological signals

Background

Sleep stage scoring is very important for the effective diagnosis and intervention of sleep disorders. However, the current automatic sleep staging methods generally have the problems of poor model generalization ability and non-portable acquisition equipment.

Method

In this paper, we propose a novel automatic sleep scoring system based on forehead electrophysiological signals that is more effective and convenient than other systems. We extract 3 channel signals from the forehead, named forehead electroencephalogram 1 (Fh1), forehead electroencephalogram 2 (Fh2), and forehead center electrooculogram (Fhz). Spectral features, statistical features, and entropy features are extracted using the discrete wavelet transform (DWT) method. Light gradient boosting machine (LGB), random forest (RF), and support vector machine (SVM) are employed to classify four stages: awake, light sleep (LS), deep sleep (DS), and rapid eye movement (REM).

Result

The performance of the proposed method is validated using databases of the Sleep-EDFX and our Own-data, which include polysomnograms (PSGs) and forehead signals of 28 subjects. The overall classification accuracy of using the combination of Fh1, Fh2, and Fhz can reach up to 90.25% accuracy with a kappa coefficient of 0.857.

Conclusions

The proposed method could provide state-of-art multichannel sleep stage scoring performance with higher portability. This will facilitate the application of long-term monitoring of sleep quality in the future.

Automatic diagnosis of sleep apnea from biomedical signals using artificial intelligence techniques: Methods, challenges, and future works

Apnea is a sleep disorder that stops or reduces airflow for a short time during sleep. Sleep apnea may last for a few seconds and happen for many while sleeping. This reduction in breathing is associated with loud snoring, which may awaken the person with a feeling of suffocation. So far, a variety of methods have been introduced by researchers to diagnose sleep apnea, among which the polysomnography (PSG) method is known to be the best. Analysis of PSG signals is very complicated. Many studies have been conducted on the automatic diagnosis of sleep apnea from biological signals using artificial intelligence (AI), including machine learning (ML) and deep learning (DL) methods. This research reviews and investigates the studies on the diagnosis of sleep apnea using AI methods. First, computer aided diagnosis system (CADS) for sleep apnea using ML and DL techniques along with its parts including dataset, preprocessing, and ML and DL methods are introduced. This research also summarizes the important specifications of the studies on the diagnosis of sleep apnea using ML and DL methods in a table. In the following, a comprehensive discussion is made on the studies carried out in this field. The challenges in the diagnosis of sleep apnea using AI methods are of paramount importance for researchers. Accordingly, these obstacles are elaborately addressed. In another section, the most important future works for studies on sleep apnea detection from PSG signals and AI techniques are presented. Ultimately, the essential findings of this study are provided in the conclusion section.

This article is categorized under:

A Systematic Review of Time Series Classification Techniques Used in Biomedical Applications

Background: Digital clinical measures collected via various digital sensing technologies such as smartphones, smartwatches, wearables, and ingestible and implantable sensors are increasingly used by individuals and clinicians to capture the health outcomes or behavioral and physiological characteristics of individuals. Time series classification (TSC) is very commonly used for modeling digital clinical measures. While deep learning models for TSC are very common and powerful, there exist some fundamental challenges. This review presents the non-deep learning models that are commonly used for time series classification in biomedical applications that can achieve high performance. Objective: We performed a systematic review to characterize the techniques that are used in time series classification of digital clinical measures throughout all the stages of data processing and model building. Methods: We conducted a literature search on PubMed, as well as the Institute of Electrical and Electronics Engineers (IEEE), Web of Science, and SCOPUS databases using a range of search terms to retrieve peer-reviewed articles that report on the academic research about digital clinical measures from a five-year period between June 2016 and June 2021. We identified and categorized the research studies based on the types of classification algorithms and sensor input types. Results: We found 452 papers in total from four different databases: PubMed, IEEE, Web of Science Database, and SCOPUS. After removing duplicates and irrelevant papers, 135 articles remained for detailed review and data extraction. Among these, engineered features using time series methods that were subsequently fed into widely used machine learning classifiers were the most commonly used technique, and also most frequently achieved the best performance metrics (77 out of 135 articles). Statistical modeling (24 out of 135 articles) algorithms were the second most common and also the second-best classification technique. Conclusions: In this review paper, summaries of the time series classification models and interpretation methods for biomedical applications are summarized and categorized. While high time series classification performance has been achieved in digital clinical, physiological, or biomedical measures, no standard benchmark datasets, modeling methods, or reporting methodology exist. There is no single widely used method for time series model development or feature interpretation, however many different methods have proven successful.

