JP5969283B2 - Biological signal analyzer and control method thereof - Google Patents

Description

  The present invention relates to a biological signal analyzer and a control method thereof, and more particularly, to a biological signal analyzer and a control method thereof for analyzing a biological signal related to sleep apnea syndrome (SAS).

  Sleep Apnea (Hypopnea) Syndrome (SAS or SAHS) is associated with excessive daytime somnolence due to sleep disruption, and 5 apneas / hour or more It is a disease that occurs 30 times / 7 hours or more. Hereinafter, for convenience, SAS and SAHS are simply referred to as SAS.

  SAS can be broadly classified into obstructive sleep apnea syndrome (OSAS), central sleep apnea syndrome (CSAS), and mixed sleep apnea syndrome (MSAS). ing. In addition, since MSAS shifts from CSAS to OSAS, it may be regarded as OSAS.

  Among these, OSAS is considered to occur when the sleep muscles deepen, the airway muscles relax, and the tongue sinks under its own weight to block the airways. In an obstructed state, it falls into an oxygen deficient state, so that sleep becomes shallow (sleep deprivation), and the muscles of the airways become tense and the obstruction and oxygen deficiency are alleviated or eliminated. Then, sleep deepens and falls into an obstructed state again. Since this cycle is repeated many times during sleep, even if he intended to have enough sleep, he did not actually get enough sleep, and as a result, he was attacked by intense sleepiness during non-sleep, It will cause trouble.

  Diagnosis of sleep apnea hypopnea syndrome includes measurements of oronasal breathing, snoring, arterial oxygen saturation (SpO2), respiratory effort, brain waves, eye movements, gluteal electromyogram, electrocardiogram, and body position overnight. An overnight polysomnography (PSG) test is required. However, the overnight polysomnography examination usually requires staying in a hospital and wearing a large number of sensors, so the burden on the patient is relatively large. Therefore, a simpler screening test (also called a simple SAS test, a simple polygraph test, etc.) is often performed before the overnight polysomnographic test. For example, Patent Document 1 discloses a sleep apnea test apparatus used for screening tests such as the presence / absence of apnea and hypopnea, the number of times, SpO2 value, snoring, and respiratory effort exercise.

JP 2006-320732 A

  For patients diagnosed with OSAS, nCPAP (nasal continuous positive airway pressure) therapy is effective for suppressing airway obstruction during sleep and alleviating symptoms. In nCPAP therapy, a CPAP device (hereinafter simply referred to as CPAP) is used to suppress obstruction of the airway by continuously sending positive pressure air into a mask that is mainly worn to cover the nose.

  CPAP is a fixed pressure type that sends air at a constant pressure, an automatic pressure adjustment type that automatically adjusts the air pressure from the pressure in the mask (also called auto CPAP or APAP), and different air supply pressures can be set for expiration and inspiration There are types such as bi-level type (also called bi-level PAP or BiPAP).

  In recent years, a device (also referred to as an ASV device or adaptive servo ventilator, hereinafter simply referred to as ASV) that performs adaptive auxiliary ventilation ASV (adaptive servo ventilation) that synchronizes the supply air pressure in response to changes in the respiratory state and airflow is also used. It is getting to be.

  CPAP and ASV are devices that supply positive pressure air to prevent airway obstruction, but the proper air pressure to be supplied depends on the individual patient. In addition, if the pressure is insufficient, the airway is blocked and a therapeutic effect cannot be obtained sufficiently. If the pressure is too high, the patient is stressed and disturbs sleep. Therefore, it is necessary to set the minimum pressure at which the sleep state of the patient is good and the sleep breathing disorder is eliminated as an appropriate pressure (prescription pressure), and the determination of the appropriate pressure is called titration.

  Tightlation is the maximum pressure to prevent an unnecessary increase in supply pressure, not only for CPAP of fixed pressure type, but also for devices that automatically adjust the supply air pressure, such as auto CPAP and ASV. It is necessary to set a time (also called a transition time, a ramp time, etc.) for holding the pressure so as not to prevent falling asleep after the start of operation.

