The design of RIP belts impacts the reliability and quality of the measured respiratory signals

PURPOSE: Evaluate the effect of respiratory inductance plethysmography (RIP) belt design on the reliability and quality of respiratory signals. A comparison of cannula flow to disposable cut-to-fit, semi-disposable folding and disposable RIP belts was performed in clinical home sleep apnea testing (HSAT) studies. METHODS: This was a retrospective study using clinical HSAT studies. The signal reliability of cannula, thorax, and abdomen RIP belts was determined by automatically identifying periods during which the signals did not represent respiratory airflow and breathing movements. Results were verified by manual scoring. RIP flow quality was determined by examining the correlation between the RIP flow and cannula flow when both signals were considered reliable. RESULTS: Of 767 clinical HSAT studies, mean signal reliability of the cut-to-fit, semi-disposable, and disposable thorax RIP belts was 83.0 ± 26.2%, 76.1 ± 24.4%, and 98.5 ± 9.3%, respectively. The signal reliability of the cannula was 92.5 ± 16.1%, 87.0 ± 23.3%, and 85.5 ± 24.5%, respectively. The automatic assessment of signal reliability for the RIP belts and cannula flow had a sensitivity of 50% and a specificity of 99% compared with manual assessment. The mean correlation of cannula flow to RIP flow from the cut-to-fit, semi-disposable, and disposable RIP belts was 0.79 ± 0.24, 0.52 ± 0.20, and 0.86 ± 0.18, respectively. CONCLUSION: The design of RIP belts affects the reliability and quality of respiratory signals. The disposable RIP belts that had integrated contacts and did not fold on top of themselves performed the best. The cut-to-fit RIP belts were most likely to be unreliable, and the semi-disposable folding belts produced the lowest-quality RIP flow signals compared to the cannula flow signal. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11325-020-02268-x.