Investigation of obstructive sleep apnea using nonlinear mode interactions in nonstationary snore signals.

Acoustic studies on snoring sounds have recently drawn attention as a potential alternative to polysomnography in the diagnosis of obstructive sleep apnea (OSA). This paper investigates the feasibility of using nonlinear coupling between frequency modes in snore signals via wavelet bicoherence (WBC) analysis for screening of OSA. Two novel markers (PF1 and PSF), which are frequency modes with high nonlinear coupling strength in their respective WBC spectrum, are proposed to differentiate between apneic and benign snores in same- or both-gender snorers. Snoring sounds were recorded from 40 subjects (30 apneic and 10 benign) by a hanging microphone, and subsequently preprocessed within a wavelet transform domain. Forty inspiratory snores (30 as training and 10 as test data) from each subject were examined. Results demonstrate that nonlinear mode interactions in apneic snores are less self-coupled and usually occupy higher and wider frequency ranges than that of benign snores. PF1 and PSF are indicative of apneic and benign snores (p < 0.0001), with optimal thresholds of PF1 = 285 Hz and PSF = 492 Hz (for both genders combined), as well as sensitivity and specificity values between 85.0 and 90.7%, respectively, outperforming the conventional diagnostic indicator (spectral peak frequency, PF = 243-275 Hz, sensitivity = 77.7-79.7%, specificity = 72.0-78.0%, p < 0.0001). Relationships between apnea-hypopnea index and the proposed markers could likely take the functional form of exponential or power. Perspectives on nonlinear dynamics analysis of snore signals are promising for further research and development of a reliable and inexpensive diagnostic tool for OSA.

Could formant frequencies of snore signals be an alternative means for the diagnosis of obstructive sleep apnea?

OBJECTIVE: To study the feasibility of using acoustic signatures in snore signals for the diagnosis of obstructive sleep apnea (OSA). METHODS: Snoring sounds of 30 apneic snorers (24 males; 6 females; apnea-hypopnea index, AHI=46.9+/-25.7events/h) and 10 benign snorers (6 males; 4 females; AHI=4.6+/-3.4events/h) were captured in a sleep laboratory. The recorded snore signals were preprocessed to remove noise, and subsequently, modeled using a linear predictive coding (LPC) technique. Formant frequencies (F1, F2, and F3) were extracted from the LPC spectrum for analysis. The accuracy of this approach was assessed using receiver operating characteristic curves and notched box plots. The relationship between AHI and F1 was further explored via regression analysis. RESULTS: Quantitative differences in formant frequencies between apneic and benign snores are found in same- or both-gender snorers. Apneic snores exhibit higher formant frequencies than benign snores, especially F1, which can be related to the pathology of OSA. This study yields a sensitivity of 88%, a specificity of 82%, and a threshold value of F1=470Hz that best differentiate apneic snorers from benign snorers (both gender combined). CONCLUSION: Acoustic signatures in snore signals carry information for OSA diagnosis, and snore-based analysis might potentially be a non-invasive and inexpensive diagnostic approach for mass screening of OSA.