Abstract
Obstructive sleep apnea (OSA) is a sleep disorder in which a person’s breathing is repeatedly interrupted because of airway obstruction. This study presents a fully convolutional neural network to diagnose the OSA by analyzing the single–lead ECG signal. This model does not employ any fully connected layers for classification, and the entire model only consists of 1D convolutional, activation, Pooling, and Batch Normalization layers. The main idea behind this model is to make decisions based on local segments of the signal, and the final classification is performed by aggregation of all decisions. This model implements the divide and conquer problem–solving method within a deep learning structure by the joint use of a convolutional layer and a global average pooling instead of a dense layer for classification. It was trained and evaluated by using a dataset available on the Physionet website. The accuracy of the proposed model outperformed other algorithms, which employ single lead ECG for the diagnosis of OSA.
Similar content being viewed by others
References
H.M. Al–Angari, A.V. Sahakian, Automated recognition of obstructive sleep apnea syndrome using support vector machine classifier. IEEE Trans. Inf. Technol. Biomed 16(3), 463–468 (2012). https://doi.org/10.1109/TITB.2012.2185809
L. Almazaydeh, K. Elleithy, M. Faezipour, Obstructive Sleep Apnea Detection Using SVM–Based Classification of ECG Signal Features, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. San Diego. CA; 4938–4941 (2012). https://doi.org/10.1109/EMBC.2012.6347100
D. Álvarez–Estévez, V. Moret–Bonillo, Fuzzy reasoning used to detect apneic events in the sleep apnea–hypopnea syndrome. Expert Syst. Appl. 36(4), 7778–7785 (2009). https://doi.org/10.1016/j.eswa.2008.11.043
S. Babaeizadeh, D.P. White, S.D. Pittman, S.H. Zhou, Automatic detection and quantification of sleep apnea using heart rate variability. J. Electrocardiol 43(6), 535–541 (2010). https://doi.org/10.1016/j.jelectrocard.2010.07.003
F. Barbé, J. Pericas, A. Munoz, L. Findley, J.M. Anto, A.G. Agusti, Automobile accidents in patients with sleep apnea syndrome: an epidemiological and mechanistic study. A J. Res. Crit. Care Med. 158(1), 18–22 (1998). https://doi.org/10.1164/ajrccm.158.1.9709135
L. Bi, D. Feng, J. Kim, Dual–path adversarial learning for Fully Convolutional Network (FCN)–based medical image segmentation. Vis. Comput. 34, 1043–1052 (2018). https://doi.org/10.1007/s00371-018-1519-5
N. Botros, J. Concato, V. Mohsenin, B. Selim, K. Doctor, H.K. Yaggi, Obstructive sleep apnea as a risk factor for type 2 diabetes. Am. J. Med. 122(12), 1122–1127 (2009). https://doi.org/10.1016/j.amjmed.2009.04.026
L. Chen, X. Zhang, C. Song, An automatic screening approach for obstructive sleep apnea diagnosis based on single–lead electrocardiogram. IEEE T. Autom. Sci. Eng. 12(1), 106–115 (2015). https://doi.org/10.1109/TASE.2014.2345667
M. Cheng, W.J. Sori, F. Jiang, A. Khan, S. Liu, Recurrent neural network–based classification of ECG signal features for obstruction of sleep apnea detection, In Computational Science and Engineering (CSE) and Embedded and Ubiquitous Computing (EUC), 199–202 (2017). https://doi.org/10.1109/CSE-EUC.2017.220
S.H. Choi, H. Yoon, H.S. Kim, H.B. Kim, H.B. Kwon, S.M. Oh, K.S. Park, Real–time apnea hypopnea event detection during sleep by convolutional neural networks. Comput. Biol. Med. 100, 123–131 (2018). https://doi.org/10.1016/j.compbiomed.2018.06.028
F. Chollet, Deep learning with python; pp 70:71 (2018)
F. Chollet, Keras (2015). http://keras.io/
J.A. Dempsey, S.C. Veasey, B.J. Morgan, C.P.O. Donnell, Pathophysiology of sleep apnea. Physiol Rev 90(1), 47–112 (2008). https://doi.org/10.1152/physrev.00043.2008