  A typical titration in fixed pressure CPAP is a polysomnogram-PSG test performed overnight with the patient wearing CPAP, and manually changing the air pressure while apnea and hypopnea. The number of occurrences is measured and an appropriate supply pressure is searched. However, as described above, the PSG test is relatively burdensome for the patient, and the titration requires adjustment of the air pressure by the engineer and observation all night, which is also a heavy burden on the engineer. Even in the case of auto CPAP or ASV, it is not known if the apparatus is actually controlling the supply air pressure based on the correct pressure measurement result without actually confirming the situation. Therefore, even if the adjustment of the supply air pressure itself is performed by the apparatus, hospitalization and overnight observation by a technician are necessary for accurate titration.

  The present invention has been made in view of such problems of the prior art, and a main object thereof is to provide a biological signal analysis apparatus and a control method thereof that can reduce the burden associated with titration.

  The above-mentioned purpose is at least information on the temporal change of pressure in the mask from the measurement result of the polygraphy examination measured in a state in which a respiratory support device that supplies a positive pressure gas is worn in the mask worn by the patient, An acquisition means for acquiring information related to the occurrence time of a respiratory disorder event, and the pressure in the mask is divided into a plurality of sections having a predetermined width, and the time within which the pressure in the mask is included in each section is divided into a plurality of sections. A means for creating a graph indicating the distribution of the sleep breathing disorder index for each section of pressure in the mask and calculating the index of sleep breathing disorder from the number of respiratory disorder events that occurred in And an output means for outputting a report.

  With such a configuration, according to the biological signal analyzer of the present invention, it is possible to reduce the burden on titration.

It is a figure which shows the structural example of the biosignal measuring apparatus as an example of the biosignal analysis apparatus which concerns on embodiment of this invention. It is a flowchart for demonstrating the example of the output operation | movement of the titration assistance report in the biosignal measuring device which concerns on embodiment of this invention. It is a figure which shows the example of the titration assistance report which the biosignal measuring apparatus which concerns on embodiment of this invention can output.

Hereinafter, the present invention will be described in detail based on preferred embodiments with reference to the drawings.
FIG. 1 is a block diagram showing a configuration example of a biological signal measuring device 100 as an example of a biological signal analyzing device according to an embodiment of the present invention and a respiratory support device 200 such as CPAP and ASV used together with the biological signal measuring device 100. It is. Note that the biological signal analyzer of this embodiment is a so-called simple polygraph inspection apparatus, which is configured to acquire a biological signal to be analyzed, specifically, a respiratory-related signal from a patient, and supplied by a respiratory support device. It has a configuration for measuring atmospheric pressure (mask pressure). However, in the present invention, a configuration for acquiring a breathing-related signal from a patient and a configuration for measuring the supply air pressure by the respiratory support device are not essential. The biological signal analyzing apparatus according to the present invention is configured to receive a respiration-related signal measured in advance or a supply air pressure (mask pressure) by a respiration support device from, for example, a storage device or a storage medium directly connected or connected via a network. What is necessary is just to be able to acquire by arbitrary methods, such as acquiring.

(Constitution)
In the biological signal measuring apparatus 100 according to the present embodiment, the SpO2 sensor 101 is a reflective sensor that measures arterial oxygen saturation (SpO2) with, for example, a fingertip of a patient. The cannula 102 has an opening in the vicinity of the nostril of the patient, and the pressure sensor 106 connected to the cannula 102 detects the patient's nasal respiratory waveform and snoring sound, and the pressure (mask pressure) in the mask 211 of the respiratory assistance device 200. Used for. The chest / abdomen sensor 103 is a sensor for detecting a patient's breathing effort.