The Predictive Role of the Upper-Airway Adipose Tissue in the Pathogenesis of Obstructive Sleep Apnoea

This study aimed to analyse the thickness of the adipose tissue (AT) around the upper airways with anthropometric parameters in the prediction and pathogenesis of OSA and obstruction of the upper airways using artificial intelligence. One hundred patients were enrolled in this prospective investigation, who were divided into control (non-OSA) and mild, moderately severe, and severe OSA according to polysomnography. All participants underwent drug-induced sleep endoscopy, anthropometric measurements, and neck MRI. The statistical analyses were based on artificial intelligence. The midsagittal SAT, the parapharyngeal fat, and the midsagittal tongue fat were significantly correlated with BMI; however, no correlation with AHI was observed. Upper-airway obstruction was correctly categorised in 80% in the case of the soft palate, including parapharyngeal AT, sex, and neck circumference parameters. Oropharyngeal obstruction was correctly predicted in 77% using BMI, parapharyngeal AT, and abdominal circumferences, while tongue-based obstruction was correctly predicted in 79% using BMI. OSA could be predicted with 99% precision using anthropometric parameters and AT values from the MRI. Age, neck circumference, midsagittal and parapharyngeal tongue fat values, and BMI were the most vital parameters in the prediction. Basic anthropometric parameters and AT values based on MRI are helpful in predicting OSA and obstruction location using artificial intelligence.

A Deep Learning Framework for Automatic Sleep Apnea Classification Based on Empirical Mode Decomposition Derived from Single-Lead Electrocardiogram

BACKGROUND

Although polysomnography (PSG) is a gold standard tool for diagnosing sleep apnea (SA), it can reduce the patient's sleep quality by the placement of several disturbing sensors and can only be interpreted by a highly trained sleep technician or scientist. In recent years, electrocardiogram (ECG)-derived respiration (EDR) and heart rate variability (HRV) have been used to automatically diagnose SA and reduce the drawbacks of PSG. Up to now, most of the proposed approaches focus on machine-learning (ML) algorithms and feature engineering, which require prior expert knowledge and experience. The present study proposes an SA detection algorithm to differentiate a normal and apnea event using a deep-learning (DL) framework based on 1D and 2D deep CNN with empirical mode decomposition (EMD) of a preprocessed ECG signal. The EMD is ideally suited to extract essential components which are characteristic of the underlying biological or physiological processes. In addition, the simple and compact architecture of 1D deep CNN, which only performs 1D convolutions, and pretrained 2D deep CNNs, are suitable for real-time and low-cost hardware implementation.

METHOD

This study was validated using 7 h to nearly 10 h overnight ECG recordings from 33 subjects with an average apnea-hypopnea index (AHI) of 30.23/h originated from PhysioNet Apnea-ECG database (PAED). In preprocessing, the raw ECG signal was normalized and filtered using the FIR band pass filter. The preprocessed ECG signal was then decomposed using the empirical mode decomposition (EMD) technique to generate several features. Several important generated features were selected using neighborhood component analysis (NCA). Finally, deep learning algorithm based on 1D and 2D deep CNN were used to perform the classification of normal and apnea event. The synthetic minority oversampling technique (SMOTE) was also applied to evaluate the influence of the imbalanced data problem.

RESULTS

The segment-level classification performance had 93.8% accuracy with 94.9% sensitivity and 92.7% specificity based on 5-fold cross-validation (5fold-CV), meanwhile, the subject-level classification performance had 83.5% accuracy with 75.9% sensitivity and 88.7% specificity based on leave-one-subject-out cross-validation (LOSO-CV).

CONCLUSION

A novel and robust SA detection algorithm based on the ECG decomposed signal using EMD and deep CNN was successfully developed in this study.