U. Erdenebayar, Y.J. Kim, J.U. Park, E.Y. Joo, K.J. Lee, Deep learning approaches for automatic detection of sleep apnea events from an electrocardiogram. Computer Methods Programs Biomed (2019). https://doi.org/10.1016/j.cmpb.2019.105001
U. Erdenebayar, J.U. Park, E.Y. Joo, K.J. Lee, Automated detection of obstructive sleep apnea events from a single–lead electrocardiogram using a convolutional neural network. Mobile Wireless Health 104, 1–8 (2018)
A. Graves, A.R. Mohamed, G. Hinton, Speech recognition with deep recurrent neural networks, In Acoustics, Speech and Signal Processing (ICASSP), 6645–6649 (2013). https://doi.org/10.1109/ICASSP.2013.6638947
D.J. Gottlieb, G. Yenokyan, A.B. Newman, G.T. O’Connor, N.M. Punjabi, S.F. Quan, S. Redline, H.E. Resnick, E.K. Tong, M. Diener–West, E. Shahar, Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure, sleep heart health study. Circulation 122(4), 352–360 (2010). https://doi.org/10.1161/CIRCULATIONAHA.109.901801
A.R. Hassan, M.A. Haque, An expert system for automated identification of obstructive sleep apnea from single–lead ECG using random under sampling boosting. Neurocomputing 235, 122–130 (2017). https://doi.org/10.1016/j.neucom.2016.12.062
G. Hinton, L. Deng, D. Yu, G.E. Dahl, A.R. Mohamed, N. Jaitly, B. Kingsbury, Deep neural networks for acoustic modeling in speech recognition, The shared views of four research groups. IEEE Signal Process. Mag. 29(6), 82–97 (2012). https://doi.org/10.1109/MSP.2012.2205597
A. Jafari, Sleep apnea detection from ECG using features extracted from reconstructed phase space and frequency domain. Biomed. Signal Process. Control 8, 551–558 (2013). https://doi.org/10.1016/j.bspc.2013.05.007
A. Khandoker, C. Karmakar, M. Palaniswami, Automated recognition of patients with obstructive sleep apnea using wavelet–based features of electrocardiogram recordings. Comput. Biol. Med 39, 88–96 (2009). https://doi.org/10.1109/TITB.2012.2185809
S. Kiranyaz, T. Ince, M. Gabbouj, Real–time patient–specific ECG classification by 1–D convolutional neural networks. IEEE Trans. Biomed. Eng. 63(3), 664–675 (2016). https://doi.org/10.1109/TBME.2015.2468589
A. Krizhevsky, I. Sutskever, G. Hinton, Image–net classification with deep convolutional neural Networks, In Advances in Neural Information Processing Systems; 25s, 1106–1114 (2012)
Y. LeCun, Y. Bengio, G. Hinton, Deep learning. Nature 521, 436–444 (2015). https://doi.org/10.1038/nature14539
J.V. Marcos, R. Hornero, D. Alvarez, M. Aboy, F. Del Campo, Automated prediction of the apnea–hypopnea index from nocturnal oximetry recordings. IEEE Trans. Biomed. Eng. 59(1), 141–149 (2012). https://doi.org/10.1109/TBME.2011.2167971
J. Marcos, R. Hornero, D. Álvarez, F. Del Campo, M. Aboy, Automated detection of obstructive sleep apnea syndrome from oxygen saturation recordings using linear discriminant analysis. Med. Biol. Eng. Comput. 48, 895–902 (2010). https://doi.org/10.1007/s11517-010-0646-6
M.O. Mendez, J. Corthout, H.S. Van, M. Matteucci, T. Penzel, S. Cerutti, A.M. Bianchi, Automatic screening of obstructive sleep apnea from the ECG based on empirical mode decomposition and wavelet analysis. Physiol. Meas. 31(3), 273–289 (2010). https://doi.org/10.1088/0967-3334/31/3/001
T. Mikolov, M. Karafiát, L. Burget, J. Černocký, S. Khudanpur, Recurrent neural network–based language Model, In INTERSPEECH, 1045–1048 (2010)
A. Nishad, R.B. Pachori, U.R. Acharya, Application of TQWT based filter–bank for sleep apnea screening using ECG signals, J. Ambient Intell. Humaniz. Comput, 1–12 (2018). https://doi.org/10.1007/s12652-018-0867-3
R.K. Pathinarupothi, E.S. Rangan, E.A. Gopalakrishnan, R.K.P. Vinaykumar, Soman, Single Sensor Techniques for Sleep Apnea Diagnosis using Deep Learning, IEEE J. Biomed. Health Inform, 524–529 (2017). https://doi.org/10.1109/ICHI.2017.37.
