V 185 Continuous sleep-apnea screening in an unattended home-setting

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1 S526 V 185 Continuous sleep-apnea screening in an unattended home-setting Simon Annaheim, Laboratory for Biomimetic Membranes and Textiles, Empa, St. Gallen, Schweiz, simon.annaheim@empa.ch Martin Camenzind, Laboratory for Biomimetic Membranes and Textiles, Empa, St. Gallen, Schweiz, martin.camenzind@empa.ch Otto Schoch, Dept. of Pulmonary and Sleep Medicine, Kantonsspital St. Gallen, St. Gallen, Schweiz, otto.schoch@kssg.ch Martin Brutsche, Dept. of Pulmonary and Sleep Medicine, Kantonsspital St. Gallen, St. Gallen, Schweiz, martin.brutsche@kssg.ch Florent Baty, Dept. of Pulmonary and Sleep Medicine, Kantonsspital St. Gallen, St. Gallen, Schweiz, florent.baty@kssg.ch René Rossi, Laboratory for Biomimetic Membranes and Textiles, Empa, St. Gallen, Schweiz, rene.rossi@empa.ch Portable monitoring is becoming more and more considered for screening of sleep apnea It is debated whether portable monitoring can match the diagnostic accuracy of in-laboratory polysomnography. Nevertheless, it shows high potential for continuous patient follow-up in order to adjust treatment strategies and to estimate treatment efficiency. Sleep apnea is common sleep disorder contributing to the development of clinically overt cerebro- and cardiovascular comorbidities. Hence, an accurate and appropriate diagnosis as well as a wellcontrolled patient-centered care is in the focus of both medical research and public health. Scientific literature proved that features derived from electro cardiogram (ECG) signals (i.e. HRV indices) constitute of clinical value to discriminate different levels of severity of sleep apnea. A new wearable system including textile ECG electrodes was developed to replace conventional self-adhesive gel electrodes. This device enables an easy application of the electrodes with low impact on wearing comfort and avoiding skin irritation. The self-humidifying part included in the device enables to conduct long term (overnight) measurements and measurements on dry skin. In this study, the validity and reliability of the ECG signal acquired with the textile ECG acquisition systems during an overnight visit of a sleep laboratory was evaluated by comparison to ECG data obtained from conventional gel electrodes in 100 patients with suspected sleep apnea. A very good agreement was observed for heart rate, RR intervals and heart rate variability. Furthermore, the significance of ECG data obtained from the new system as well as the conventional gel electrodes is evaluated with regard to the assessment of the severity of sleep apnea. Both approaches revealed a good agreement when compared to PSG as gold standard. Finally, preliminary data from the continuous ECG monitoring in a home setting is presented and discussed with regard to data obtained from screening in an in-laboratory setting.

2 S527 V 187 Detection of nightly snore events in OSA patients Lisa Steinbrecher, Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen, Deutschland, lisa.steinbrecher@lse.thm.de Keywan Sohrabi, Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen, Deutschland, keywan.sohrabi@ges.thm.de Nilab Taher, Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen, Deutschland, nilab.taher@ges.thm.de Schahab Moeri, Schlafmedizinisches Zentrum, Universitätsklinikum Gießen Marburg, Marburg, Deutschland, schahabmoaeri@gmail.com Ulrich Koehler, Schlafmedizinisches Zentrum, Universitätsklinikum Gießen Marburg, Marburg, Deutschland, koehleru@med.uni-marburg.de Andreas Weissflog, Thora Tech GmbH, Gießen, Deutschland, weissflog@thoratech.de Volker Groß, Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen, Deutschland, volker.gross@ges.thm.de Snoring is understood as a respiratory sound, which is caused in the upper airway during sleep, and mostly appears in middle-aged men. Detection and classification of snore events can be helpful for diagnosis of obstructive sleep apnea (OSA). It is the most important form of sleep-related breathing disorders. Due to its high prevalence and its potential for developing cardiovascular diseases, resulting in increased morbidity. Improving methods for early diag-nosis and suitable therapy will lead to a more positive long-term outcome and will help to pre-vent sleep related breathing disorders. The purpose of this study is to describe and detect snore events during the night with a mobile lung sound monitor called LEOSound. Extensive recordings of nightly lung sounds (6-8 h) were realized with LEOSound. Additional to LEOSound, polysomnography data of every subject were recorded. The study includes 24 subjects with snore. The subjects are 21 men and 3 women aged between years (mean: 57 years; std: 13 years). Their recordings were audiovisually analyzed by experts as reference for automatic detection. The detector for snoring includes different features which describes snoring volume, intensity, and entropy. The sound of snoring shows a high level of inter- and intraindividual variability, which results in differences in frequency and intensity. Although the automatic detection by LEOSound is pos-sible with a high accuracy and every subject was properly identified as snorer by the detector.

