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Fan X, Chen X, Ma W, Gao W. BAFNet: Bottleneck Attention Based Fusion Network for Sleep Apnea Detection. IEEE J Biomed Health Inform 2024; 28:2473-2484. [PMID: 37216250 DOI: 10.1109/jbhi.2023.3278657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Sleep apnea (SA) is a common sleep-related breathing disorder that tends to induce a series of complications, such as pediatric intracranial hypertension, psoriasis, and even sudden death. Therefore, early diagnosis and treatment can effectively prevent malignant complications SA incurs. Portable monitoring (PM) is a widely used tool for people to monitor their sleep conditions outside of hospitals. In this study, we focus on SA detection based on single-lead electrocardiogram (ECG) signals which are easily collected by PM. We propose a bottleneck attention based fusion network named BAFNet, which mainly includes five parts of RRI (R-R intervals) stream network, RPA (R-peak amplitudes) stream network, global query generation, feature fusion, and classifier. To learn the feature representation of RRI/RPA segments, fully convolutional networks (FCN) with cross-learning are proposed. Meanwhile, to control the information flow between RRI and RPA networks, a global query generation with bottleneck attention is proposed. To further improve the SA detection performance, a hard sample scheme with k-means clustering is employed. Experiment results show that BAFNet can achieve competitive results, which are superior to the state-of-the-art SA detection methods. It means that BAFNet has great potential to be applied in the home sleep apnea test (HSAT) for sleep condition monitoring.
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Lechat B, Scott H, Manners J, Adams R, Proctor S, Mukherjee S, Catcheside P, Eckert DJ, Vakulin A, Reynolds AC. Multi-night measurement for diagnosis and simplified monitoring of obstructive sleep apnoea. Sleep Med Rev 2023; 72:101843. [PMID: 37683555 DOI: 10.1016/j.smrv.2023.101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/13/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
Substantial night-to-night variability in obstructive sleep apnoea (OSA) severity has raised misdiagnosis and misdirected treatment concerns with the current prevailing single-night diagnostic approach. In-home, multi-night sleep monitoring technology may provide a feasible complimentary diagnostic pathway to improve both the speed and accuracy of OSA diagnosis and monitor treatment efficacy. This review describes the latest evidence on night-to-night variability in OSA severity, and its impact on OSA diagnostic misclassification. Emerging evidence for the potential impact of night-to-night variability in OSA severity to influence important health risk outcomes associated with OSA is considered. This review also characterises emerging diagnostic applications of wearable and non-wearable technologies that may provide an alternative, or complimentary, approach to traditional OSA diagnostic pathways. The required evidence to translate these devices into clinical care is also discussed. Appropriately sized randomised controlled trials are needed to determine the most appropriate and effective technologies for OSA diagnosis, as well as the optimal number of nights needed for accurate diagnosis and management. Potential risks versus benefits, patient perspectives, and cost-effectiveness of these novel approaches should be carefully considered in future trials.
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Affiliation(s)
- Bastien Lechat
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia.
