Sleep staging is a challenging task, typically manually performed by sleep technologists based on electroencephalogram and other biosignals of patients taken during overnight sleep studies. Recent work aims to leverage automated algorithms to perform sleep staging not based on electroencephalogram signals, but rather based on the airflow signals of subjects. Prior work uses ideas from topological data analysis (TDA), specifically Hermite function expansions of persistence curves (HEPC) to featurize airflow signals. However, finite order HEPC captures only partial information. In this work, we propose Fourier approximations of persistence curves (FAPC), and use this technique to perform sleep staging based on airflow signals. We analyze performance using an XGBoost model on 1155 pediatric sleep studies taken from the Nationwide Children's Hospital Sleep DataBank (NCHSDB), and find that FAPC methods provide complimentary information to HEPC methods alone, leading to a 4.9% increase in performance over baseline methods.

Sleep apnea is a disorder that has serious consequences for the pediatric population. There has been recent concern that traditional diagnosis of the disorder using the apnea-hypopnea index may be ineffective in capturing its multi-faceted outcomes. In this work, we take a first step in addressing this issue by phenotyping patients using a clustering analysis of airflow time series. This is approached in three ways: using feature-based fuzzy clustering in the time and frequency domains, and using persistent homology to study the signal from a topological perspective. The fuzzy clusters are analyzed in a novel manner using a Dirichlet regression analysis, while the topological approach leverages Takens embedding theorem to study the periodicity properties of the signals.

Purpose: This study evaluated a novel approach for diagnosis and classification of obstructive sleep apnea (OSA), called Obstructive Sleep Apnea Smart System (OSASS), using residual networks and single-channel nasal pressure airflow signals. Methods: Data were collected from the sleep center of the First Affiliated Hospital, Sun Yat-sen University, and the Integrative Department of Guangdong Province Traditional Chinese Medical Hospital. We developed a new model called the multi-resolution residual network (Mr-ResNet) based on a residual network to detect nasal pressure airflow signals recorded by polysomnography (PSG) automatically. The performance of the model was assessed by its sensitivity, specificity, accuracy, and F1-score. We built OSASS based on Mr-ResNet to estimate the apnea‒hypopnea index (AHI) and to classify the severity of OSA, and compared the agreement between OSASS output and the registered polysomnographic technologist (RPSGT) score, assessed by two technologists. Results: In the primary test set, the sensitivity, specificity, accuracy, and F1-score of Mr-ResNet were 90.8%, 90.5%, 91.2%, and 90.5%, respectively.

While the gold standard for measuring airflow is to use a spirometer with an occlusive seal, this is not practical for ambulatory monitoring of patients. Advances in sensor technology have made measurement of motion of the thorax and abdomen feasible with small inexpensive devices, but estimation of airflow from these time series is challenging. We propose to use the nonlinear-type time-frequency analysis tool, synchrosqueezing transform, to properly represent the thoracic and abdominal movement signals as the features, which are used to recover the airflow by the locally stationary Gaussian process. We show that, using a dataset that contains respiratory signals under normal sleep conditions, an accurate prediction can be achieved by fitting the proposed model in the feature space both in the intra-and inter-subject setups. We also apply our method to a more challenging case, where subjects under general anesthesia underwent transitions from pressure support to unassisted ventilation to further demonstrate the utility of the proposed method. Keyword: high-frequency physiological data; Gaussian process regression; time-frequency analysis; synchrosqueezing transform.