A systematic review of deep learning methods for modeling electrocardiograms during sleep

Sleep is one of the most important human physiological activities and plays an essential role in human health. Polysomnography (PSG) is the gold standard for measuring sleep quality and disorders, but it is time-consuming, labor-intensive, and prone to errors. Current research has confirmed the correlations between sleep and the respiratory/circulatory system. Electrocardiography (ECG) is convenient to perform, and ECG data are rich in breathing information. Therefore, sleep research based on ECG data has become popular. Currently, deep learning (DL) methods have achieved promising results on predictive health care tasks using ECG signals. Therefore, in this review, we systematically identify recent research studies and analyze them from the perspectives of data, model, and task. We discuss the shortcomings, summarize the findings, and highlight the potential opportunities. For sleep-related tasks, many ECG-based DL methods produce more accurate results than traditional approaches by combining multiple signal features and model structures. Methods that are more interpretable, scalable, and transferable will become ubiquitous in the daily practice of medicine and ambient-assisted-living applications. This paper is the first systematic review of ECG-based DL methods for sleep tasks.

The Identification of ECG Signals Using Wavelet Transform and WOA-PNN

Electrocardiogram (ECG) signal identification technology is rapidly replacing traditional fingerprint, face, iris and other recognition technologies, avoiding the vulnerability of traditional recognition technologies. This paper proposes an ECG signal identification method based on the wavelet transform algorithm and the probabilistic neural network by whale optimization algorithm (WOA-PNN). Firstly, Q, R and S waves are detected by wavelet transform, and the P and T waves are detected by local windowed wavelet transform. The characteristic values are constructed by the detected time points, and the ECG data dimension is smaller than that of the non-reference detection. Secondly, combined with the probabilistic neural network, the mean impact value algorithm is used to screen the characteristic values, the characteristic values with low influence are eliminated, and the input and complexity of the model are simplified. Finally, a WOA-PNN combined classification method is proposed to intelligently optimize the hyper parameters in the probabilistic neural network algorithm to improve the model accuracy. According to the simulation verification on three databases, ECG-ID, MIT-BIH Normal Sinus Rhythm and MIT-BIH Arrhythmia, the identification accuracy of a single ECG cycle is 96.97%, and the identification accuracy of three ECG cycles is 99.43%.

Detection of Sleep Apnea from Electrocardiogram and Pulse Oximetry Signals Using Random Forest

Sleep apnea (SA) is a common sleep disorder which could impair the human physiological system. Therefore, early diagnosis of SA is of great interest. The traditional method of diagnosing SA is an overnight polysomnography (PSG) evaluation. When PSG has limited availability, automatic SA screening with a fewer number of signals should be considered. The primary purpose of this study is to develop and evaluate a SA detection model based on electrocardiogram (ECG) and blood oxygen saturation (SpO2). We adopted a multimodal approach to fuse ECG and SpO2 signals at the feature level. Then, feature selection was conducted using the recursive feature elimination with cross-validation (RFECV) algorithm and random forest (RF) classifier used to discriminate between apnea and normal events. Experiments were conducted on the Apnea-ECG database. The introduced algorithm obtained an accuracy of 97.5%, a sensitivity of 95.9%, a specificity of 98.4% and an AUC of 0.992 in per-segment classification, and outperformed previous works. The results showed that ECG and SpO2 are complementary in detecting SA, and that the combination of ECG and SpO2 enhances the ability to diagnose SA. Therefore, the proposed method has the potential to be an alternative to conventional detection methods.

Research on control method of upper limb exoskeleton based on mixed perception model

As one of the research hotspots in the field of rehabilitation robotics, the upper limb exoskeleton robot has been widely used in the field of rehabilitation. However, the existing methods cannot comprehensively and accurately reflect the motion state of patients, which may lead to overtraining and secondary injury of patients in the process of rehabilitation training. In this paper, an upper limb exoskeleton control method based on mixed perception model of motion intention and intensity is proposed, which is based on the 6 degree-of-freedom upper limb rehabilitation exoskeleton in the laboratory. First, the kinematic information and heart rate information in the rehabilitation process of patients are collected, corresponding to patients’ motion intention and motion intensity, and fused to obtain the mixed perception vector. Second, the motion perception model based on long short-term memory neural network is established to realize the prediction of upper limb motion trajectory of patients and compared with back-propagation neural network to prove its effectiveness. Finally, the control system is built, and both offline and online test of the control method proposed are implemented. The experimental results show that the method can achieve comprehensive motion state perception of patients, realize real-time and accurate prediction trajectory according to human motion intention and intensity. The average prediction accuracy is 95.3%, and predicted joint angle error is less than 5 degrees. Therefore, the control method based on mixed perception model has good robustness and universality, which provides a new method for the active control of upper limb exoskeleton.

