1. Presenter ： Yu-Hsiang Yen Advisior ： Dr. Chun-Ju Hou Date ： 2013.10.23 Establishment of Analysis System for Sleep Respiratory Activities 睡眠呼吸活動分析系統之建立

2. Outline Problems and Rationale Purpose and Specific Aims Background and Literatures Review Materials and Methods Preliminary Results References Future Work 2015/10/6 2

3. Problems and Rationale Sleep disorders Taiwan Society of Sleep Medicine (2013) 2015/10/6 3

4. Problems and Rationale Sleep Apnea Obstructive Sleep Apnea(OSA) Central Sleep Apnea(CSA) Mixed Sleep Apnea(MSA) 2015/10/6 4

5. Problems and Rationale Symptom of Sleep Apnea Snoring :Affecting 67.9% of the general population. Evaluation indexes Apnea- hypopnea index AHI : (a). 5–15/ hr = mild, (b).15–30/ hr = moderate, (c). > 30/ hr = severe 2015/10/6 5

6. Problems and Rationale Physiology Hypertension Atherosclerosis Coronary artery disease Cognitive impairments Sudden death during sleep Psychosis Tired Sleepiness Inattention Grumpy Dejection 2015/10/6 6

7. Problems and Rationale Technology for sleep measurement PSG Actigraphy Oximeter 2015/10/6 7 Source: Labsystem Source: myhealthyfeeling Source: Philips

8. Problems and Rationale The global homecare respiratory market had generated 15% compound annual growth from the year of 2009 to 2015. 2015/10/6 8 Source: 工研院 IEK (2009)

9. Purpose and Specific Aims To develop analysis system for sleep respiratory activities To develop the analysis algorithm for sleep respiratory activities To establish database management system 2015/10/6 9

10. Background and Literatures Review Relative Thresholding With Under-Mattress Pressure Sensors to Detect Central Apnea 2015/10/6 10 Daphne Townsend, Student Member, IEEE, Megan Holtzman, Student Member, IEEE, Rafik Goubran, Senior Member, IEEE, Monique Frize, Senior Member, IEEE, and Frank Knoefel IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT, VOL. 60, NO. 10, OCTOBER 2011

11. Background and Literatures Review Moving variance Parameter selection framework 2015/10/6 11

12. Background and Literatures Review 2015/10/6 12

13. Background and Literatures Review Validation of Unobtrusive Pressure Sensor Array for Central Sleep Apnea Screening 2015/10/6 13 Daphne Townsend, Student Member, IEEE, Rafik Goubran, Fellow, IEEE, Frank Knoefel, and Judith Leech IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT, VOL. 61, NO. 7, JULY 2012

14. Background and Literatures Review ANTHROPOMETRIC INFORMATION FOR STUDY PARTICIPANTS 2015/10/6 14

15. Background and Literatures Review Block diagram of prevalidation work 2015/10/6 15

16. Background and Literatures Review 2015/10/6 16

17. Materials and Methods System Architecture 2015/10/6 17

18. Materials and Methods Event tagging PSG data Pressure sensing data 2015/10/6 18

19. Materials and Methods Signal processing(49 channel) 2015/10/6 19

20. Materials and Methods Signal proccessing(Matlab) 2015/10/6 20 Pressure signal (raw data) Baseline detrend Fast Fourier transform Low-pass filter (0.5Hz) Display Waveform

21. Materials and Methods Tagging Resipiratory event (PSG) 2015/10/6 21

22. Materials and Methods Resipiratory event report 2015/10/6 22

23. Materials and Methods Database(MSSQL) 2015/10/6 23 Database Pressure Signal& DateTime Body Movement Medical Information Device Imformation Apnea Type

24. Materials and Methods Database(MSSQL) 2015/10/6 24 Pressure Signal Body Movement Medical Information Device Imformation Apnea Type

25. Preliminary Results Basic data of 40 subjects 2015/10/6 25 No. OSACAMix apneaHypopneaTotal 160060 66 2000 56 311311172 287 413810110 249 54363179 231 6000112 71800110 128 825911154 415 9871030 118 10187030146 363 1118400104 288 121025678 191 1323121153 189 143380174 413 150000 0 16320192385 447 174090030 439 1882541 56 193800102 140 20109039 58

26. Preliminary Results 2015/10/6 26 21172008 180 2289273083 229 231600196 212 247932229 313 2533004174 2622003355 271451770223 455 284411670 518 291793463 249 302007072 3129602560 32000110 338005967 3400013 35764045 125 3600043 37697254 132 386226392 462 39791298 180 Total378412819336907795 N=23N=20N=17N=38

27. Preliminary Results Right lying Central sleep apnea(Pressure sensing signal vs PSG) 2015/10/6 27

28. Future Work Establishment of analysis algorithm Signal fusion Feature extraction Database management system Create table 2015/10/6 28

29. References [1] 張慈映， 2009. 睡眠呼吸治療市場商機。工業技術研究院產業經濟與趨勢研究中心 [2] 2013. 國人睡眠大調查。台灣睡眠醫學學會 [3] R. Bhattacharjee, L. Kheirandish-Gozal, G. Pillar, and D. Gozal, “Cardiovascular complications of obstructive sleep apnea syndrome: Evidence from children,” Prog. Cardiovasc. Dis., vol. 51, no. 5, pp. 416–433, 2009. [4] W. Flemons andW. Tsai, “Quality of life consequences of sleep-disordered breathing,” J. Allergy Clin. Immunol., vol. 99, no. 2, pp. S750–S756, 1997. [5] W.W. Flemons,M.R.Littner, J.A.Rowley, P. Gay,W. M. Anderson, D.W. Hudgel, R. D. McEvoy, and D. I. Loube, “Home diagnosis of sleep apnea: A systematic review of the literature,” Chest, vol. 124, pp. 1543–1579, 2003. 2015/10/6 29

30. Thanks for your attention !