JP6482107B1 - Sleep evaluation device, sleep evaluation method, and sleep evaluation program - Google Patents

Abstract

A technique for accurately evaluating sleep evaluation based on a pulse wave is provided.
A first apnea / hypopnea event extraction unit that extracts an apnea / hypopnea event based on a shape of temporal change in amplitude of a pulse wave, and the apnea / hypopnea event extraction unit extracts the apnea / hypopnea event extraction unit. Among the first apnea / hypopnea events, the first apnea / hypopnea event during the period in which the measured blood oxygen concentration is not decreased is excluded and the rest is used as the second apnea event. A second apnea / hypopnea event extraction unit that extracts as a hypopnea event, and determines the second apnea / hypopnea event as a true apnea / hypopnea event Sleep evaluation device.
[Selection] Figure 2A

Description

  The present invention relates to a sleep evaluation technique, and more particularly to a sleep apnea / hypopnea syndrome evaluation technique.

  As a technique for evaluating sleep, an overnight polysomnography (PSG) is well known.

  The PSG test is known as a device for confirming a sleep disorder or sleep respiratory disorder by a test that measures the state of the body during sleep at night through a worn electrode. In particular, it is possible to accurately diagnose sleep disorders by measuring brain waves.

  Measuring brain waves increases device complexity and measurement costs, so alternative tests are being studied.

For example, Patent Document 1 discloses the following technique.
An optical probe including a light emitting element that emits light to a blood vessel through the skin, and a light receiving element that receives reflected light from the blood vessel or transmitted light through the blood vessel through the skin, and an input drive A blood vessel pulse wave measurement is performed using an optical probe circuit including a drive circuit that drives the light-emitting element based on a signal, and a detection circuit that converts light received by the light-receiving element into an electrical signal and outputs the electrical signal. In the vascular pulse wave measurement system to be performed, the electric signal is directly and synchronously fed back to the drive circuit as the drive signal to generate a self-excited oscillation signal from the detection circuit, and the self-excited oscillation signal is converted into the vascular pulse wave. Measuring means for measuring as a signal, and control means for controlling an operating point of at least one of the detection circuit and the driving circuit so that the level of the self-excited oscillation signal is substantially maximized. Blood vessels Measurement system.

  With the above technique, even when the propagation distance of light from the light emitting element to the light receiving element is different, pulsation waveform data can be acquired with a simple configuration, and blood vessel pulse wave measurement can be performed.

Patent Document 2 discloses the following technique.
A first pressure sensor that is provided through the skin on the blood vessel of the radial artery of the human body and that detects a pressure change of the pulse wave flowing through the blood vessel and measures it as a voltage value of the blood vessel pulse wave signal; A controllable pressure application mechanism, provided in the vicinity of the first pressure sensor, the pressure value is calibrated in advance, and stress is applied to the blood vessel via the second pressure sensor and the skin by the pressure application mechanism. A second pressure sensor that detects a pressure value when applied, and a pressure change of a pulse wave that is provided through the skin on the blood vessel of the fingertip of the human body and that flows through the blood vessel to detect a vascular pulse wave signal Based on the third sensor to measure as a voltage value, each vascular pulse wave signal and the detected pressure value, the first maximum blood pressure value of the radial artery portion and the second maximum blood pressure of the fingertip portion A sleep means comprising a control means for measuring values A Nita ring system,
The control means includes
(A) When the first maximum blood pressure value is increased by a predetermined first threshold value or more during a predetermined time period, the second maximum blood pressure value is decreased by a predetermined second threshold value or more. The human body is determined to be awake,
(B) In the time period, when the first maximum blood pressure value is increased by the first threshold value or more, the second maximum blood pressure value is increased by a predetermined third threshold value or more, Alternatively, the human body is in a sleep state when the second maximum blood pressure value is decreased by the third threshold value or more when the first maximum blood pressure value is decreased by the threshold value or more. The sleep state monitoring system characterized by determining.

