A comparison of 2 visual methods for classifying obstructive vs central hypopneas

Endotyping Sleep Apnea One Breath at a Time: An Automated Approach for Separating Obstructive from Central Sleep-disordered Breathing

“…The visual approach used known physiological features in a stepwise fashion to aid human scorers in classifying respiratory events. In a recent study by Dupuy-McCauley and colleagues, the performance of this visual approach was similar to the AASM recommended rules, and the accuracy of either method capped at 69.3% ( 23 ). In contrast, by using additional features and subjectively weighting them, the proposed P obs obtains a greater performance both on a breath-by-breath level and on a subject level ( 17 ).…”

“…Although some events may be clearly central (or obstructive), many events have a combined etiology, and a lack of consensus on their identification and reporting makes it difficult for labs to operationalize any event-based rules. As recently reported, the classification performance based on these rules is relatively low ( 23 ). Here, we have shown how our breath-by-breath probability may overcome these limitations.…”

“…As recently reported, the classification performance based on these rules is relatively low. 23 Here, we have shown how our breath-by-breath probability may overcome these limitations. Breaths are the smallest division using which one can measure an individual's primary type of sleep apnea.…”

“…al., the performance of this visual approach was similar to the AASM recommended rules, and the accuracy of either method capped at 69.3%. 23 In contrast, by using additional features and subjectively weighting them, the proposed P obs obtains a greater performance both on a breath-by-breath level and on a subject-level. 17 The relative importance of features using the data-driven random forest, further confirms the validity of our subjectively weighing the features.…”

Mandibular movements are a reliable noninvasive alternative to esophageal pressure for measuring respiratory effort in patients with sleep apnea syndrome

“…In sleep laboratories, the presence of elevated RE is assessed by the examination of the dual respiratory inductive plethysmography (RIP) belts signal (eg amplitude and phase shift) and changes in the shape of inspiratory nasal pressure (eg flow limitation or plateau aspect) and/or the appearance of a crescendo or stable snoring. [5][6][7][8] RIP signals can be misleading because the presence of obesity can cause misclassification of obstructive events as central. In addition, the shape of the nasal pressure signal is altered by mouth breathing.…”