Diagnosis of sleep apnea by the analysis of heart rate variation

A mini review

Junichiro Hayano, Eiichi Watanabe, Yuji Saito, Fumihiko Sasaki, Kiyohiro Kawai, Itsuo Kodama, Hiroki Sakakibara

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Citations (Scopus)

Abstract

Cyclic variation of heart rate (CVHR) associated with sleep apnea/hypopnea episodes has been suggested as a marker of sleep disordered breathing (SDB). This study examined the utility of ECG-based CVHR detection for diagnosing SDB using simultaneous polysomnography as the reference standard. We used a previously developed automated CVHR detection algorithm (autocorrelated wave detection with adaptive threshold, ACAT) that provides the number of CVHR per hour (CVHR index). The ACAT was refined using a polysomnographic database of 194 subjects with various severities of SDB and then, applied to a single channel ECG obtained during standard overnight polysomnography in 862 consecutive subjects referred for SDB diagnosis. Using multiple thresholds of CVHR index 38 and 27, positive and negative predictive values of 95.6% and 95.1%, respectively, were achieved for detecting and excluding subjects with apnea-hypopnea index (AHI) 30, leaving 58 (6.7%) unclassified subjects. Positive and negative likelihood ratios (LRs) were 97.3 and 0.23, respectively. Also, thresholds of CVHR index 29 and 7 provided 96.1% and 95.1% of positive and negative predictive values, respectively, for subjects with AHI 15 (LRs, 50.6 and 0.11), leaving 426 (49.4%) unclassified subjects. The CVHR correlated with the AHI (r 0.86) and showed the limits of agreement with the AHI of 19.6 and 18.6. Automated detection of CVHR by the ACAT algorithm provides useful screening tool for both increasing and decreasing probability of moderate and sever SDB with adequate thresholds.

Original languageEnglish
Title of host publication33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011
Pages7731-7734
Number of pages4
DOIs
Publication statusPublished - 26-12-2011
Event33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011 - Boston, MA, United States
Duration: 30-08-201103-09-2011

Other

Other33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011
CountryUnited States
CityBoston, MA
Period30-08-1103-09-11

Fingerprint

Sleep Apnea Syndromes
Heart Rate
Apnea
Polysomnography
Electrocardiography
Sleep
Screening
Databases

All Science Journal Classification (ASJC) codes

  • Signal Processing
  • Biomedical Engineering
  • Computer Vision and Pattern Recognition
  • Health Informatics

Cite this

Hayano, J., Watanabe, E., Saito, Y., Sasaki, F., Kawai, K., Kodama, I., & Sakakibara, H. (2011). Diagnosis of sleep apnea by the analysis of heart rate variation: A mini review. In 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011 (pp. 7731-7734). [6091905] https://doi.org/10.1109/IEMBS.2011.6091905
Hayano, Junichiro ; Watanabe, Eiichi ; Saito, Yuji ; Sasaki, Fumihiko ; Kawai, Kiyohiro ; Kodama, Itsuo ; Sakakibara, Hiroki. / Diagnosis of sleep apnea by the analysis of heart rate variation : A mini review. 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011. 2011. pp. 7731-7734
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title = "Diagnosis of sleep apnea by the analysis of heart rate variation: A mini review",
abstract = "Cyclic variation of heart rate (CVHR) associated with sleep apnea/hypopnea episodes has been suggested as a marker of sleep disordered breathing (SDB). This study examined the utility of ECG-based CVHR detection for diagnosing SDB using simultaneous polysomnography as the reference standard. We used a previously developed automated CVHR detection algorithm (autocorrelated wave detection with adaptive threshold, ACAT) that provides the number of CVHR per hour (CVHR index). The ACAT was refined using a polysomnographic database of 194 subjects with various severities of SDB and then, applied to a single channel ECG obtained during standard overnight polysomnography in 862 consecutive subjects referred for SDB diagnosis. Using multiple thresholds of CVHR index 38 and 27, positive and negative predictive values of 95.6{\%} and 95.1{\%}, respectively, were achieved for detecting and excluding subjects with apnea-hypopnea index (AHI) 30, leaving 58 (6.7{\%}) unclassified subjects. Positive and negative likelihood ratios (LRs) were 97.3 and 0.23, respectively. Also, thresholds of CVHR index 29 and 7 provided 96.1{\%} and 95.1{\%} of positive and negative predictive values, respectively, for subjects with AHI 15 (LRs, 50.6 and 0.11), leaving 426 (49.4{\%}) unclassified subjects. The CVHR correlated with the AHI (r 0.86) and showed the limits of agreement with the AHI of 19.6 and 18.6. Automated detection of CVHR by the ACAT algorithm provides useful screening tool for both increasing and decreasing probability of moderate and sever SDB with adequate thresholds.",
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Hayano, J, Watanabe, E, Saito, Y, Sasaki, F, Kawai, K, Kodama, I & Sakakibara, H 2011, Diagnosis of sleep apnea by the analysis of heart rate variation: A mini review. in 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011., 6091905, pp. 7731-7734, 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011, Boston, MA, United States, 30-08-11. https://doi.org/10.1109/IEMBS.2011.6091905

Diagnosis of sleep apnea by the analysis of heart rate variation : A mini review. / Hayano, Junichiro; Watanabe, Eiichi; Saito, Yuji; Sasaki, Fumihiko; Kawai, Kiyohiro; Kodama, Itsuo; Sakakibara, Hiroki.

33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011. 2011. p. 7731-7734 6091905.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

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Hayano J, Watanabe E, Saito Y, Sasaki F, Kawai K, Kodama I et al. Diagnosis of sleep apnea by the analysis of heart rate variation: A mini review. In 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011. 2011. p. 7731-7734. 6091905 https://doi.org/10.1109/IEMBS.2011.6091905