以自動調壓連續陽壓呼吸器治療阻塞型睡眠呼吸中止症之演算法開發

Development of Algorithm for Autotitrating CPAP for Treating Obstructive Sleep Apnea

喬鈺安(Yu-An Chiao)

指導教授 ： 闕志達

共同指導教授 ： 李佩玲(Pei-Lin Lee)

國立臺灣大學/電機資訊學院/電子工程學研究所/碩士(2016年)

https://doi.org/10.6342/NTU201610242

摘要

對睡眠呼吸中止症的患者而言，連續陽壓呼吸器為目前最建議的治療方法。但是由於到睡眠中心進行陽壓呼吸器調整皆須花費許多時間、金錢，以及人力資源。因此若能讓呼吸器自身偵測患者當下的呼吸狀態，自行調整壓力，這樣便能達到節省各項成本，亦能增加患者使用呼吸器來治療的舒適度。
本論文提出一個陽壓呼吸器治療氣壓自動控制演算法，並使用睡眠中心所提供的陽壓呼吸器病患的臨床資料進行驗證。此項全新的演算法僅利用藉由呼吸器氣流訊號，藉由信號處理分析氣流訊號進行呼吸中止與淺呼吸事件偵測；並從氣流訊號中產生時域、頻域、多尺度熵相關的特徵值，進行特徵值篩選後使用k-means分群演算法去除極端值，將特徵值以深度學習類神經網路產生分類器，使用交叉驗證的方式驗證，以實現打呼事件偵測；最後也利用一簡單的方式分析氣流訊號來判斷中樞型呼吸中止。藉由以上這些偵測出來的呼吸事件來決定應當打出多大的治療氣壓。

關鍵字

呼吸中止症 ； 自動型陽壓呼吸器 ； 呼吸事件偵測 ； 類神經網路 ； 治療氣壓自動調整

並列摘要

For patients suffering from sleep apnea, continuous positive airway pressure (CPAP) is the most recommended therapy currently. However, manual CPAP titration at sleep center is time consumption and high-cost. Therefore, PAP machine (APAP) which can detect the breathing event and further automatically adjust the therapeutic pressure has been demonstrated to lower therapeutic pressure than fixed-pressure CPAP. Also, patients prefer APAP than fixed-pressure CPAP though the compliance was similar between two devices.
In this thesis, an automated CPAP titration algorithm is proposed. We verified our algorithm with database of overnight CPAP titration in the sleep center of NTUH. This novel algorithm only used PAP flow signal. Apnea and hypopnea detection can be realized by signal processing of several signals. Besides, we extracted several features from PAP flow signal, do feature selection, put them into deep-learning neural network to generate a classifier for snore detection, and use cross-validation method to do verification. A simple recheck method was also introduced to do CSA detection. Finally, the therapeutic pressure of CPAP was determined with algorithm according to the aforementioned event detections.

並列關鍵字

sleep apnea ； automatically-adjusting positive airway pressure ； breathing event detection ； neural network ； therapeutic pressure autotitration

參考文獻

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