  The electrocardiogram electrode 104 is an electrode for acquiring an electrocardiogram mainly for detecting a heart rate, for example, an electrode for detecting a monopolar or bipolar two-channel electrocardiogram. The acceleration sensor 105 is a sensor for measuring the body position (for example, right-side-down position, left-side-down position, supine position, prone position, and standing position).

  The memory 107 is used by the control unit 110 for work. Note that a non-volatile area in which the setting value of the device is stored may be provided. The display unit 108 includes, for example, a liquid crystal display (LCD), and is used to display the operation status of the apparatus, measurement waveform, user information, GUI, and the like.

  The control unit 110 controls the operation of the biological signal measuring apparatus 100. The control unit 110 includes, for example, a CPU, a nonvolatile memory that stores a control program executed by the CPU, and a RAM that is used by the CPU to execute a program read from the nonvolatile memory. The nonvolatile memory and the RAM may be the memory 107.

  The input unit 109 is used by the user to input various instructions and settings. The input unit 109 can include any input device that allows the user to input instructions and settings. The input device may be a device that accepts non-mechanical input such as voice recognition as well as a device that performs mechanical input such as a switch, a button, a dial, and a touch panel. An input from the input unit 109 is given to the control unit 110, and the control unit 110 realizes an operation according to the input.

  Note that sound generation means such as a speaker may be provided to notify the user of the operation state of the apparatus, the occurrence of an error, an operation procedure, and the like by voice or the like.

  The recording unit 111 records the measured data on a recording medium and reads the measured data recorded on the recording medium. The configuration of the recording unit varies depending on the recording medium to be used, and the recording medium to be used is not particularly limited, but a semiconductor memory card can be preferably used from the viewpoint of miniaturization and low power consumption.

  The output unit 112 is an interface for communicating with an external device. There are no particular restrictions on the types of external devices that can be connected and the communication protocol, and the communication medium may be either wired or wireless.

  The breathing support apparatus 200 is an apparatus that suppresses the occurrence of apnea and hypopnea by supplying positive pressure air to a patient's airway, such as CPAP (fixed pressure type, APAP, BiPAP) and ASV. In the breathing support apparatus 200, a main body 210 and a mask 211 are connected by a hose 212, and air of a predetermined pressure is supplied into the mask 211 through the hose 212 by a blower included in the main body 210. In the case of APAP or ASV, the pressure in the mask 211 is measured by the pressure sensor 213, and the main body 210 controls the air blower by controlling the blower according to the breathing state or the airway obstruction state. In the case of the fixed pressure type CPAP, the main body 210 continuously operates the blower with the set supply pressure.

  In addition, since the breathing assistance apparatus 200 is not directly related to the present invention and is publicly known, the detailed description thereof will be omitted. Here, it is assumed that an apparatus such as APAP, BiPAP, or ASV that automatically adjusts the supply air pressure according to the output of the pressure sensor 213 is used. In addition, when using fixed-pressure type CPAP, it sets beforehand so that supply air pressure may be changed sequentially for every predetermined time. When measurement is performed when the breathing assistance apparatus 200 is not operated (supply pressure 0), it is desirable to perform measurement with the mask removed in order to prevent re-intake of carbon dioxide.

(Measurement and recording operation)
When various sensors 101 to 105 are attached to a predetermined part of a patient and a measurement start instruction is input from the input unit 109, the biological signal measuring apparatus 100 starts measuring and recording the biological signal. The control unit 110 applies predetermined processing such as A / D conversion and filter processing to the input signals from the various sensors 101 and 103 to 106 and sequentially writes them in the memory 107 in association with the measurement time. go.

  A pressure sensor 106 connected to the cannula 102 converts the airflow from the nasal or oral nasal cannula into an electrical signal. The control unit 110 applies amplification processing and filter processing to this electrical signal, and shows a signal indicating a change in mask pressure by a frequency component, a signal indicating a respiratory waveform, and an airway sound (snoring) for the signal obtained from the pressure sensor 106. Separate into signals. If the cannula is a nasal cannula, a nasal respiratory waveform is obtained. If the cannula is an nasal cannula having an opening near the mouth, an oral nasal respiratory waveform is obtained.

