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Wavelet analysis of oximetry recordings to assist in the automated detection of moderate-to-severe pediatric sleep apnea-hypopnea syndrome

BACKGROUND: The gold standard for pediatric sleep apnea hypopnea syndrome (SAHS) is overnight polysomnography, which has several limitations. Thus, simplified diagnosis techniques become necessary. OBJECTIVE: The aim of this study is twofold: (i) to analyze the blood oxygen saturation (SpO(2)) signa...

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Detalles Bibliográficos
Autores principales: Vaquerizo-Villar, Fernando, Álvarez, Daniel, Kheirandish-Gozal, Leila, Gutiérrez-Tobal, Gonzalo C., Barroso-García, Verónica, Crespo, Andrea, del Campo, Félix, Gozal, David, Hornero, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286069/
https://www.ncbi.nlm.nih.gov/pubmed/30532267
http://dx.doi.org/10.1371/journal.pone.0208502
Descripción
Sumario:BACKGROUND: The gold standard for pediatric sleep apnea hypopnea syndrome (SAHS) is overnight polysomnography, which has several limitations. Thus, simplified diagnosis techniques become necessary. OBJECTIVE: The aim of this study is twofold: (i) to analyze the blood oxygen saturation (SpO(2)) signal from nocturnal oximetry by means of features from the wavelet transform in order to characterize pediatric SAHS; (ii) to evaluate the usefulness of the extracted features to assist in the detection of pediatric SAHS. METHODS: 981 SpO(2) signals from children ranging 2–13 years of age were used. Discrete wavelet transform (DWT) was employed due to its suitability to deal with non-stationary signals as well as the ability to analyze the SAHS-related low frequency components of the SpO(2) signal with high resolution. In addition, 3% oxygen desaturation index (ODI3), statistical moments and power spectral density (PSD) features were computed. Fast correlation-based filter was applied to select a feature subset. This subset fed three classifiers (logistic regression, support vector machines (SVM), and multilayer perceptron) trained to determine the presence of moderate-to-severe pediatric SAHS (apnea-hypopnea index cutoff ≥ 5 events per hour). RESULTS: The wavelet entropy and features computed in the D(9) detail level of the DWT reached significant differences associated with the presence of SAHS. All the proposed classifiers fed with a selected feature subset composed of ODI3, statistical moments, PSD, and DWT features outperformed every single feature. SVM reached the highest performance. It achieved 84.0% accuracy (71.9% sensitivity, 91.1% specificity), outperforming state-of-the-art studies in the detection of moderate-to-severe SAHS using the SpO(2) signal alone. CONCLUSION: Wavelet analysis could be a reliable tool to analyze the oximetry signal in order to assist in the automated detection of moderate-to-severe pediatric SAHS. Hence, pediatric subjects suffering from moderate-to-severe SAHS could benefit from an accurate simplified screening test only using the SpO(2) signal.