3 S528 V 188 Evaluation of patient compliance during BIPAP-ventilation Florian Schudt, Faculty of Health Sciences, University of Applied Sciences, Gießen, Deutschland, florian.schudt@ges.thm.de Keywan Sohrabi, Faculty of Health Sciences, University of Applied Sciences, Gießen, Deutschland, keywan.sohrabi@ges.thm.de Werner Seeger, University of Giessen and Marburg Lung Center (UGMLC), Gießen, Deutschland, werner.seeger@innere.med.uni-giessen.de Andreas Weissflog, Thora Tech GmbH, Gießen, Deutschland, weissflog@thoratech.de Volker Groß, Faculty of Health Sciences, University of Applied Sciences, Gießen, Deutschland, volker.gross@ges.thm.de An important therapeutic approach in Chronic Obstructive Pulmonary disease (COPD) is the nocturnal noninvasive biphasic positive airway pressure (BIPAP) ventilation. By now, there is no comfortable and objective method to monitor the acceptance of the patient to this ventilation, so the doctor is mainly reliant on his experience and the patient s feeling in the morning. A new technical system, (RespAccept, Thora Tech GmbH, Germany), which is able to monitor the ventilation overnight by comparing the pressure values supported by the ventilation machine with the pressure values generated by the patient, has been tested. The RespAccept-system is connected via two small tubes with the ventilation tube and measures the pressures near to the patient and near to the ventilator simultaneously. An algorithm compares both pressures in order to interpret an synchronous behaviour between patient and ventilator, whereby a high synchronism is classified as a good patientcompliance. After the measuring, the discrepancies of pressure values are illustrated in graphs for each breath cycle. In our study, we investigated the pressure values recorded by the RespAccept-system by means of analysis of variance in order to find typical patterns and different parameter for the synchronism between patient and ventilator. Our aim was to facilitate the evaluation of the patient-compliance and the patient s well-being after the nocturnal ventilation based on the synchronism of patient and ventilation. This will support the doctors in verifying the adjusted ventilation parameters.