  For example, an electric signal obtained from the pressure sensor 106 is applied with a low-pass filter having a cutoff frequency of about 500 Hz as a basic signal, and a low-pass filter with a cutoff frequency of 2 to 3 Hz is applied to the basic signal. A signal obtained by applying a signal obtained by applying a high-pass filter having a cutoff frequency of 0.01 to 0.1 Hz and a low-pass filter having a cutoff frequency of 2 to 3 Hz with respect to the basic signal as a mask pressure signal, A signal obtained by applying a high-pass filter having a cutoff frequency of 0.01 to 0.1 Hz and a low-pass filter having a cutoff frequency of 150 to 200 Hz to the basic signal can be separated as an airway sound signal.

In addition, signals related to changes in mask pressure (mask pressure signal), signals indicating respiratory waveform (breathing signal), and signals indicating airway sound (snoring) (airway sound signal), respiratory-related signals, respectively, from voltage to pressure [cmH2O ] And recorded. In addition, although a respiration signal and an airway sound signal are continuously recorded, a mask pressure signal is converted into a predetermined time unit (for example, second unit) and recorded.
The respiratory effort waveform is obtained from the chest / abdomen sensor. In this embodiment, the suprasternal fossa waveform is not measured, but the suprasternal fovea waveform may be acquired.

  The control unit 110 sequentially writes various signals and measurement values into the memory, and performs measurement data analysis processing. In the analysis process, the presence or absence of apnea or hypopnea interval, duration and frequency, body position and changes, presence or absence of decrease of SpO2 by more than a predetermined percentage (2 to 4%), duration and frequency, pulse rate (maximum, minimum) , Average) and so on. For example, apnea is a state where breathing has stopped for 10 seconds or more, and hypopnea is a significant decrease in ventilation (a decrease of 30% or more from the amplitude of normal breathing is 10 seconds or more), and SpO2 is 3 to 4%. It can be detected as a lowered state.

Here, the normal breath is a breath waveform at the normal time of the patient, and the control unit 110 extracts, for example, a breath satisfying the following condition as a normal breath from the breath signal.
・ It must be a waveform that is estimated to be respiration.

Note that the waveform estimated as breathing is a pair of peaks (waves that are convex upward) and valleys (waves that are convex downward) (peaks and peaks are alternately present), and an amplitude (mountain that exceeds a predetermined value) And a peak-to-valley peak distance). This predetermined value is set to a predetermined ratio (for example, a value selected from a range of 20 to 30%) of the absolute value average of the respiratory waveform amplitude within the immediately preceding predetermined time (for example, several minutes), and is sequentially updated. However, a predetermined fixed value is used for the first predetermined time.
In order to improve detection accuracy, conditions such as the time width (peak time difference) between a pair of peaks and valleys and the time width of adjacent peaks may be further applied.

In addition, the minimum reference amplitude is also sequentially updated based on the average value of normal breath amplitudes within a predetermined time immediately before (for example, several minutes). However, a predetermined fixed value is used for the first predetermined time.
In order to improve the detection accuracy, the amplitude to be averaged may be changed according to the number of normal breaths detected within the predetermined time immediately before. For example, if the number of normal breaths is large (if it is greater than or equal to a predetermined number), the average value from the second largest amplitude to the n (n ≧ 3) largest amplitude is used, and the number of normal breaths is less than the predetermined number. For example, the average value of all amplitudes can be obtained. The reason why the maximum amplitude is excluded in the former is because the possibility that an extremely large amplitude is included due to the influence of noise or the like is taken into consideration.

  The control unit 110 supplies various waveforms and measurement values written in the memory to the recording unit 111 and sequentially records them in a predetermined file format on the recording medium. Information obtained by the analysis is also recorded by the recording unit 111.

