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Obstructive Sleep Apnea Characterization: A Multimodal Cross-Recurrence-Based Approach for Investigating Atrial Fibrillation

Year: 2024

Type: article

Abstract: Obstructive sleep apnea (OSA) is believed to contribute significantly to atrial fibrillation (AF) development in certain patients. Recent studies indicate a rising risk of AF with increasing OSA severity. However, the commonly used apnea-hypopnea index in clinical practice may not adequately account for the potential cardiovascular risks associated with OSA.1) Objective:to propose and explore a novel method for assessing OSA severity considering potential connection to cardiac arrhythmias.2) Method:the approach utilizes cross-recurrence features to characterize OSA and AF by considering the relationships among oxygen desaturation, pulse arrival time, and heart-beat intervals. Multinomial logistic regression models were trained to predict four levels of OSA severity and four groups related to heart rhythm issues. The rank biserial correlation coefficient,$r_{rb}$, was used to estimate effect size for statistical analysis. The investigation was conducted using the MESA database, which includes polysomnography data from 2055 subjects.3) Results:a derived cross-recurrence-based index showed a significant association with a higher OSA severity (p$< $0.01) and the presence of AF (p$< $0.01). Additionally, the proposed index had a significantly larger effect,$r_{rb}$, than the conventional apnea-hypopnea index in differentiating increasingly severe heart rhythm issue groups: 0.14$>$0.06, 0.33$>$0.10, and 0.41$>$0.07.4) Significance:the proposed method holds relevance as a supplementary diagnostic tool for assessing the authentic state of sleep apnea in clinical practice.

Source: IEEE Journal of Biomedical and Health Informatics

DOI: 10.1109/jbhi.2024.3428845