Peltarion.com/knowledge–center/documentation/modeling–view/build–an–ai–model/loss–functions/binary–crossentropy
T. Penzel, G.B.M. Rg, M.A.L. Goldberges, Peter H.: The Apnea–ECG Database; pp 255–258 (2000)
P.E. Peppard, M. Szklo–Coxe, K.M. Hla, T. Young, longitudinal association of sleep–related breathing disorder and depression. Arch. Intern. Med. 166, 1709–1715 (2006). https://doi.org/10.1001/archinte.166.16.1709
L.V. Pham, A.R. Schwartz, The pathogenesis of obstructive sleep apnea, J. Thorac Dis., 7(8):1358–1372, (2015). https://doi.org/10.3978/j.issn.2072-1439.2015.07.28. 7(8): 1439–2072
N.M. Punjabi, The epidemiology of adult obstructive sleep apnea. Proc. Am. Thorac. Soc. 5, 136–143 (2008). https://doi.org/10.1513/pats.200709-155MG
D. Ravi, C. Wong, F. Deligianni, M. Berthelot, J.A. Perez, B. Lo, G.Z. Yang, Deep learning for health Informatics. IEEE J. Biomed. Health Inform 21(1), 4–21 (2016). https://doi.org/10.1109/JBHI.2016.2636665
M. Sharma, S. Agarwal, U.R. Acharya, Application of an optimal class of antisymmetric wavelet filter banks for obstructive sleep apnea diagnosis using ECG signals. Comput. Biol. Med. 100, 100–113 (2018). https://doi.org/10.1016/j.compbiomed.2018.06.011
C. Song, K. Liu, X. Zhang, L. Chen, X. Xian, An obstructive sleep apnea detection approach using a discriminative hidden Markov model from ECG signals. IEEE Trans. Biomed. Eng. 9294(c), 1532–1542 (2015). https://doi.org/10.1109/TBME.2015.2498199
I. Sutskever, O. Vinyals, Q.V. Le, Sequence to sequence learning with neural networks, Adv. Neural Inf. Process Syst.; 2, 3104–3112 (2014). arXiv: 1409.3215
T. Tieleman, G. Hinton, Lecture 6.5—RMSProp, COURSERA: Neural Networks for Machine Learning.Technical report (2012)
R.K. Tripathy, Application of intrinsic band function technique for automated detection of sleep apnea using HRV and EDR signals. Biocybern. Biomed. Eng. 38, 136–144 (2018). https://doi.org/10.1016/j.bbe.2017.11.003
C. Varon, A. Caicedo, D. Testelmans, B. Buyse, S. Van Huffel, A novel algorithm for the automatic detection of sleep apnea from single–lead ECG. IEEE Trans Biomed Eng. 62(9), 2278–2296 (2015). https://doi.org/10.1109/TBME.2015.2422378
C.S. Viswabhargav, R.K. Tripathy, U.R. Acharya, Automated detection of sleep apnea using sparse residual entropy features with various dictionaries extracted from heart rate and EDR signals. Comput. Biol. Med. 108, 20–30 (2019). https://doi.org/10.1016/j.compbiomed.2019.03.016
A.N. Vgontzas, D.A. Papanicolaou, E.O. Bixler, K. Hopper, A. Lotsikas, H.M. Lin, A. Kales, G.P. Chrousos, Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and Hypercytokinemia. J. Clin. Endocrinol. Metab 85(3), 1151–1158 (2000). https://doi.org/10.1210/jcem.85.3.6484
A. Yildiz, M. Akın, M. Poyraz, An expert system for automated recognition of patients with obstructive sleep apnea using electrocardiogram recordings. Expert Syst. Appl 38, 12880–12890 (2011). https://doi.org/10.1016/j.eswa.2011.04.080
A. Zarei, B.M. Asl, Automatic detection of obstructive sleep apnea using wavelet transform and entropy–based features from single–lead ECG signal. IEEE J. Biomed. Health Inf. 23(3), 1011–1021 (2018). https://doi.org/10.22489/CinC.2020.400
Z. Zhang, W. Guo, W. Yu, W. Yu, Multi–task fully convolutional networks for building segmentation on SAR images. J. Eng. 20, 7074–7077 (2019). https://doi.org/10.1049/joe.2019.0569
Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial, or not–for–profit sectors.
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics Approval
Not applicable.
Consent to Participate
Not applicable.
Consent for Publication
Not applicable.
Data Availability
Available at https://physionet.org/physiobank/database/#ecg/
Code Availability
If needed, you can contact the corresponding author.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ayashm, S., Chehel Amirani, M. & Valizadeh, M. Analysis of ECG Signal by Using an FCN Network for Automatic Diagnosis of Obstructive Sleep Apnea. Circuits Syst Signal Process 41, 6411–6426 (2022). https://doi.org/10.1007/s00034-022-02091-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00034-022-02091-7