(Generation of titration support report)
Next, the titration support report generation operation in the biological signal analysis apparatus 100 of the present embodiment will be described using the flowchart shown in FIG.

  In S <b> 101, the control unit 110 reads from the recording unit 111 at least measurement data related to the mask pressure and the sleep disordered breathing event for the patient specified through the input unit 109 among the measured data recorded in the recording unit 111. Here, examples of sleep disordered breathing events include the following: apnea events, hypopnea events, and oxygen desaturation events. In addition, measured data shall be measured during sleep.

  The acquisition of data does not exclude acquisition of data other than measurement data related to mask pressure and sleep disordered breathing events. Other data that may be useful for titration, such as arrhythmia event data and body position data, may also be obtained. For example, body position data can be used to determine whether a patient is sleeping. .

In many cases, an electroencephalogram is used to determine whether or not a patient is sleeping. However, when the electroencephalogram is not measured as in the present embodiment, strictly, measurement data regarding a mask pressure and a sleep disordered breathing event is “sleeping”. I do not know if it was measured. However, it is possible to estimate whether the patient is sleeping based on the posture measured by the acceleration sensor 105 and its change (that is, body movement). For example, it can be estimated that there is a high possibility that the patient is not sleeping in a section in which the body position is standing or sitting, or a section in which the body position varies greatly. Therefore, by excluding the data of the section in which the possibility that the patient is not sleeping among the measured data, the data of the remaining section can be handled as measured during sleep. Processing of such data may be performed in advance by an engineer, or a condition regarding the posture and its variation is determined in advance, and the control unit 110 is configured to exclude data in a section that meets the condition. Also good.
Note that the method for determining whether or not the patient is sleeping is not directly related to the present invention, and any method can be used.

In S <b> 103, the control unit 110 creates a histogram indicating the distribution of sleep respiratory disorder determination index values for each section of a predetermined width of the mask pressure.
As described above, in the present embodiment, mask pressure data is recorded in seconds. First, the controller 110 divides the mask pressure into a plurality of sections having a predetermined width (for example, a width of 1 cmH 2 O). And the frequency | count of the sleep respiratory disorder event which generate | occur | produced within the time when mask pressure is contained in each area is counted for every event.

  For example, the control unit 110 sets the measurement time to a mask pressure interval, such as a time (period) in which the mask pressure is 0 (no air supply), a time in excess of 0 and less than 1 cmH 2 O, and a time in the range of 1 to 2 cmH 2 O. Sort by And the control part 110 counts the frequency | count of the sleep respiratory disorder event which generate | occur | produced in the classified area. Then, a sleep respiratory disorder determination index is calculated from the length of time in each section and the number of occurrences of the event, and a histogram is created.

In the present embodiment, the sleep breathing disorder determination index is as follows.
Apnea index AI: total number of apneas during sleep / sleep time (hr)
Hypopnea index (HI): total number of hypopneas during sleep / sleep time (hr)
Apnea hypopnea index (AHI): total number of apnea and hypopnea during sleep / sleep time (hr)
Oxygen desaturation index or oxygen dip index (ODI): Total decrease in SpO2 by more than a given percentage / sleep time (hr)
Usually, the predetermined percentage of ODI is either 2, 3, or 4. When the predetermined percentage is 3%, it is expressed as 3% ODI, ODI (3%), ODI (3), or the like.

  For example, if the total time of the section where the mask pressure is greater than or equal to 1 and less than 2 cmH2O is 3 hours, and an apnea event has occurred 15 times in the meantime, the controller 110 may be the section where the mask pressure is greater than or equal to 1 and less than 2 cmH2O AI is calculated as 15 times / 3 hours = 5.0 (times / hr). Similarly, the control unit 110 calculates other indices for each mask pressure section.

  For AHI, AI and HI are counted separately, and a histogram is generated so that the ratio of AI and HI in AHI can be identified.