| | - Hannah Scott
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Jack Manners
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Robert Adams
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Simon Proctor
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Sutapa Mukherjee
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Peter Catcheside
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Danny J Eckert
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Andrew Vakulin
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia
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Walter J, Lee JY, Blake S, Kalluri L, Cziraky M, Stanek E, Miller J, Harty BJ, Yu L, Park J, Zhang M, Coughlin S, Serao A, Lee J, Buban A, Bae M, Edel C, Toloui O, Rangel SM, Power T, Xu S. A new wearable diagnostic home sleep testing platform: comparison with available systems and benefits of multinight assessments. J Clin Sleep Med 2023; 19:865-872. [PMID: 36692166 PMCID: PMC10152349 DOI: 10.5664/jcsm.10432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/25/2023]
Abstract
STUDY OBJECTIVES We assessed the real-world performance of the ANNE Sleep system against 2 Food and Drug Administration-cleared home sleep testing platforms and the intraindividual night-to-night variability of respiratory event index measured by ANNE Sleep. METHODS We evaluated the home performance of the ANNE Sleep system compared with 2 Food and Drug Administration-cleared home sleep testing platforms (WatchPAT: n = 29 and Alice NightOne: n = 46) during a synchronous night with unsupervised patient application. Additionally, we evaluated night-to-night variability of respiratory event index and total sleep time using the ANNE Sleep system (n = 30). RESULTS For the diagnosis of moderate and severe obstructive sleep apnea, the ANNE Sleep system had a positive percent agreement of 58% (95% confidence interval, 28-85%) and a negative percent agreement of 100% (95% confidence interval, 80-100%) compared to WatchPAT. The positive and negative percent agreement for ANNE Sleep vs Alice NightOne was 85% (95% confidence interval, 66-96%) and 95% (95% confidence interval, 74-100%). There were no differences in mean total sleep time or respiratory event index across multiple nights of monitoring with ANNE. There were no differences consistent with a first-night effect but testing multiple nights reclassified obstructive sleep apnea severity in 5 (17%) individuals and detected 3 additional cases of moderate disease, with only a 12% (standard deviation, 28%) mean fluctuation in respiratory event index from the first night of testing compared to a mean of multiple nights. Overall, 80% of users found ANNE comfortable and easy to use. CONCLUSIONS ANNE Sleep exhibited stronger concordance with Alice NightOne compared to WatchPAT. While we illustrated low night-to-night variability for ANNE Sleep, the results suggest multiple nights increased detection of moderate or severe obstructive sleep apnea. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: ANNE Diagnostic Agreement With Home Sleep Testing; URL: https://clinicaltrials.gov/ct2/show/NCT05421754; Identifier: NCT05421754. CITATION Walter J, Lee JY, Blake S, et al. A new wearable diagnostic home sleep testing platform: comparison with available systems and benefits of multinight assessments. J Clin Sleep Med. 2023;19(5):865-872.
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Affiliation(s)
- Jessica Walter
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
| | | | | | | | | | | | | | | | - Lian Yu
- Sibel Health, Niles, Illinois
| | | | - Michael Zhang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | | | | | | | | | - Claire Edel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Stephanie M. Rangel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Shuai Xu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
- Sibel Health, Niles, Illinois
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Bandera-Barros JJ, Méndez-Hernández JC, Wilches-Visbal JH. Oximetría de pulso en enfermedades respiratorias. NOVA 2022. [DOI: 10.22490/24629448.6588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
El pulsioxímetro es un dispositivo que utiliza principios de espectrofotometría y fotopletismografía para la medición de la saturación de oxígeno arterial, así como el ciclo cardiaco y respiratorio, lo que resulta útil para monitorear pacientes con compromisorespiratorio. En este trabajo se realiza una revisión bibliográfica de los principios físicos del pulsioxímetro y sus avances más recientes en pacientes con enfermedad pulmonar obstructiva crónica (EPOC), asma y COVID-19. Se encontró que la oximetría de pulso es una herramienta confiable y eficaz en el diagnóstico y la prevención de complicaciones en pacientes con estas enfermedades respiratorias.
