Pre-determination of OSA degree using morphological features of the ECG signal

Obstructive sleep apnea (OSA) is a very common, but a difficult sleep disorder to diagnose. Recurrent obstructions form in the airway during sleep, such that OSA can threaten a breathing capacity of patients. Clinically, continuous positive airway pressure (CPAP) is the most specific and effective treatment for this. In addition, these patients must be separated according to its degree, with CPAP treatment applied as a result. In this study, 30 OSA patients from two different databases were automatically classified using electrocardiogram (ECG) data, identified as mild, moderate, and severe. One of the databases was original recordings which had 9 OSA patients with 8303 epochs and the other one was Physionet benchmark database which had 21 patients with 20,824 epochs. Fifteen morphological features could be identified when apnea was seen, both before and after it presented. Five data groups in total for first dataset and second dataset were prepared with these features and 10-fold cross validation was used to effectively determine the test data. Then, sequential backward feature selection (SBFS) algorithm was applied to understand the more effective features. The prepared data groups were evaluated with artificial neural networks (ANN) to obtain optimum classification performance. All processes were repeated for ten times and error deviation was calculated for the accuracy. Furthermore, different classifiers which are frequently used in the literature were tested with selected features. The degree of OSA was estimated from three epochs in pre-apnea data, yielding the success rates of 97.20 ± 2.15% and 90.18 ± 8.11% with the SBFS algorithm for the first and second datasets, respectively. Also, SVM classifier followed ANN system in the success rates of 96.23 ± 3.48% and 88.75 ± 8.52% for used datasets.