  In S105, the control unit 110 generates a report in which the created histogram is laid out according to a predetermined output format. The output format is determined in advance according to the report output method (display, print, report data transmission, etc.).

  In S107, the control unit 110 outputs a report to the output unit 112 and / or the display unit 108 according to a preset output method.

  FIG. 3 is a diagram illustrating an example of a titration support report (referred to as a CPAP report for convenience) output from the biological signal measurement apparatus according to the present embodiment. In FIG. 3, only characteristic information is described in the present embodiment, but information that is generally included in a report, for example, information specifying a patient, information such as measurement date and time, and the like may be included. Needless to say, it is good.

  The CPAP report shown in FIG. 3 is a histogram as an example of a graph showing the relationship between the mask pressure information area 310 for showing the statistical information of the mask pressure and the distribution of the mask pressure and the value of the judgment index of sleep disordered breathing. And sleep and breathing disorder index histogram regions 320 and 330, and an event that seems to be useful for titration in addition to sleep and breathing disorder events, or an auxiliary information region 340 that shows the relationship between predetermined information and mask pressure. doing.

  The mask pressure information area 310 includes an area 311 indicating the maximum value, minimum value, and average value of the mask pressure, and an area 312 indicating the distribution ratio of the mask pressure as a pie chart. The distribution ratio in the region 312 is a ratio for each predetermined mask pressure range, but may be different from a mask pressure division unit in a histogram described later.

  In the present embodiment, the sleep breathing disorder index histogram areas 320 and 330 are an AHI (AI, HI) index histogram area 320 and an ODI histogram area 330. Other sleep respiratory disorder index histogram regions may be included, or the ODI histogram region 330 may not be present.

  Since the SAS determination is generally made based on AHI, the AHI histogram area 320 is essential. In the AHI histogram area 320, an AHI histogram 322 in which the AI 324 and the HI 323 are identifiable for each section of a predetermined width of the mask pressure is shown. Specifically, AHI is shown with AI 324 and HI 323 aligned vertically. By using such a format, it is possible to grasp the ratio of AI 324 and HI 323 in AHI and how each of AI 324 and HI 323 changes according to the mask pressure.

  Above the AHI histogram 322, there is provided an area 321 in which AHI, AI, and HI are enumerated numerically. Since the AHI histogram 322 is intended to present the relationship between the mask pressure and the value more easily than the actual value of each event, the individual value is not described. Therefore, an actual value is shown in the numerical value area 321. Therefore, the actual value in each section of the mask pressure can be known by referring to the numerical value area 321.

  In the ODI histogram area 330, ODI is presented using a histogram 332 and a numerical value area 331 as in the case of AHI. By including the ODI histogram region 330 in addition to the AHI histogram region 320, it is possible to perform titration based on a plurality of pieces of information, and to improve the reliability of the titration.

  In addition, although the example which used the histogram as an example of the graph which shows the relationship between mask pressure and the distribution of the value of the judgment index of sleep breathing disorder was shown, the relationship between the mask pressure and the distribution of the value of the judgment index of sleep breathing disorder Any form of graph can be formed that can represent

  In the present embodiment, the arrhythmia event is presented in the auxiliary information area 340 in the same manner as the sleep respiratory disorder event. Though the opinion about the correlation between arrhythmia and AHI and ODI has not yet been established, there are reports that arrhythmia decreases due to the use of CPAP, and reports that arrhythmia increases when the pressure of CPAP is too high. May be helpful.

  In addition to the information shown in the example of FIG. 3, snoring detection frequency for each mask pressure section, body position classification for each mask pressure section (in this case, not frequency, time for each body position), A graph or the like showing a ratio of SpO2 of 90% or more for each mask pressure section can be shown in the auxiliary information area 340.

