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Sleep quality of subjects with and without sleep-disordered breathing based on the cyclic alternating pattern rate estimation from single-lead ECG.

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The term sleep quality is widely used by researchers and clinicians despite the lack of a definitional consensus, due to different assumptions on quality quantification. It is usually assessed using… Click to show full abstract

The term sleep quality is widely used by researchers and clinicians despite the lack of a definitional consensus, due to different assumptions on quality quantification. It is usually assessed using the subject self-reporting, a method that has a major limitation since the subject is a poor self-observer of its sleep behaviors. A more precise method requires the estimation of physiological signals through polysomnography, a procedure that has high costs, is uncomfortable for the subjects and it is unavailable to a large group of the world population. To address these issues, a sleep quality prediction method was developed based on the analysis of the cyclic alternating pattern rate estimated using a single-lead electrocardiogram. The algorithm analyzes the causality, entropy of the variability and connection of respiratory volume and the N-N interbeat intervals as features for a classifier to assess the cyclic alternating pattern and non-rapid eye movement periods. This information was then combined to estimate the cyclic alternating pattern rate and define the quality of sleep by considering the age-related cyclic alternating pattern rate percentages as a reference threshold. The best results were achieved using a deep stacked autoencoder as a classifier and employing the minimal-redundancy-maximal-relevance as feature selection algorithm. Data collected from three databases and one hospital was used for training and testing the algorithms, achieving an average accuracy of, respectively, 76% and 77% for the cyclic alternating pattern and non-rapid eye movement sleep classification. The predicted sleep quality achieved a high agreement when considering either the cyclic alternating pattern rate, the arousal index, apnea-hypopnea index or the sleep efficiency as quantification for sleep quality. A moderate correlation was achieved with the Epworth sleepiness score and Pittsburgh sleep quality index. Total sleep time presented a higher variation on the correlation analysis.

Keywords: quality; cyclic alternating; pattern rate; sleep quality; alternating pattern

Journal Title: Physiological measurement
Year Published: 2019

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