Deep Neural Network Hyper-Parameter Setting for Classification of Obstructive Sleep Apnea Episodes

Abstract Purpose In 2-dimensional lateral cephalometric radiographs, patients with severe obstructive sleep apnea (OSA) exhibit a more crowded oropharynx in comparison with non-OSA. We tested the hypothesis that machine learning, an application of artificial intelligence (AI), could be used to detect patients with severe OSA based on 2-dimensional images. Methods A deep convolutional neural network was developed (n = 1258; 90%) and tested (n = 131; 10%) using data from 1389 (100%) lateral cephalometric radiographs obtained from individuals diagnosed with severe OSA (n = 867; apnea hypopnea index > 30 events/h sleep) or non-OSA (n = 522; apnea hypopnea index < 5 events/h sleep) at a single center for sleep disorders. Three kinds of data sets were prepared by changing the area of interest using a single image: the original image without any modification (full image), an image containing a facial profile, upper airway, and craniofacial soft/hard tissues (main region), and an image containing part of the occipital region (head only). A radiologist also performed a conventional manual cephalometric analysis of the full image for comparison. Results The sensitivity/specificity was 0.87/0.82 for full image, 0.88/0.75 for main region, 0.71/0.63 for head only, and 0.54/0.80 for the manual analysis. The area under the receiver-operating characteristic curve was the highest for main region 0.92, for full image 0.89, for head only 0.70, and for manual cephalometric analysis 0.75. Conclusions A deep convolutional neural network identified individuals with severe OSA with high accuracy. Future research on this concept using AI and images can be further encouraged when discussing triage of OSA.

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Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire

PLoS ONE ◽

10.1371/journal.pone.0258040 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258040

Author(s):

Eric Yeh ◽

Eileen Wong ◽

Chih-Wei Tsai ◽

Wenbo Gu ◽

Pai-Lien Chen ◽

...

Keyword(s):

Neural Network ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Physiological Data ◽

Apnea Hypopnea Index ◽

Clinical Practices ◽

Sleep Study ◽

Link Type ◽

Obstructive Sleep ◽

Sensitivity Specificity

Many wearables allow physiological data acquisition in sleep and enable clinicians to assess sleep outside of sleep labs. Belun Sleep Platform (BSP) is a novel neural network-based home sleep apnea testing system utilizing a wearable ring device to detect obstructive sleep apnea (OSA). The objective of the study is to assess the performance of BSP for the evaluation of OSA. Subjects who take heart rate-affecting medications and those with non-arrhythmic comorbidities were included in this cohort. Polysomnography (PSG) studies were performed simultaneously with the Belun Ring in individuals who were referred to the sleep lab for an overnight sleep study. The sleep studies were manually scored using the American Academy of Sleep Medicine Scoring Manual (version 2.4) with 4% desaturation hypopnea criteria. A total of 78 subjects were recruited. Of these, 45% had AHI < 5; 18% had AHI 5–15; 19% had AHI 15–30; 18% had AHI ≥ 30. The Belun apnea-hypopnea index (bAHI) correlated well with the PSG-AHI (r = 0.888, P < 0.001). The Belun total sleep time (bTST) and PSG-TST had a high correlation coefficient (r = 0.967, P < 0.001). The accuracy, sensitivity, specificity in categorizing AHI ≥ 15 were 0.808 [95% CI, 0.703–0.888], 0.931 [95% CI, 0.772–0.992], and 0.735 [95% CI, 0.589–0.850], respectively. The use of beta-blocker/calcium-receptor antagonist and the presence of comorbidities did not negatively affect the sensitivity and specificity of BSP in predicting OSA. A diagnostic algorithm combining STOP-Bang cutoff of 5 and bAHI cutoff of 15 events/h demonstrated an accuracy, sensitivity, specificity of 0.938 [95% CI, 0.828–0.987], 0.944 [95% CI, 0.727–0.999], and 0.933 [95% CI, 0.779–0.992], respectively, for the diagnosis of moderate to severe OSA. BSP is a promising testing tool for OSA assessment and can potentially be incorporated into clinical practices for the identification of OSA. Trial registration: ClinicalTrial.org NCT03997916 https://clinicaltrials.gov/ct2/show/NCT03997916?term=belun+ring&draw=2&rank=1

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Tormented Sunrises

Sleep Disorders ◽

10.1093/med/9780190671099.003.0022 ◽

2019 ◽

pp. 418-434

Author(s):

Maha Alattar

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

General Population ◽

Sleep Disorders ◽

Headache Disorders ◽

Distinct Subset ◽

Obstructive Sleep ◽

High Prevalence ◽

The Relationship

This chapter covers the relationship between sleep-related headaches and sleep disorders such as obstructive sleep apnea (OSA). Sleep apnea headache (SAH), a type of sleep-related headache that is classified in the International Classification of Headache Disorders, is a distinct subset of headache that is caused by OSA and occurs distinctly on awakening. Once recognized, treatment of OSA is associated with significant improvement in, and often resolution of, SAH. Given the high prevalence of headaches in the general population, sleep disorders must be considered in the evaluation of patients with headaches. A comprehensive sleep evaluation should be an integral part of the assessment of headache disorders. Sleep apnea headache and other types of headaches associated with sleep are reviewed in this chapter.

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