  A report such as that shown in FIG. 3 can provide information useful in determining the proper air pressure for an individual patient. For example, AHI does not occur when the supply pressure of CPAP is 7 cmH2O or more. Also, ODI does not occur when the supply air pressure is 7 cmH2O or more. Therefore, for example, the next measurement can be performed with a supply pressure of 7 cmH2O as a reference, or the maximum supply pressure can be set to about 9 cmH2O to perform a more accurate evaluation. By repeatedly performing such evaluation, it is possible to assist the engineer in determining the final appropriate pressure from the evaluation result, and it is possible to reduce the labor involved in the titration.

  As described above, according to the present embodiment, it is possible to reduce the labor involved in the titration of the respiratory support device by outputting a report indicating the relationship between the distribution of the mask pressure and the value of the sleep breathing disorder determination index. It becomes possible.

  In addition, since the mask pressure can be measured with a simple polygraphy device, etc., when a respiratory support device is used for a patient who has undergone a simple polygraphy examination, the mask pressure is within a narrow range based on the supply pressure that is considered to be appropriate. It is considered that the burden on both the patient and the engineer can be reduced because the titration can be performed by changing the air supply pressure.

(Modification)
In addition to generating a report as shown in FIG. 3, the optimal supply pressure (mask pressure) for titration is estimated from the relationship between the number of occurrences of sleep disordered breathing events and the supply pressure (mask pressure). Also good.

In particular,
・ Minimum mask pressure at which the frequency or frequency of occurrence of sleep disordered breathing events is below a predetermined value, or ・ Minimum mask pressure at which the frequency or frequency of occurrence of sleep disordered breathing events is constant below a predetermined value ,
Can be estimated as the optimum supply air pressure (mask pressure) for titration.

  Here, the predetermined value is a value that is considered to have an extremely low occurrence frequency and frequency of sleep disordered breathing events, or a value that is considered to be sufficiently small with respect to the measured maximum frequency and frequency. For example, the event occurrence frequency can be set to a value such as 10 times / hr or less or 5 times / hr or less, or to a value such as 1/3 or less and 1/4 or less of the maximum frequency. However, these are merely examples, and can be set as appropriate according to the type of event.

  Further, “being constant” means a state in which the occurrence frequency and frequency of sleep disordered breathing events do not vary even when the air pressure (mask pressure) is changed. For example, sleep disordered breathing in a range of 2 cmH 2 O or higher or 3 cm H 2 O or higher. When there is no change in the frequency and number of occurrences of events, it can be regarded as “constant”.

  For example, when the relationship between the number of occurrences of sleep disordered breathing events and the supply air pressure (mask pressure) is as shown in FIG. 3, the oxygen saturation lowering index ODI has an occurrence frequency of 3 cmH2O or more and less than 7 cmH2O. It becomes constant at times / hr. In such a case, the minimum 3 cmH 2 O can be estimated as the optimum supply air pressure (mask pressure) for the titration.

  Further, it may be estimated that the air supply pressure (mask pressure) is optimal for titration for a plurality of types of sleep respiratory disorder events, and the maximum value is estimated as the final optimum value.

The estimation process described here can be executed by the control unit 110 based on the histogram generated in S103 and the number of sleep disordered breathing events counted at the time of histogram generation. Further, the estimated optimum supply air pressure (mask pressure) can be included in the CPAP report of FIG. At this time, the estimated optimum supply air pressure (mask pressure) may be expressed on the histogram.
Thus, according to this modification, it becomes possible to further reduce the labor involved in the titration of the respiratory assistance device.

  The biological signal analyzing apparatus according to the present invention is realized as a program (application software) that causes a general-purpose information processing apparatus such as a personal computer to execute the display operation of FIGS. 2 and 4. You can also. Therefore, such a program and a storage medium storing the program (an optical recording medium such as a CD-ROM or DVD-ROM, a magnetic recording medium such as a magnetic disk, a semiconductor memory card, etc.) also constitute the present invention. .

