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Breath variability increases in the minutes preceding obstructive sleep apneic events

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

It is unclear if there is a consistent signature in breath patterns prior to an impending obstructive apneic event in patients with sleep-disordered breathing (SDB).

Objective

To use continuous recordings of ambient sound in sleep using a smartphone to track auditory signatures of breaths and measure their regularity preceding apneic events.

Methods

We studied 50 patients evaluated for SDB in whom sound was recorded using smartphones concurrently with polysomnography (PSG). Whole-night sound files were analyzed for time and frequency domain analyses of breath periodicity during periods of normal and sleep-disordered breathing.

Results

Fifty patients (44% women, 42.0 ± 9.4 years old, BMI 32.8 ± 10.8 kg/m2) recorded sound, of whom 30 were diagnosed with OSA and 20 were not. We analyzed a total of 497 apneic (≥10 s) and 481 non-apneic intervals, confirmed by PSG. Interbreath intervals were 3.75 ± 0.62 s for 1 min in quiet breathing, with SD 1.11 ± 0.48 s that increased to 4.16 ± 3.06 s in successive 60-s epochs up to apnea (p < 0.001). Interbreath SD in the 60 s immediately preceding apnea was higher than the SD in random non-apneic periods (p < 0.01, ANOVA). Interbreath SD ≥1.49 s gave 87.3% sensitivity and 86.5% specificity for predicting apnea in the next minute (c-statistic 0.94).

Conclusions

Breaths increase in variability minutes before proven obstructive apnea in patients with suspected SDB. These results suggest that it may be possible to predict and thus potentially avert apneic events and provide insights into events leading to SDB.

Trial registration

NCT03288376, clinicaltrials.org

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Abbreviations

AASM:

American Academy of Sleep Medicine

AHI:

Apnea Hypopnea Index

BMI:

body mass index (kg/m2)

CPAP:

continuous positive airway pressure

dB:

decibel

ECG:

electrocardiogram

EEG:

electroencephalogram

Epoch:

one-minute audio segment

HST:

home sleep testing

IRB:

Institutional Review Board

PSG:

polysomnography

OSA:

obstructive sleep apnea

SD:

standard deviation

SDB:

sleep-disordered breathing

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Authors and Affiliations

  1. Resonea Inc., 16580 N. 92nd Street #3001, Scottsdale, AZ, 85260, USA

    Tharun Niranjan Gomudurai Pandian, Ruchir Sehra & Sanjiv Narayan

Authors
  1. Tharun Niranjan Gomudurai Pandian
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  2. Ruchir Sehra
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  3. Sanjiv Narayan
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Corresponding author

Correspondence to Sanjiv Narayan.

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Conflict of interest

Dr. Narayan, Dr. Sehra, and Mr. Niranjan are inventors of an intellectual property owned by Resonea Inc. Dr. Sehra and Mr. Niranjan are employees of Resonea Inc.

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All participants involved in the study gave their informed consent.

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Pandian, T.N.G., Sehra, R. & Narayan, S. Breath variability increases in the minutes preceding obstructive sleep apneic events. Sleep Breath 25, 271–280 (2021). https://doi.org/10.1007/s11325-020-02094-1

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  • DOI: https://doi.org/10.1007/s11325-020-02094-1

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