BI - Directional long short-term memory for automatic detection of sleep apnea events based on single channel EEG signal

Sleep apnea syndrome (SAS) is a sleeping disorder in which breathing stops regularly. Even though its prevalence is high, many cases are not reported due to the high cost of inspection and the limits of monitoring devices. To address this, based on the bidirectional long and short-term memory network (BI-LSTM), we designed a single-channel electroencephalography (EEG) sleep monitoring model that can be used in portable SAS monitoring devices. Model training and evaluation of EEG signals obtained by polysomnography were performed on the event segments of 42 subjects. Adam and 10-fold cross-validation were employed to optimize parameters and evaluate network performance. The results showed that BI-LSTM has a precision of 84.21% and accuracy of 92.73%.

Machine learning approaches for screening the risk of obstructive sleep apnea in the Taiwan population based on body profile

(a) Objective: Obstructive sleep apnea syndrome (OSAS) is typically diagnosed through polysomnography (PSG). However, PSG incurs high medical costs. This study developed new models for screening the risk of moderate-to-severe OSAS (apnea-hypopnea index, AHI ≥15) and severe OSAS (AHI ≥30) in various age groups and sexes by using anthropometric features in the Taiwan population.(b) Participants: Data were derived from 10,391 northern Taiwan patients who underwent PSG.(c) Methods: Patients' characteristics - namely age, sex, body mass index (BMI), neck circumference, and waist circumference - was obtained. To develop an age- and sex-independent model, various approaches - namely logistic regression, k-nearest neighbor, naive Bayes, random forest (RF), and support vector machine - were trained for four groups based on sex and age (men or women; aged <50 or ≥50 years). Dataset was separated independently (training:70%; validation: 10%; testing: 20%) and Cross-validated grid search was applied for model optimization. Models demonstrating the highest overall accuracy in validation outcomes for the four groups were used to predict the testing dataset.(d) Results: The RF models showed the highest overall accuracy. BMI was the most influential parameter in both types of OSAS severity screening models.(e) Conclusion: The established models can be applied to screen OSAS risk in the Taiwan population and those with similar craniofacial features.

Comparison of Hospital-Based and Home-Based Obstructive Sleep Apnoea Severity Measurements with a Single-Lead Electrocardiogram Patch

Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. We enrolled 125 Taiwanese patients who underwent PSG while wearing a single-lead electrocardiogram patch (RootiRx). After the PSG, all participants were instructed to continue wearing the RootiRx over three subsequent nights. Scores on OSA indices—namely, the apnoea–hypopnea index, chest effort index (CEI), cyclic variation of heart rate index (CVHRI), and combined CVHRI and CEI (Rx index), were determined. The patients were divided into three groups based on PSG-determined OSA severity. The variables (various severity groups and environmental measurements) were subjected to mean comparisons, and their correlations were examined by Pearson’s correlation coefficient. The hospital-based CVHRI, CEI, and Rx index differed significantly among the severity groups. All three groups exhibited a significantly lower percentage of supine sleep time in the home-based assessment, compared with the hospital-based assessment. The percentage of supine sleep time (∆Supine%) exhibited a significant but weak to moderate positive correlation with each of the OSA indices. A significant but weak-to-moderate correlation between the ∆Supine% and ∆Rx index was still observed among the patients with high sleep efficiency (≥80%), who could reduce the effect of short sleep duration, leading to underestimation of the patients’ OSA severity. The high supine percentage of sleep may cause OSA indices’ overestimation in the hospital-based examination. Sleep recording at home with patch-type wearable devices may aid in accurate OSA diagnosis.

