Screening of sleep apnea based on heart rate variability and long short-term memory

Sleep Breath. 2021 Dec;25(4):1821-1829. doi: 10.1007/s11325-020-02249-0. Epub 2021 Jan 10.

Abstract

Purpose: Sleep apnea syndrome (SAS) is a prevalent sleep disorder in which apnea and hypopnea occur frequently during sleep and result in increase of the risk of lifestyle-related disease development as well as daytime sleepiness. Although SAS is a common sleep disorder, most patients remain undiagnosed because the gold standard test polysomnography (PSG), is high-cost and unavailable in many hospitals. Thus, an SAS screening system that can be used easily at home is needed.

Methods: Apnea during sleep affects changes in the autonomic nervous function, which causes fluctuation of the heart rate. In this study, we propose a new SAS screening method that combines heart rate measurement and long short-term memory (LSTM) which is a type of recurrent neural network (RNN). We analyzed the data of intervals between adjacent R waves (R-R interval; RRI) on the electrocardiogram (ECG) records, and used an LSTM model whose inputs are the RRI data is trained to discriminate the respiratory condition during sleep.

Results: The application of the proposed method to clinical data showed that it distinguished between patients with moderate-to-severe SAS with a sensitivity of 100% and specificity of 100%, results which are superior to any other existing SAS screening methods.

Conclusion: Since the RRI data can be easily measured by means of wearable heart rate sensors, our method may prove to be useful as an SAS screening system at home.

Keywords: Machine learning; Sleep apnea syndrome; Telemedicine; Wearable sensor.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autonomic Nervous System / physiopathology*
  • Electrocardiography
  • Female
  • Heart Rate / physiology*
  • Humans
  • Machine Learning*
  • Male
  • Middle Aged
  • Neural Networks, Computer*
  • Sensitivity and Specificity
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / physiopathology*
  • Young Adult