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Acoustic characterization of upper airway variations from wakefulness to sleep with respect to obstructive sleep apnea

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Abstract

The upper airway (UA) is in general thicker and narrower in obstructive sleep apnea (OSA) population than in normal. Additionally, the UA changes during sleep are much more in the OSA population. The UA changes can alter the tracheal breathing sound (TBS) characteristics. Therefore, we hypothesize the TBS changes from wakefulness to sleep are significantly correlated to the OSA severity; thus, they may represent the physiological characteristics of the UA. To investigate our hypothesis, we recorded TBS of 18 mild-OSA (AHI < 15) and 22 moderate/severe-OSA (AHI > 15) during daytime (wakefulness) and then during sleep. The power spectral density (PSD) of the TBS was calculated and compared within the two OSA groups and between wakefulness and sleep. The average PSD of the mild-OSA group in the low-frequency range (< 280 Hz) was found to be decreased significantly from wakefulness to sleep (p-value < 10−4). On the other hand, the average PSD of the moderate/severe-OSA group in the high-frequency range (> 900 Hz) increased marginally significantly from wakefulness to sleep (p-value < 9 × 10−3). Our findings show that the changes in spectral characteristics of TBS from wakefulness to sleep correlate with the severity of OSA and can represent physiological variations of UA. Therefore, TBS analysis has the potentials to assist with diagnosis and clinical management decisions in OSA patients based on their OSA severity stratification; thus, obviating the need for more expensive and time-consuming sleep studies.

Tracheal breathing sound (TBS) changes from wakefulness to sleep and their correlation with Obstructive sleep apnea (OSA) were investigated in individuals with different levels of OSA severity. We also assessed the classification power of the spectral characteristics of these TBS for screening purposes. Consequently, we analyzed and compared spectral characteristics of TBS recorded during wakefulness (a combination of mouth and nasal TBS) to those during sleep for mild and moderate/severe OSA groups.

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Abbreviations

AHI:

Apnea/hypopnea index

ANOVA:

analysis of variance

BMI:

Body mass index

HSS:

Home sleep study

MRI:

Magnetic resonance imaging

NC:

Neck circumference

OSA:

Obstructive sleep apnea

PSD:

Power spectrum density

PSDavg :

Average power spectrum density

PSG:

Polysomnography

SE:

Standard error

SVM:

Support vector machine

TBS:

Tracheal breathing sounds

UA:

Upper airway

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Authors and Affiliations

  1. Biomedical Engineering Program, University of Manitoba, Winnipeg, MB, Canada

    Farahnaz Hajipour & Zahra Moussavi

  2. Department of Internal Medicine, Section of Respirology, University of Manitoba, Winnipeg, MB, Canada

    Eleni Giannouli

  3. Department of Electrical & Computer Engineering, University of Manitoba, Winnipeg, MB, Canada

    Zahra Moussavi

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  1. Farahnaz Hajipour
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  3. Zahra Moussavi
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Correspondence to Farahnaz Hajipour.

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Hajipour, F., Giannouli, E. & Moussavi, Z. Acoustic characterization of upper airway variations from wakefulness to sleep with respect to obstructive sleep apnea. Med Biol Eng Comput 58, 2375–2385 (2020). https://doi.org/10.1007/s11517-020-02234-5

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