Abnormal EEG Complexity and Alpha Oscillation of Resting State in Chronic Stroke Patients

A valid evaluation of neurological functions after stroke may improve clinical decision-making. The aim of this study was to compare the performance of EEG-related indexes in differentiating stroke patients from control participants, and to investigate pathological EEG changes after chronic stroke. 20 stroke and 13 healthy participants were recruited, and spontaneous EEG signals were recorded during the resting state. EEG rhythms and complexity were calculated based on Fast Fourier Transform and the fuzzy approximate entropy (fApEn) algorithm. The results showed a significant difference of alpha rhythm (p = 0.019) and fApEn (p = 0.003) of EEG signals from brain area among ipsilesional, contralesion hemisphere of stroke patients and corresponding brain hemisphere of healthy participants. EEG fApEn had the best classification accuracy (84.85%), sensitivity (85.00%), and specificity (84.62%) among these EEG-related indexes. Our study provides a potential method to evaluate alterations in the properties of the injured brain, which help us to understand neurological change in chronic strokes.

Automatic detection of epileptic seizures using Riemannian geometry from scalp EEG recordings

This paper proposes a new framework for epileptic seizure detection using non-invasive scalp electroencephalogram (sEEG) signals. The major innovation of the current study is using the Riemannian geometry for transforming the covariance matrices estimated from the EEG channels into a feature vector. The spatial covariance matrices are considered as features in order to extract the spatial information of the sEEG signals without applying any spatial filtering. Since these matrices are symmetric and positive definite (SPD), they belong to a special manifold called the Riemannian manifold. Furthermore, a kernel based on Riemannian geometry is proposed. This kernel maps the SPD matrices onto the Riemannian tangent space. The SPD matrices, obtained from all channels of the segmented sEEG signals, have high dimensions and extra information. For these reasons, the sequential forward feature selection method is applied to select the best features and reduce the computational burden in the classification step. The selected features are fed into a support vector machine (SVM) with an RBF kernel to classify the feature vectors into seizure and non-seizure classes. The performance of the proposed method is evaluated using two long-term scalp EEG (CHB-MIT benchmark and private) databases. Experimental results on all 23 subjects of the CHB-MIT database reveal an accuracy of 99.87%, a sensitivity of 99.91%, and a specificity of 99.82%. In addition, the introduced algorithm is tested on the private sEEG signals recorded from 20 patients, having 1380 seizures. The proposed approach achieves an accuracy, a sensitivity, and a specificity of 98.14%, 98.16%, and 98.12%, respectively. The experimental results on both sEEG databases demonstrate the effectiveness of the proposed method for automated epileptic seizure detection, especially for the private database which has noisier signals in comparison to the CHB-MIT database. Graphical Abstract Block diagram of the proposed epileptic seizure detection algorithm.

MONITORING OF NON-INVASIVE VITAL SIGNS FOR DETECTION OF SLEEP APNEA

Sleep apnea (SA) syndrome is a respiratory disorder that occurs during the sleep. Polysomnography (PSG) has been widely applied by clinicians as a gold standard in the clinical diagnosis of SA syndrome. However, the use of PSG is inconvenient, intrusive, and significantly affects the sleep quality of patient. In this paper, we provide a nonintrusive solution for SA detection. Specifically, a force sensor was employed for the noninvasive vital sign acquisition during the patient’s sleep, where the respiratory signal was extracted adaptively by using the morphological filter. It was observed that the morphological variations before and during the occurrence of the SA events were significant for the SA discrimination. By taking advantage of the differential features with respect to the respiratory signal, the recognition of the SA event was performed using classifiers. For validation, the all-night PSG recordings of 12 volunteers with 8 SA syndrome patients were obtained from the National Clinical Research Center for Respiratory Disease. Numerical results showed that the proposed scheme achieved an averaged accuracy, sensitivity and specificity of 83.67%, 58.57% and 85.13%, respectively, for the SA recognition.

Automatic Sleep Stage Classification Using Temporal Convolutional Neural Network and New Data Augmentation Technique from Raw Single-Channel EEG

BACKGROUND AND OBJECTIVE

This paper presents a new framework for automatic classification of sleep stages using a deep learning algorithm from single-channel EEG signals. Each segmented EEG signal appended with its label of stages is fed into a deep learning model to create an automatic sleep stage classification. This is one of the most important problems that is critical to the realization of monitoring patients with sleep disorder.

METHODS

In the present study, a neural network architecture is introduced utilizing Convolutional Neural Networks (CNNs) to extract features, followed by Temporal Convolutional Neural Network to extract the temporal features from the extracted features vector of CNN. Finally, the performance of our model is improved by a Conditional Random Field layer. We also employed a new data augmentation technique to enhance the CNNs training which has auxiliary effects.