Claims (8)

From the measurement result of the polygraphy examination measured with the breathing support device that supplies the positive pressure gas in the mask worn by the patient, at least information on the temporal change of the pressure in the mask and the respiratory disorder event An acquisition means for acquiring information about the occurrence time;
The pressure in the mask is divided into a plurality of sections having a predetermined width, and for each of the plurality of sections, the time during which the pressure in the mask is included in the section and the number of occurrences of the disordered breathing event that occurred within the time Creating means for calculating an index of sleep breathing disorder from the above, and creating a graph showing the distribution of the sleep breathing disorder index for each section of pressure in the mask;
Output means for outputting a report in which the graph is arranged;
A biological signal analyzing apparatus comprising: 2. The biological signal analyzer according to claim 1, wherein the graph is a histogram showing a distribution of the sleep breathing disorder index for each section of a predetermined width of the pressure in the mask. The biological signal according to claim 1 or 2, wherein the sleep disorder disorder index includes at least an apnea hypopnea index AHI among an apnea hypopnea index AHI and an oxygen saturation lowering index ODI. Analysis device. The sleep disordered breathing index includes an apnea index AI and a hypopnea index HI, and the graph shows the apnea hypopnea index AHI so that the ratio of the apnea index AI and the hypopnea index HI can be identified. The biological signal analyzer according to claim 3, wherein the biological signal analyzer is provided. From the measurement result of the polygraphy examination measured with the breathing support device that supplies the positive pressure gas in the mask worn by the patient, at least information on the temporal change of the pressure in the mask and the respiratory disorder event An acquisition means for acquiring information about the occurrence time;
The pressure in the mask is divided into a plurality of sections having a predetermined width, and for each of the plurality of sections, the time during which the pressure in the mask is included in the section and the number of occurrences of the disordered breathing event that occurred within the time And estimating means for estimating a mask pressure suitable for titration,
The estimation means has a minimum mask pressure at which the occurrence frequency or frequency of the respiratory disorder event is equal to or less than a predetermined value, or a minimum mask pressure at which the occurrence frequency or frequency of the respiratory disorder event is constant at a predetermined value or less. A biological signal analyzer that estimates the mask pressure suitable for the titration. A control method for a biological signal analyzer,
The acquisition means of the biological signal analyzer is configured to obtain at least the pressure in the mask from a measurement result of a polygraphy test measured in a state in which a breathing support device that supplies a positive pressure gas is mounted in a mask worn by a patient. An acquisition step of acquiring information about a change with time and information about an occurrence time of a respiratory disorder event;
The creation means of the biological signal analyzer divides the pressure in the mask into a plurality of sections having a predetermined width, and for each of the plurality of sections, the time within which the pressure in the mask is included in the section A step of calculating a sleep disordered breathing index from the number of occurrences of the disordered breathing event occurring in a step, and creating a graph showing the distribution of the sleep disordered breathing index for each section of pressure in the mask;
Output means of the biological signal analysis apparatus, an output step of outputting a report in which the chart is located,
A control method for a biological signal analyzer, comprising: A control method for a biological signal analyzer,
The acquisition means of the biological signal analyzer is configured to obtain at least the pressure in the mask from a measurement result of a polygraphy test measured in a state in which a breathing support device that supplies a positive pressure gas is mounted in a mask worn by a patient. An acquisition step of acquiring information about a change with time and information about an occurrence time of a respiratory disorder event;
The estimation means of the biological signal analyzer divides the pressure in the mask into a plurality of sections having a predetermined width, and for each of the plurality of sections, the time within which the pressure in the mask is included in the section Estimating the mask pressure suitable for titration from the number of occurrences of the respiratory disorder event occurring in
In the estimating step , the estimating means is constant at a minimum mask pressure at which the occurrence frequency or frequency of the disordered breathing event is not more than a predetermined value, or at an occurrence frequency or frequency of the disordered breathing event not more than a predetermined value. A control method for a biological signal analyzer, wherein a minimum mask pressure is estimated as a mask pressure suitable for the titration.   The program for functioning a computer as each means of the biological signal analyzer of any one of Claim 1 thru | or 5.