  With the above technique, it is possible to measure the blood pressure with an extremely simple configuration and with high accuracy using the data of the pulse waveform signal, and to determine the arousal state or the sleep state with high accuracy. .

Japanese Patent No. 5017501 Japanese Patent No. 6059699

  In the technique described in Patent Document 1, sleep evaluation is performed based on changes in pulse pressure during sleep. Specifically, from the graph of the pulse waveform, at the time of REM awakening, the maximum blood pressure value Pmax gradually rises compared to during apnea, then falls and repeats, and during apnea, It shows that the maximum blood pressure value Pmax rises earlier than REM awakening, then falls, and is repeated. However, a technique for accurately detecting a sleep disorder, in particular, sleep apnea / hypopnea syndrome, based on such a pulse wave waveform is not disclosed.

  Further, in the technique described in Patent Document 2, the human body is compared with the measured pressure based on the pressure change of the pulse wave between the radial artery portion of the human body and the blood vessel of the fingertip portion of the human body. Therefore, it is possible to determine the awake state or the sleep state with high accuracy.

  However, Patent Document 2 does not disclose a technique for accurately detecting sleep disorders, particularly sleep apnea / hypopnea syndrome.

  An object of this invention is to provide the technique which evaluates sleep evaluation accurately based on a pulse wave.

  According to one aspect of the present invention, a first apnea / hypopnea event extraction unit that extracts an apnea / hypopnea event based on a temporal change shape of the amplitude of a pulse wave, and the apnea / hypopnea event Out of the first apnea / hypopnea events extracted by the extraction unit, the first apnea / hypopnea event during the period in which the measured blood oxygen concentration is not decreased is excluded and the rest A second apnea / hypopnea event extraction unit that extracts the second apnea / hypopnea event, and determines that the second apnea / hypopnea event is a true apnea / hypopnea event. A sleep evaluation apparatus is provided.

  As the shape of the time variation of the amplitude of the pulse wave, a first period in which a gradual fluctuation of the amplitude (voltage) occurs, followed by a large drop in amplitude (voltage), and then a second that returns to the original amplitude (voltage). It is preferable to use a template composed of two periods, i.e., a period of the above-mentioned period, and to set the first apnea / hypopnea event period as a period in which the shape approximates the template from an actual pulse wave.

  The second apnea / hypopnea event period is compared with the third apnea / hypopnea event period measured in the electroencephalogram measurement. It is preferable to perform processing using the pulse wave shape in the second apnea / hypopnea event period that coincides with the template as the template.

  It is preferable to determine whether or not the patient has an apnea / hypopnea syndrome based on the second apnea / hypopnea event number in a certain period.

  It is preferable to modify the template so that the number of events is equal while comparing with the PSG evaluation result.

  As the pulse wave, a peripheral pulse wave and a radial pulse wave may be used.

  According to another aspect of the present invention, a first apnea / hypopnea event extracting step of extracting an apnea / hypopnea event based on a shape of time variation of the amplitude of the pulse wave, and the apnea / hypopnea Among the first apnea / hypopnea events extracted by the event extraction step, the first apnea / hypopnea events in the period in which the measured blood oxygen concentration is not decreased are excluded and remain. Extracting a second apnea / hypopnea event as a second apnea / hypopnea event, wherein the second apnea / hypopnea event is a true apnea / hypopnea event. A sleep evaluation method characterized by determining is provided.

  In addition, the present invention provides a first apnea / hypopnea event extraction procedure for extracting an apnea / hypopnea event based on the shape of time variation of the amplitude of the pulse wave, and the apnea / hypopnea event extraction procedure. Out of the extracted first apnea / hypopnea events, the first apnea / hypopnea event during the period when the measured blood oxygen concentration is not decreased is excluded and the rest is set to the second A second apnea / hypopnea event extraction procedure that extracts as an apnea / hypopnea event, and determining the second apnea / hypopnea event as a true apnea / hypopnea event A program for causing a computer to execute a characteristic sleep evaluation method.

