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Investigating Relative Respiratory Effort Signals During Mixed Sleep Apnea Using Photoplethysmogram

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Abstract

Sleep disordered breathing does show different types of events. These are obstructive apnea events, central apnea events and mixed sleep apnea (MSA) which have a central component with a pause in airflow without respiratory effort followed by an obstructive component with respiratory effort. The esophageal pressure (Pes) is the accurate method to assess respiratory effort. The aim of the present study is to investigate whether the features extracted from photo-plethysmogram (PPG) could relate with the changes in Pes during MSA. Therefore, Pes and PPG signals during 65 pre-scored MSA events and 10 s preceding the events were collected from 8 patients. Pulse intervals (PPI), Pulse wave amplitudes (PWA) and wavelet decomposition (Wv) of PPG signals at level 8 (0.15–0.32 Hz) were derived from PPG signals. Results show that significant correlations (r = 0.63, p < 0.01; r = 0.42, p < 0.05; r = 0.8, p < 0.01 for OSA part) were found between reductions in Pes and that in PPG based surrogate respiratory signals PPI, PWA and Wv. Results suggest that PPG based relative respiratory effort signal can be considered as an alternative to Pes as a means of measuring changes in inspiratory effort when scoring OSA and CSA parts of MSA events.

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Acknowledgments

The authors would like to thank members of sleep research team at Charite Hospital in Berline for providing sleep studies. This study was partially supported by a research contract with ResMed Ltd in Sydney, Australia.

Conflict of Interest

There is no conflict of interests in this manuscript: Ahsan Khandoker.

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Authors and Affiliations

  1. Department of Electrical & Electronic Engineering, The University of Melbourne, Parkville, VIC, 3010, Australia

    A. H. Khandoker, C. K. Karmakar & M. Palaniswami

  2. Department of Biomedical Engineering, Khalifa University of Science, Technology and Research (KUSTAR), P.O. Box 127788, Abu Dhabi, UAE

    A. H. Khandoker

  3. Department for Cardiology, Interdisciplinary Sleep Medicine Center, Charite Universitätsmedizin Berlin, Berlin, Germany

    T. Penzel & M. Glos

Authors
  1. A. H. Khandoker
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  2. C. K. Karmakar
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  3. T. Penzel
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  4. M. Glos
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  5. M. Palaniswami
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Correspondence to A. H. Khandoker.

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Associate Editor John H. Linehan oversaw the review of this article.

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Khandoker, A.H., Karmakar, C.K., Penzel, T. et al. Investigating Relative Respiratory Effort Signals During Mixed Sleep Apnea Using Photoplethysmogram. Ann Biomed Eng 41, 2229–2236 (2013). https://doi.org/10.1007/s10439-013-0827-1

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  • DOI: https://doi.org/10.1007/s10439-013-0827-1

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