Professional Documents
Culture Documents
2Chief of Respiratory Care unit, China Medical University Hospital, Taichung, Taiwan
Abstract- Sleep disorder, such as Obstructive sleeps
apnoea (OSA), and is now regarded as an important risk factor
monitor OSA patients for their homecare need. This system includes MSP430 chip as A/D converter, that is low-power requirement. ECG amplifier with Bluetooth transmission function is also included. This system can remote monitor the patient's ECG signal, that is useful for hospital medications to monitor patients sleep in time. An OSA state determination algorithm, based on the HRV LF power, can
give a warning sign for the high OSA risk patients to visit
the doctors.
II. METHOD
A. System structure
sleep monitoring, and it can reduce the abundant burdens of hospital sleep centers.
Keywords
(1) Hardware:
We develop an ECG amplifier with gain 100 and low
dangerous of sleep-related diagnoses, and it has been increasingly implicated in the initiation and progression of cardiovascular diseases [1]. The standard approach to diagnosis of OSA is with an in-laboratory, technician-attended full Polysomnography (PSG), but it's labor-intensive and time-consuming. Therefore an alternative approach, such as portable monitoring for home diagnosis is a hot research topic [2]-[3]. In 2000, Computers in Cardiology (CINC) and PhysioNet encourage investigating sleep monitoring by ECG, and many ECG-derived parameters may be useful candidate [4]. In this paper, we setup a low-power ECG monitoring system, with wireless transmission by Bluetooth, and implemented an OSA diagnosis algorithm based on ECG to
MSP430F449 IC, produced by TI instruments. This IC has a low power requirement and compatible with 8 channel
analog input. Four AAA cell can provide the system power efficiently. This property can make the system smaller and being portable. The MSP430 sampling frequency is 200 Hz. (2) Bluetooth ECG transmission: There are several wireless transmission methods, such as Bluetooth, Zigbee, RF, and WiFi. The Bluetooth transmission rate is 2.1 Mbps, operated on 2.4GHz, transmission range from 10 cm to 100 meter. We choose Bluetooth due to its short distance, high transmission capacity, and higher security concern. Low power requirement is also a major factor. All such Bluetooth properties are good for home-based ECG transmission. We adopt the Bluetooth module from J3 Company [5],
309
computer.
(3) Host PC monitoring interface and remote monitoring: The ECG monitoring interface is programmed by
D. OSA identification algorithm
Labview. We also program a remote monitoring interface beside the host computer that is also coded by Labview. Figure 1 is the illustration of the system structure described above.
identification algorithm:
(1) Choose five hour sleep ECG from the whole night recording.
(4) Statistical testing by t-test analysis. (5) OSA clustering performance by receiver operating characteristic (ROC) curve. All the above algorithms are implemented by Matlab, and coded into the Labview module.
Fig. 1. Structure of Bluetooth_based sleep ECG monitoring system
IV. RESULTS
A. Hardware system
The ECG transmission performance of the system had been tested by three aspects. At first, we compare the
ECG amplifier performance with commercial ECG amplifier.
Second, the digital output ECG signal was compared with analog ECG to test the MSP430 A/D converter performance. The test ECG signals are from simulator and real ECG signals. Third, the Bluetooth transmission performance; include the ECG signal loss after transmission and transmission range are also investigated.
C. OSA subjects information
respiratory disturbance index (RDI)>15 (26 male and 4 female, age 42.8+10.7, and RDI is 77.4+15.5, range from 103.8 to 41.5), and another thirty patients with RDI<15 (19 male and 11 female, age 35.2+12.5, and RDI is 6.9+4.4,
range from 13.8 to 0), data are recorded from sleep center of
figure 2a. The digital ECG pattern after MSP430 are recorded by Labview through RS233 connect; and the further Bluetooth transmitted ECG are also compared, and both shown in figure 2b. The likelihood between figure2b is tested by template matching method. Maximum value is 0.96, that means the ECG output between MSP430 (before Bluetooth transmission) and Bluetooth transmission ECG is very similar. Bluetooth transmission doesn't distort ECG pattern. Figure 3 is the user interface coded by Labview. The remote monitoring site has similar interface. In the interface, the ECG can be saved and reload for further analysis. Figure 2b is also the demonstration of the reloaded ECG signal,
which is saved on the host computer after Bluetooth transmission.
310
Table 1.
The ECG-derived parameters for RDI> 15 and RDI< 15.
r
C1
'I
DLl~l
flfD
2t
S [I0SI4,D IIfl
4fD
Ut
--I
parameters
RDl<15
RDI>15
18.214.1 *E8
P value
HRV Power
7.43.8 *E8
0.0002
.Q.. --.
a
(0.04-0.06 Hz)
----
LB_.rL.
10 fl5
O(
20X
X5
flD
IDO
power(0.04-0.06
Hz )/ total power
0.236 0.084
0.377 0.129
7.69E-06
Fig. 2b
LF/(LF+HF)
LF power
0.5710.148
19.510.7 *E8
0.6370.135
36.432.4 *E8
0.006
0.010
LF/HF
1.7221.368
2.6681.724
0.022
8000000000 7000000000
im 6000000000
N 5000000000
o 4000000000
4 3000000000
2000000000
1000000000
10 15 20 25 30
peak detection
can
curve
of figure 5. The
and
be
group,
cm 0.6 * 0.5
= 0.4
4'
0.8 0.7
RDI>15 and RDI <15, and their t-test results. The most
between
0.3 0.2
0.1
0 0
0.2
0.4
0.6
0.8
marked
square
311
The OSA identification algorithm proposed in this paper can also used with conventional CPAP system to monitor the
figure 7. Patients can upload their sleep ECG into the system,
and less than one min later, the interface will give different
takes a further examination in the hospital. The analysis result is also connected to the hospital database, and the doctor can trace the patient's OSA treatment performance immediately.
patient sleep and to take a proper medical treatment in time. It would be very useful in the future,
ACKNOWLEDGMENT
Fig. 7
Review of the Literature An Evidence Review Cosponsored by the American Academy of Sleep Medicine, the American Collegeof Chest
The host computer contain signal demonstration and user interface. HRV sub-band power based OSA identification
algorithm is also implemented in the system. This system is based on the whole night ECG to estimate the OSA. Traditional R wave detection algorithm developed on Tompkins is very useful in this study. The major goal of this study is to develop homecare oriented sleep monitoring system, and ECG is chosen due to its vital sign characteristics. Low cost, low power demand, easy to setup and friendly user interface are all major factor to be considered. Such system is especially useful for the primary screen on OSA candidate and for further traces after OSA
treatment.
312