4 S529 V 189 Comparison of camera-based and contact based estimation of the respiratory rate Fabian Schrumpf, Hochschule für Technik, Wirtschaft und Kultur Leipzig, Leipzig, Deutschland, fabian.schrumpf@htwk-leipzig.de Christoph Mönch, Hochschule für Technik, Wirtschaft und Kultur Leipzig, Leipzig, Deutschland, christoph.moench@htwk-leipzig.de Bianca Reichard, Hochschule für Technik, Wirtschaft und Kultur Leipzig, Leipzig, Deutschland, biancareichard@googl .com Mirco Fuchs, Hochschule für Technik, Wirtschaft und Kultur Leipzig, Leipzig, Deutschland, mirco.fuchs@htwk-leipzig.de The assessment of the respiratory rate serves as an essential indicator for changes in a patient s condition. Since respiration influences the electrical activity of the heart it is possible to estimate its rate from electrocardiographic (ECG) and photoplethysmographic (PPG) data. Although being non-invasive these methods require the connection of sensors to the patient s body. In recent years, advances have been made to measure respiration signals using a camera. In principle, these signals are either derived on the basis of evaluating motion (e.g. movements of the chest) or similarly to PPG - by analyzing blood volume dynamics recorded remotely using camera-based PPG (rppg). The contactless measurement of respiration signals is prone to artefacts (e.g. patient movements, changes in illumination) which renders common techniques (e.g., FFT, number of zerocrossings) to estimate the respiration rate often useless. An alternative is the estimation on the basis of the autocorrelation function of the respiratory signal. We conducted an evaluation study (10 subjects) to compare contact- and camera-based respiratory rate estimation by means of autocorrelation. The subjects were lying in a supine position and were asked to synchronize their respiration to a metronome. The frequency was varied from 10 to 30 bpm (6 different levels, each lasted 10 periods). ECG and PPG were recorded using a PLUX biosignals researcher system. Two cameras (ids UI-3160CP) were used to derive videos of (1) the subject s face to provide an optimal measurement of rppg and (2) the upper body including chest. Respiration signals were derived from the ECG, PPG, rppg and body movements using various techniques (e.g. R-peak and RR-interval modulation, empirical mode decomposition (EMD)). It turned out that camera-based respiration rate estimation using EMD (i.e. from rppg and movement signals) and autocorrelation results in a very good agreement to respiration rates estimated from contact-based signals.

5 S530 V 191 Time-frequency representations of combined EEG and MEG recordings during NREM sleep Tilmann Sander-Thömmes, Physikalisch-Technische Bundesanstalt, Berlin, Deutschland, tilmann.sanderthoemmes@ptb.de Martin Glos, Interdisziplinäres Schlafmedizinisches Zentrum, Charité, Berlin, Deutschland, martin.glos@charite.de Alois Schlögl, IST Austria, Klosterneuburg, Österreich, alois.schloegl@ist.ac.at Christian Veauthier, Interdisziplinäres Schlafmedizinisches Zentrum, Charité, Berlin, Deutschland, christian.veauthier@charite.de Polysomnography is an important tool in clinical medicine and in research. So far brain signals during sleep are recorded exclusively using electroencephalography (EEG). Since EEG and magnetoencephalography (MEG) are sensitive to complementary parts of neuronal signals the inclusion of MEG might lead to a better understanding of sleep patterns. But modalities such as MEG and functional magnetic resonance imaging (fmri) require both experimental settings not well suited to sleep. The inherent noise produced during fmri prevents the subjects to enter any level of sleep, whereas in MEG the restrictions in head and body position prevent normal body movements occuring during sleep. MEG systems are both available for seated and supine subject positioning. A supine positioning in the MEG was chosen in this study to record sleep MEG together with PSG from 8 subjects during the first half of the night for a typical duration of 3.5 hours. Due to the limited time the REM sleep was not reached, but the observed NREM sleep was of sufficient quality for manual sleep staging of the PSG signals. The 125 MEG gradiometer channels were separated into 19 groups of neighbouring channels with each group consisting of 5-7 channels. The central channel of each group was selected for further processing. The time-frequency representation of sleep EEG signals complements manual sleep staging particularly by quantifying persistent oscillatory activity, but exact determination of oscillation frequency is time consuming for a human scorer. A time-frequency representation was calculated for the selected 19 MEG channels using nonoverlapping 20 s windows, which were further divided into 4 s windows. The average spectrum of the five 4 s spectra was the spectral estimate for the 20 s window. Time-frequency representations of EEG and MEG were compared. For the alpha, delta, and theta range MEG and EEG show similar overall patterns, but the relative amplitude between the oscillation bands can be different for MEG and EEG. This will be further investigated in a coupling analysis between EEG and MEG signals.

Non-contact Screening System with Two Microwave Radars in the Diagnosis of Sleep Apnea-Hypopnea Syndrome

Medinfo2013 Decision Support Systems and Technologies - II Non-contact Screening System with Two Microwave Radars in the Diagnosis of Sleep Apnea-Hypopnea Syndrome 21 August 2013 M. Kagawa 1, K. Ueki 1,