RESULTS

We evaluated our model by two different single-channel EEG signals (i.e., Fpz-Cz and Pz-Oz EEG channels) from two public sleep datasets, named Sleep-EDF-2013 and Sleep-EDF-2018. The evaluation results on both datasets showed that our model obtains the best total accuracy and kappa score (EDF-2013: 85.39%- 0.80, EDF-2018: 82.46%- 0.76) compared to the state-of-the-art methods.

CONCLUSIONS

This study will possibly allow us to have a wearable sleep monitoring system with a single-channel EEG. Also, unlike hand-crafted features methods, our model finds its own patterns through training epochs, and therefore, it may minimize engineering bias.

Automatic Detection of Obstructive Sleep Apnea Events Using a Deep CNN-LSTM Model

Obstructive sleep apnea (OSA) is a common sleep-related respiratory disorder. Around the world, more and more people are suffering from OSA. Because of the limitation of monitor equipment, many people with OSA remain undetected. Therefore, we propose a sleep-monitoring model based on single-channel electrocardiogram using a convolutional neural network (CNN), which can be used in portable OSA monitor devices. To learn different scale features, the first convolution layer comprises three types of filters. The long short-term memory (LSTM) is used to learn the long-term dependencies such as the OSA transition rules. The softmax function is connected to the final fully connected layer to obtain the final decision. To detect a complete OSA event, the raw ECG signals are segmented by a 10 s overlapping sliding window. The proposed model is trained with the segmented raw signals and is subsequently tested to evaluate its event detection performance. According to experiment analysis, the proposed model exhibits Cohen's kappa coefficient of 0.92, a sensitivity of 96.1%, a specificity of 96.2%, and an accuracy of 96.1% with respect to the Apnea-ECG dataset. The proposed model is significantly higher than the results from the baseline method. The results prove that our approach could be a useful tool for detecting OSA on the basis of a single-lead ECG.

Enhancing Obstructive Apnea Disease Detection Using Dual-Tree Complex Wavelet Transform-Based Features and the Hybrid "K-Means, Recursive Least-Squares" Learning for the Radial Basis Function Network

Background:

The obstructive sleep apnea (OSA) detection has become a hot research topic because of the high risk of this disease. In this paper, we tested some powerful and low computational signal processing techniques for this task and compared their results with the recent achievements in OSA detection.

Methods:

The Dual-tree complex wavelet transform (DT-CWT) is used in this paper to extract feature coefficients. From these coefficients, eight non-linear features are extracted and then reduced by the Multi-cluster feature selection (MCFS) algorithm. The remaining features are applied to the hybrid “K-means, RLS” RBF network which is a low computational rival for the Support vector machine (SVM) networks family.

Results and Conclusion:

The results showed suitable OSA detection percentage near 96% with a reduced complexity of nearly one third of the previously presented SVM based methods.

Automatic seizure detection using orthogonal matching pursuit, discrete wavelet transform, and entropy based features of EEG signals

BACKGROUND AND OBJECTIVE

Epilepsy is a prevalent disorder that affects the central nervous system, causing seizures. In the current study, a novel algorithm is developed using electroencephalographic (EEG) signals for automatic seizure detection from the continuous EEG monitoring data.

METHODS

In the proposed methods, the discrete wavelet transform (DWT) and orthogonal matching pursuit (OMP) techniques are used to extract different coefficients from the EEG signals. Then, some non-linear features, such as fuzzy/approximate/sample/alphabet and correct conditional entropy, along with some statistical features are calculated using the DWT and OMP coefficients. Three widely-used EEG datasets were utilized to assess the performance of the proposed techniques.

RESULTS

The proposed OMP-based technique along with the support vector machine classifier yielded an average specificity of 96.58%, an average accuracy of 97%, and an average sensitivity of 97.08% for different types of classification tasks. Moreover, the proposed DWT-based technique provided an average sensitivity of 99.39%, an average accuracy of 99.63%, and an average specificity of 99.72%.

CONCLUSIONS

The experimental findings indicated that the proposed algorithms outperformed other existing techniques. Therefore, these algorithms can be implemented in relevant hardware to help neurologists with seizure detection.