  According to the present invention, sleep evaluation can be accurately evaluated based on pulse waves.

It is a system diagram showing an example of 1 composition of a sleep evaluation system which can apply sleep evaluation technology by a 1st embodiment of the present invention. It is a functional block diagram which shows the example of 1 structure of the sleep evaluation data analysis apparatus by this Embodiment. It is a functional block diagram which shows one structural example of the comparison extraction part which compares an apnea / hypopnea event and blood oxygen concentration, and extracts a true apnea / hypopnea event. It is a figure which shows one structural example of a memory | storage part. It is a flowchart figure which shows the flow of a data analysis process. It is a flowchart figure which shows an example of the process of step S4 demonstrated in 1st Embodiment. FIG. 6A is a diagram showing an example of a baseline (template) in the apnea / hypopnea period and the subsequent awakening period, and FIG. 6B is a pulse in the period corresponding to FIG. It is a figure which shows an example of the time change of the amplitude of a wave. It is a figure which shows an example of the time change of the amplitude (voltage) of a pulse wave, blood oxygen concentration (SpO2), snoring, and a body motion. It is the figure which contrasted and showed the 1st apnea / hypopnea event based on the pulse wave of a different patient, and the apnea / hypopnea event based on an electroencephalogram measurement (PSG).

  Hereinafter, a sleep evaluation technique according to an embodiment of the present invention will be described in detail with reference to the drawings.

(First embodiment)
FIG. 1 is a system diagram showing a configuration example of a sleep evaluation system to which the sleep evaluation technique according to the first embodiment of the present invention can be applied. FIG. 2A is a functional block diagram illustrating a configuration example of the sleep evaluation data analysis apparatus according to the present embodiment. FIG. 2B is a functional block diagram illustrating a configuration example of a comparison / extraction unit that extracts a true apnea / hypopnea event by comparing an apnea / hypopnea event with a blood oxygen concentration. FIG. 3 is a diagram illustrating a configuration example of the storage unit. FIG. 4 is a flowchart showing the flow of data analysis processing. FIG. 6A is a diagram showing an example of a baseline (template) in the apnea / hypopnea period and the subsequent awakening period, and FIG. 6B is a pulse in the period corresponding to FIG. It is a figure which shows an example of the time change of the amplitude of a wave. FIG. 7 is a diagram illustrating an example of temporal changes in amplitude (voltage) of pulse wave, blood oxygen concentration (SpO2), snoring, and body movement. FIG. 8 is a diagram showing a contrast between a first apnea / hypopnea event based on pulse waves of different patients and an apnea / hypopnea event based on electroencephalogram measurement (PSG).

(System and device configuration)
As shown in FIG. 1, the sleep evaluation system A to which the sleep evaluation technique according to the present embodiment can be applied is a sensor group provided in a subject H, and the sensor group is, for example, a reflective optical sensor or the like A rib pulse wave measuring sensor (1) 3, a peripheral pulse wave measuring sensor (2) 1, a blood oxygen saturation (SpO2) measuring unit 5, and a body position sensor 7 for detecting body movement. And a snoring sensor 11.

  The sleep data storage device 21 includes an interface unit 23 that receives sensor values from the sensor group, and a data storage unit (memory) 25 that stores the sensor values. Furthermore, it has a data analysis device 31 connected to the sleep data storage device 21 (AR1) and performing data processing to be described later. The data storage unit (memory) 25 and the data analysis device 31 may be a personal computer PC, and the program stored in the hard disk is preferably executed by the CPU.

  As shown in FIG. 2A, the data analysis device 31 includes a data acquisition unit 31-1 that acquires sensor values from the sensor group, a template (base line) Lb and a peripheral pulse wave measurement sensor (2) 1 described later. The Lb-La comparison unit 31-2 that compares the pulse wave La acquired by the above, and the first apnea / hypopnea event extraction that extracts the apnea / hypopnea event from the temporal change shape of the amplitude of the pulse wave Part (event Ia extraction part) 31-2 and second apnea / hypopnea event extraction that extracts only the region of low blood oxygen concentration due to SpO2 as the second apnea / hypopnea event in event Ia Part (Ia-SpO2 comparison and extraction part) 31-4.