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Davies C, Lee JY, Walter J, Kim D, Yu L, Park J, Blake S, Kalluri L, Cziraky M, Stanek E, Miller J, Harty BJ, Schauer J, Rangel SM, Serao A, Edel C, Ran DS, Olagbenro MO, Lim A, Gill K, Cooksey J, Toloui O, Power T, Xu S, Zee P. A single-arm, open-label, multicenter, and comparative study of the ANNE sleep system vs polysomnography to diagnose obstructive sleep apnea. J Clin Sleep Med 2022; 18:2703-2712. [PMID: 35934926 PMCID: PMC9713912 DOI: 10.5664/jcsm.10194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES Evaluate per-patient diagnostic performance of a wireless dual-sensor system (ANNE sleep) compared with reference standard polysomnography (PSG) for the diagnosis of moderate and severe obstructive sleep apnea (OSA) with a minimum prespecified threshold of 80% for both sensitivity and specificity. METHODS A multicenter clinical trial was conducted to evaluate ANNE sleep vs PSG to diagnose moderate and severe OSA in individuals 22 years or older. For each testing approach, apnea-hypopnea index (AHI) was manually scored and averaged by 3 registered sleep technologists blinded to the other system. Average variations > 15% were adjudicated by a sleep medicine physician. RESULTS In a total of n = 225 participants (mean age 53 years, range 22-88 years), PSG diagnosed 30% (n = 68) of participants with moderate or severe OSA (AHI ≥ 15 events/h) compared to 29% (n = 65) diagnosed by ANNE sleep (P = .55). The sensitivity and specificity for ANNE sleep were 90% (95% confidence interval: 80-96%) and 98% (95% confidence interval: 94-99%), respectively. Strong correlation was shown in terms of final AHI (r = .93), with an average AHI bias of 0.5 (95% limits of agreement: -12.8 to 11.8). The majority of users noted comfort with using the ANNE sleep in the home setting. No adverse events were noted. CONCLUSIONS Using PSG as the gold standard, ANNE sleep demonstrated high sensitivity and specificity for the diagnosis of moderate or severe OSA. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Comparative Study of the ANNE™ One System to Diagnose Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/NCT04643782; Identifier: NCT04643782. CITATION Davies C, Lee JY, Walter J et al. A single-arm, open-label, multicenter, and comparative study of the ANNE sleep system vs polysomnography to diagnose obstructive sleep apnea. J Clin Sleep Med. 2022;18(12):2703-2712.
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Affiliation(s)
- Charles Davies
- Carle Neuroscience Institute, Division of Sleep Medicine, Carle Foundation Hospital, Urbana, Illinois
| | - Jong Yoon Lee
- Sibel Health, Niles, Illinois
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois
| | - Jessica Walter
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
| | | | - Lian Yu
- Sibel Health, Niles, Illinois
| | | | | | | | | | | | | | | | - Jacob Schauer
- Department of Preventative Medicine, Northwestern University, Chicago, Illinois
| | - Stephanie M. Rangel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alexa Serao
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Claire Edel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Davina S. Ran
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew O. Olagbenro
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Andrew Lim
- Division of Sleep Medicine, Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kuljeet Gill
- Central DuPage Hospital, Northwestern Medicine, Winfield, Illinois
- Division of Sleep Medicine, Department of Neurology, Northwestern University, Chicago, Illinois
| | - Jessica Cooksey
- Division of Sleep Medicine, Department of Neurology, Northwestern University, Chicago, Illinois
- Lake Forest Hospital, Northwestern Medicine, Lake Forest, Illinois
| | - Omid Toloui
- Anthem, Inc. Elevance Health, Indianapolis, Indiana
| | | | - Shuai Xu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Department of Pediatrics (Division of Dermatology), Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Phyllis Zee
- Division of Sleep Medicine, Department of Neurology, Northwestern University, Chicago, Illinois
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Peripheral Biomarkers to Diagnose Obstructive Sleep Apnea in Adults: A Systematic Review and Meta-Analysis. Sleep Med Rev 2022; 64:101659. [DOI: 10.1016/j.smrv.2022.101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
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O’Reilly BM, Wang Q, Collen J, Matsangas P, Colombo CJ, Mysliwiec V. Performance comparison of peripheral arterial tonometry-based testing and polysomnography to diagnose obstructive sleep apnea in military personnel. J Clin Sleep Med 2022; 18:1523-1530. [DOI: 10.5664/jcsm.9894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Qing Wang
- Madigan Army Medical Center, Tacoma, Washington
| | - Jacob Collen
- Walter Reed National Military Medical Center, Bethesda, Maryland
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Hunasikatti M. Night-to-night fluctuations in sleep apnea severity: diagnostic and treatment implications and the need to be less prescriptive in guidelines. J Clin Sleep Med 2020; 16:1623. [PMID: 32515346 DOI: 10.5664/jcsm.8626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dzierzewski JM, Dautovich ND, Taylor SA. Nightly fluctuations in sleep apnea severity and clinical practice guidelines for diagnostic testing. J Clin Sleep Med 2020; 16:1625-1626. [PMID: 32620185 DOI: 10.5664/jcsm.8654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Natalie D Dautovich
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Samuel A Taylor
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia
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