Obstructive sleep apnea detection using discrete wavelet transform-based statistical features

MOTIVATION AND OBJECTIVE

Obstructive sleep apnea (OSA) is a sleep disorder identified in nearly 10% of middle-aged people, which deteriorates the normal functioning of human organs, notably that of the heart. Furthermore, untreated OSA is associated with increased hypertension, diabetes, stroke, and cardiovascular diseases, thereby increasing the mortality risk. Therefore, early identification of sleep apnea is of significant interest.

METHOD

In this paper, an automated approach for OSA diagnosis using a single-lead electrocardiogram (ECG) has been reported. Three sets of features, namely moments of power spectrum density (PSD), waveform complexity measures, and higher-order moments, are extracted from the 1-min segmented ECG subbands obtained from discrete wavelet transform (DWT). Later, correlation-based feature selection with particle swarm optimization (PSO) search strategy is employed for getting an optimum feature vector. This process retained 18 significant features from initially computed 32 features. Finally, the acquired feature set is fed to different classifiers including, linear discriminant analysis, nearest neighbors, support vector machine, and random forest to perform per segment classification.

RESULTS

Experiments on the publicly available physionet single-lead ECG dataset show that the proposed approach using the random forest classifier effectively discriminates normal and OSA ECG signals. Specifically, our method achieved an accuracy of 89% and 90%, with 50-50 hold-out validation and 10-fold cross-validation, respectively. Besides, in both these validation scenarios, our method obtained 96% of the area under ROC. Importantly, our proposed approach provided better performance results than most of the existing methodologies.

A Novel Hybrid Machine Learning Classification for the Detection of Bruxism Patients Using Physiological Signals

Bruxism is a sleep disorder in which the patient clinches and gnashes their teeth. Bruxism detection using traditional methods is time-consuming, cumbersome, and expensive. Therefore, an automatic tool to detect this disorder will alleviate the doctor workload and give valuable help to patients. In this paper, we targeted this goal and designed an automatic method to detect bruxism from the physiological signals using a novel hybrid classifier. We began with data collection. Then, we performed the analysis of the physiological signals and the estimation of the power spectral density. After that, we designed the novel hybrid classifier to enable the detection of bruxism based on these data. The classification of the subjects into “healthy” or “bruxism” from the electroencephalogram channel (C4-A1) obtained a maximum specificity of 92% and an accuracy of 94%. Besides, the classification of the sleep stages such as the wake (w) stage and rapid eye movement (REM) stage from the electrocardiogram channel (ECG1-ECG2) obtained a maximum specificity of 86% and an accuracy of 95%. The combined bruxism classification and the sleep stages classification from the electroencephalogram channel (C4-P4) obtained a maximum specificity of 90% and an accuracy of 97%. The results show that more accurate bruxism detection is achieved by exploiting the electroencephalogram signal (C4-P4). The present work can be applied for home monitoring systems for bruxism detection.

Performance evaluation of the spectral autocorrelation function and autoregressive models for automated sleep apnea detection using single-lead ECG signal

BACKGROUND AND OBJECTIVE

This paper addresses the automated recognition of obstructive sleep apnea (OSA) from the analysis of single-lead ECG signals. This is one of the most important problems that is, critical to the realization of monitoring patients with sleep apnea.

METHODS

In the present study, a novel solution based on autoregressive (AR) modeling of the single-lead ECG, and spectral autocorrelation function as an ECG feature extraction method is presented. The more effective features are opted by sequential forward feature selection (SFFS) technique and fed into the random forest for binary classification between the apnea and normal events.

RESULTS

Experimental results on Apnea-ECG database proved that the introduced algorithm resulted in an accuracy of 93.90% (sensitivity of 92.26% and specificity of 94.92%) in per-segment classification, which outperforms the other cutting-edge automatic OSA recognition techniques. Moreover, the proposed algorithm provided an accuracy of 97.14% (sensitivity of 95.65% and specificity of 100%) in discrimination of apnea patients from the normal subjects, which is comparable to the traditional and existing approaches.

CONCLUSIONS

This study suggests that automatic OSA recognition from single-lead ECG signals is possible, which can be used as an inexpensive and low complexity burden alternative to more conventional methods such as Polysomnography.