  As shown in FIG. 2B, the second apnea / hypopnea event extraction unit (Ia-SpO2 comparison extraction unit) 31-4 includes the PSG data / event Ib comparison unit 31-4-1 and the event data separation unit 31. -4-2, a PSG match event data acquisition unit 31-4-3, a PSG match event data Ibx extraction unit 31-4-4, and an Ibx match Lb application unit 31-4-5.

  As shown in FIG. 3, the data storage unit (memory) 25 has an area for storing sensor data. For example, the optical sensor pulsation data storage unit 25-1, the snoring data storage unit 25-2, and body motion It has a data storage unit 25-3 and an SpO2 / pulsation number storage unit 25-4. Optionally, a PSG data storage unit may be included. These data are stored in synchronization with each other.

(Processing procedure)
As shown in FIG. 4, the data analysis process is started (Start), and in step S1, each data acquisition unit 31-1 stores each data of peripheral pulse wave, SpO2, snoring, and body motion in a data storage unit (memory) 25. Get from. In step S2, the Lb-La comparison unit 31-2 compares the apnea / hypopnea pulse wave pattern detection template (base line Lb) with the peripheral pulse wave La acquired in step S1.

  Next, in step S3, the event Ia extraction unit 31-3 matches both in step S2, that is, the apnea / hypopnea pulse wave pattern detection template (base line Lb) matches the peripheral pulse wave La. The hypopnea / apnea event Ia detected from the peripheral pulse wave is extracted.

  As shown in FIG. 6A, the inventor of the present application has the following characteristics in the shape of time variation of the pulse wave amplitude of a typical patient with sleep apnea / hypopnea syndrome. Pay attention.

  That is, when a time change of the amplitude of the pulse wave (corresponding to the output voltage of the optical sensor or the like) is taken, a first period (no / low breathing period) in which a gradual fluctuation of the amplitude (voltage) occurs and the first period It can be seen that it consists of two periods: a large drop in the amplitude (voltage) following the second period, and then a second period (wake-up period) in which the amplitude (voltage) almost returns to the original. Such a pulse wave waveform is used as a base line (template). Then, a period in which the shape of the template approximates the pulse wave of the subject as shown in FIG. 6B is defined as the first apnea / hypopnea event period. An event that occurs during the first apnea / hypopnea event period is defined as a first event Ia.

  For example, in order to extract the event Ia, the brain wave is searched for a shape as shown in FIG. In FIG. 6 (b), Ia is extracted at three locations. The horizontal axis is a period obtained by combining the no-hypopnea period and the awakening period. That is, the event portion in FIG. 6B is obtained by capturing a characteristic amplitude pattern “sleep to awakening” shown in FIG. 6A as an event.

  FIG. 6B shows the change of the pulse wave over time and the result of the electroencephalogram examination by PSG performed at the same time. It is known that in the PSG test, the apnea / hypopnea period and the subsequent arousal period can be accurately evaluated. On the other hand, it can be seen that the pulse wave can also extract the no-hypopnea period and the subsequent awakening period as the event Ia as substantially the same period.

  That is, FIG. 7 shows a state in which an actual pulse wave event is detected based on the event detection definition shown in FIGS.

  Returning to FIG. 4, as shown in step S4, from the first event Ia detected in step S3, an event of only a period T2 (FIG. 7) in which the SpO2 value is low is extracted and is extracted as a second event Ib. And Since SpO2 indicates how much oxygen the blood can actually carry, it means that the higher this is, the better the efficiency of carrying oxygen with blood. The period T2 in which the SpO2 value is low indicates a period during which oxygen is not efficiently carried by blood. The period T1 other than this period is a period during which an event unrelated to sleep apnea / hypopnea syndrome occurs. You can consider it. In addition, since the apparatus which can measure SpO2 and a pulse wave with the same pulse oximeter is marketed, it is convenient.

