Real-time detection of sleep breathing disorders

Sleep and Control of Breathing

et al. 2017

Self Cite

Obstructive sleep apnea (OSA) occurs when the upper airway narrows or collapses due to the loss of upper airway muscle activation at sleep onset. This study investigated the effectiveness of triggered kinesthetic stimulation in patients with OSA. This proof-of-concept, open-label, multicenter prospective study was conducted on 24 patients with severe OSA. During a one night evaluation, kinesthetic stimulation was intermittently delivered in 30 minute periods. The duration of apneas and hypopneas during Stim on and Stim off periods were compared. Five hospital-based university centers in France participated. Sleep studies were evaluated by a single scorer at a core laboratory (CHU Grenoble). Results show that during the Stim on phases, statistically significant decreases in durations of apneas and hypopneas were observed in 56% and 46% of patients, respectively. Overall, 75% of patients showed an improvement in apneas or hypopneas durations. The mean reduction in durations for patients with a significant decrease was 4.86 seconds for apneas and 6.00 seconds for hypopneas. This proof of concept study is the first to identify kinesthetic stimulation as a potentially effective therapy for OSA. These data justify evaluation in a controlled study.

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Kinesthetic stimulation for obstructive sleep apnea syndrome: an “on-off” proof of concept trial

Hernández

Trenard

Sleep and Control of Breathing

et al. 2017

Self Cite

“…Concerning respiratory event detection, the initial method presented by our team in [11], was improved and evaluated retrospectively. It should be noticed that the proposed method has been developed for a real-time control application, in order to activate the kinesthetic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…A hypopnea event is detected when inhalation amplitude falls below 50% below inhalation baseline for more than δ h ∈ [5, ..., 10] seconds. A complete description, as well as a prospective evaluation of this method can be found on a recent publication [11]. In this paper, we propose an improvement of this detector, integrating the following modifications:…”

Section: Real-time Respiratory Event Detectormentioning

confidence: 99%

PASITHEA: An Integrated Monitoring and Therapeutic System for Sleep Apnea Syndromes Based on Adaptive Kinesthetic Stimulation

Hernández

Guerrero

et al. 2016

IRBM

International audienceSleep apnea syndromes are characterized by repeated episodes of breathing pauses (apnea) or significant reductions in respiratory amplitude (hypopnea) during the patient's sleep. These episodes significantly alter the sleep structure of the patient and provoke acute cardiorespiratory responses that may be deleterious in the long term. Continuous positive airway pressure (CPAP) therapy is the gold-standard treatment for SAS, but patient compliance to this therapy is low. This paper presents a new system for real-time detection, monitoring and treatment of SAS, based on triggered kinesthetic stimulation. The system is composed of 3 components: i) a cardio-respiratory recorder, ii) a kinesthetic stimulator and iii) a real-time processing application, integrating an " on-off " control method to trigger the kinesthetic stimulation as a function respiratory event detections. A preliminary evaluation of the system , performed on 46 patients suffering from severe SAS is also presented. This evaluation is focused on i) the performance characterization of the real-time respiratory event detector and ii) a qualitative description of the effect of the therapy. A satisfactory real-time respiratory event detection performance (sensitivity= 89.2%, positive predictive value = 59%) was obtained with the proposed detector, when evaluated retrospectively using the acquired data. Three case reports, describing the cardiorespiratory response to the therapy of a responder, a partially-responder and a non-responder patients ar

“…The NP signal is processed by a real-time apnea/hypopnea detector which has three possibles outputs: no apnea/hypopnea detected, apnea detected and hypopnea detected. A complete description of the apnea/hypopnea detector was published in [7].…”

Section: Controller Descriptionmentioning

confidence: 99%

Closed:loop Kinesthetic Stimulation for the Treatment of Sleep Apnea Syndromes

Romero

Guerrero

2016 Computing in Cardiology Conference (CinC)

et al. 2016

Self Cite

Sleep apnea syndrome (SAS) is a common disease characterized by recurrent episodes of breathing pauses or important reductions in respiratory amplitude during patient's sleep. These episodes provoke significant cardiorespiratory modifications that may have long-term cardiovascular consequences. This paper proposes a novel approach for the treatment of SAS, based on a closedloop kinesthetic stimulation, adapted as a function of the patient's physiological response. The closed-loop control system is based on concurrent, coupled proportionalderivative (PD) controllers that modulate the stimulation amplitude delivered to the patient. The controller was tested on a first phase of a clinical protocol including 12 patients with previously diagnosed SAS. Results from one patient are presented in this paper, showing how the proposed controller is capable to adapt stimulation parameters, converging to a minimum patient-specific amplitude. These results are encouraging regarding the feasibility of the integration of the proposed controller into the therapy for the adaptive optimization of the kinesthetic stimulation amplitude and warrant a second phase of the clinical study of this system.