Obstructive Sleep Apnea Screening and Airway Structure Characterization During Wakefulness Using Tracheal Breathing Sounds

Ahmed Elwali, Zahra Moussavi
Annals of Biomedical Engineering 2017, 45 (3): 839-850
Screening for obstructive sleep apnea (OSA) disorder during wakefulness is challenging. In this paper, we present a set of tracheal breathing sounds characteristics with classification power for separating individuals with apnea/hypopnea index (AHI) ≥ 10 (OSA group) from those with AHI ≤ 5 (non-OSA group) during wakefulness. Tracheal breathing sound signals were recorded during wakefulness in supine position; subjects were instructed to have a few deep breaths through their nose, then through their mouth. Study participants were 147 individuals (80 males) referred to overnight polysomnography (PSG) assessment; their AHI scores were collected after their overnight-PSG study was completed. The signals were normalized; then, their power spectra were estimated. After conducting a multi-stage process for feature extraction and selection on a subset of training data, two spectral features showing significant differences between the two groups were selected for classification. These features showed a correlation of 0.42 with AHI. A 2-class support vector machine classifier with a linear kernel was used. Following this an exhaustive leave-two-out cross-validation was performed. The overall accuracies were 83.83 and 83.92% for training and testing datasets, respectively, while the overall sensitivity and specificity of the test datasets were 82.61 and 85.22%, respectively. We also applied the same method for anthropometric information (i.e., age, weight, etc.) as features, and they resulted in an overall accuracy of 77.6 and 76.2% for training and testing datasets, respectively. The results of this study show a superior classification power of respiratory sound features compared to anthropometric features for a quick screening of OSA during wakefulness. The relationship of the sound features and known morphological upper airway structure of OSA subjects are also discussed.

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