  According to the above procedure, as shown in FIG. 7, the event indicated by the downward arrow in the period T2 is handled as the second event (true event).

  By doing in this way, even by pulse wave evaluation, an event can be detected with the same accuracy as PSG evaluation.

[Example 1]
(Demonstration example)
FIG. 8 is a diagram illustrating an example in which an event is detected by performing an evaluation on four different patients A to D in the same manner as the above evaluation technique. The evaluation based on the pulse wave and the evaluation based on the PSG are shown together. The event Ia shown in FIG. 8 is a first event that does not consider the SpO2 value.
The results shown in FIG. 8 are shown in Table 1.

  Table 1 shows the total number of low / apnea first events Ia detected from peripheral pulse wave evaluations for patients A to D and the events based on PSG evaluation (apnea / hypopnea period and It is the table | surface which showed the total number of events) including the subsequent awakening period for every patient.

  As shown in Table 1, it can be seen that the number of first events by pulse wave analysis evaluation is larger than the number of events obtained by PSG evaluation. However, PSG evaluation is considered more accurate.

  Therefore, it is necessary to obtain the second event obtained by considering the SpO2 value.

  Table 2 is a table in Table 1 that takes the SpO2 value as the second event in the pulse wave event.

  As shown in Table 2, when the second event number in consideration of the SpO2 value in the pulse wave event is compared with the event number based on the PSG evaluation, it can be seen that they are almost the same.

In addition, the following knowledge was acquired by comparing Table 1 and Table 2.
(1) Even subjects who lacked only SpO2 events tend to agree with the PSG results.
(2) The number of events may be excessive for a subject who is sufficient only for the SpO2 event.

  Therefore, it is necessary to determine whether or not the patient has apnea / hypopnea syndrome in consideration of the findings (1) and (2).

  Eventually, when an abnormality is observed in the above-described inspection, which is a primary inspection, it is necessary to perform PSG evaluation as a secondary inspection.

  As described above, according to the present embodiment, sleep evaluation can be accurately evaluated based on pulse waves. In particular, it is useful as a primary test before evaluation by an electroencephalogram.

(Second Embodiment)
Next, a second embodiment of the present invention will be described. FIG. 5 is a flowchart showing an example of the process of step S4 described in the first embodiment, and is a flowchart showing the flow of the baseline feedback process. When the process of step S4 is started, PSG data and the second event Ib are compared in step S4-1. In step S4-2, the second event data Ibx that matches the PSG data in step S4-1 and the second event data Iby that does not match the PSG data are separated.

  In step S4-3, the template (baseline) data is corrected so that a large amount of the second event data Ibx that matches in step S4-2 can be obtained.

  Next, in step S4-4, it is determined whether Ibx ≦ Ns. Here, Ns is a threshold value of a predetermined number of events, and for example, the number of events obtained from PSG evaluation can be applied.

  If the determination result in step S4-4 is Yes, it is determined in step S4-5 that the corrected baseline data has good detection accuracy for sleep apnea / hypopnea syndrome, and the data storage unit (memory) 25 Etc., the base line data is stored, and the process is terminated (End).

  When the determination result in step S4-4 is No, it is determined that the corrected baseline data has poor detection accuracy of sleep apnea / hypopnea syndrome, and the process returns to step S4-1 to correct the baseline data. Based on the above, the same processing is repeated.

  Through the above processing, in the present embodiment, the baseline data is corrected so that the number of events is equal while being compared with the PSG evaluation result. The detection accuracy can be improved.

  The above processing and control can be performed by software processing using a CPU (Central Processing Unit) or GPU (Graphics Processing Unit), ASIC (Application Specific Integrated Circuit), or FPGA (Field Programmable Gate) hardware.

  Further, in the above-described embodiment, the illustrated configuration and the like are not limited to these, and can be appropriately changed within a range in which the effect of the present invention is exhibited. In addition, various modifications can be made without departing from the scope of the object of the present invention.

