Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a serious sleep disordered affecting up to 24% of men and 9% of woman in the middle aged population. The current standard for the OSAHS diagnosis is Polysomnography (PSG), which refers to the continuous monitoring of multiple physiological variables over the course of a night. The main outcomes of the PSG test are the OSAHS severity measures, such as the Respiratory Disturbance Index (RDI), Arousal Index, Latencies and other information to determine the macro sleep architecture (MSA), which is defined by Wake, Rapid-eye-movement (REM) and non-REM states of sleep. The MSA results are essential for computing the diagnostic measures reported in a PSG. The existing methods of the MSA analysis require the recording of 5-7 electrophysiological signals, including the Electroencephalogram (EEG), Electroculogram (EOG), and the Electromyogram (EMG). Sleep clinicians have to depend on the manual scoring of the overnight data records using the criteria given by Rechtschaffen and Kales (R&K, 1968). The manual analysis of MSA is tedious, subjective and suffers from inter- and intra-scorer variability. Additionally, the RDI and the Apnea-Hypopnea Index (AHI) parameters although used as the primary measures of the OSAHS severity, suffers from subjectivity, low reproducibility and a poor correlation with the symptoms of OSAHS. Sleep is essentially a neuropsychological phenomenon, and the EEG remains the best technique for the functional imaging of the brain during sleep. The EEG is the direct result of the neuronal activity of the brain. However, despite the potential, the wealth of information available in the EEG signal remains virtually untapped in current OSAHS diagnosis. Although the EEG is extensively used in traditional sleep analysis, its usage is mainly limited to staging sleep, based on the four-decade old R&K criteria. This thesis addresses these issues plaguing the PSG. We develop a novel, fully-automated algorithm (Higher-order Estimated Sleep States, HESS-algorithm) for the MSA analysis, which requires only one channel of the EEG data. We also develop an objective MSA analysis technique that uses a single, one-dimensional slice of the Bispectrum of the EEG, representing a nonlinear transformation of a system function that can be considered as the EEG generator. The agreement between the human and the proposed technology was found to be in the range of 70%-87%, which are similar to those, possible between expert human scorers. The ability of the HESS algorithm to compute the MSA parameters reliably and objectively will make a dramatic impact on the diagnosis and treatment of OSAHS and other sleep diseases, such as insomnia. The proposed technology uses low-computation-load Bispectrum techniques independent of R&K Criteria (1968) making real-time automated analysis a reality. In the thesis we also propose a new index (the IHSI) to characterise the severity of sleep apnea. The new index is based on the hemispherical asymmetry of the brain and is computed from the EEG coherence analysis. We achieved a significant (p=0.0001) accuracy of up to 91% in classifying patients into apneic and non-apneic group. Our statistical analysis results show that the IHSI carries potential for providing us with a reproducible measure to assist in diagnosing of OSAHS. With the proposed methods in this thesis it may be possible to develop the technology that will not only attempt to screen the OSAHS patients but will be able to provide OSAHS diagnosis with detailed sleep architecture via home based test. These technologies will simplify the instrumentation dramatically and will make possible to extend EEG/MSA analysis to portable systems as well.
| Identifer | oai:union.ndltd.org:ADTP/279205 |
| Creators | Vinayak Swarnkar |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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