  Each component of the present invention can be arbitrarily selected, and an invention having a selected configuration is also included in the present invention.

  In addition, a program for realizing the functions described in the present embodiment is recorded on a computer-readable recording medium, and the program recorded on the recording medium is read into a computer system and executed to execute processing of each unit. May be performed. The “computer system” here includes an OS and hardware such as peripheral devices.

  Further, the “computer system” includes a homepage providing environment (or display environment) if a WWW system is used.

  The present invention can be used for a sleep evaluation apparatus.

A ... Sleep evaluation system 1 ... Peripheral pulse wave measurement sensor (2)
3 ... Pulse wave measurement sensor for ribs (1)
5 ... Blood oxygen saturation (SpO2) measurement unit 7 ... Body position sensor 11 ... Snoring sensor 25 ... Data storage unit (memory)
31 ... Data analysis device 31-1 ... Each data acquisition unit 31-2 ... Lb-La comparison unit 31-3 ... First apnea / hypopnea event extraction unit (event Ia extraction unit)
31-4 ... Second apnea / hypopnea event extraction unit (Ia-SpO2 comparison extraction unit)

Claims (8)

A first apnea / hypopnea event extraction unit that extracts an apnea / hypopnea event based on a shape of time variation of the amplitude of the pulse wave;
Among the first apnea / hypopnea events extracted by the apnea / hypopnea event extraction unit, the first apnea / hypopnea during a period in which the measured blood oxygen concentration has not decreased. A second apnea / hypopnea event extractor that excludes the event and extracts the rest as a second apnea / hypopnea event;
The sleep evaluation apparatus characterized in that the second apnea / hypopnea event is determined as a true apnea / hypopnea event. As the shape of the time variation of the amplitude of the pulse wave,
Using a template consisting of two periods, a first period in which a gradual fluctuation of the amplitude occurs, followed by a large drop in amplitude and then a second period in which the amplitude returns to the original amplitude, The sleep evaluation apparatus according to claim 1, wherein a period in which the shape approximates the template is set as the first apnea / hypopnea event period. Comparing the second apnea / hypopnea event period with a third apnea / hypopnea event period measured in the electroencephalogram measurement;
The processing using the shape of a pulse wave in the second apnea / hypopnea event period substantially coincident with the third apnea / hypopnea event period as the template is performed. Sleep evaluation device.   4. The sleep evaluation apparatus according to claim 2, wherein it is determined whether or not an apnea / hypopnea syndrome is based on the second apnea / hypopnea event number in a certain period.   The sleep evaluation apparatus according to any one of claims 2 to 4, wherein the template is modified so that the number of events is equal while being compared with a PSG evaluation result.   The sleep evaluation apparatus according to any one of claims 2 to 5, wherein a peripheral pulse wave and a radial pulse wave are used as the pulse wave. A first apnea / hypopnea event extraction step for extracting an apnea / hypopnea event based on a time-varying shape of the amplitude of the pulse wave;
Among the first apnea / hypopnea events extracted by the apnea / hypopnea event extracting step, the first apnea / hypopnea in a period in which the measured blood oxygen concentration is not decreased. A second apnea / hypopnea event extraction step that excludes the event and extracts the rest as a second apnea / hypopnea event;
The sleep evaluation method, wherein the second apnea / hypopnea event is determined as a true apnea / hypopnea event. A first apnea / hypopnea event extraction procedure for extracting an apnea / hypopnea event based on a time-varying shape of the amplitude of the pulse wave;
Among the first apnea / hypopnea events extracted by the apnea / hypopnea event extraction procedure, the first apnea / hypopnea in a period in which the measured blood oxygen concentration has not decreased. A second apnea / hypopnea event extraction procedure that excludes the event and extracts the rest as a second apnea / hypopnea event;
A program for causing a computer to execute a sleep evaluation method, wherein the second apnea / hypopnea event is determined as a true apnea / hypopnea event.