Acoustical flow estimation in patients with obstructive sleep apnea during Sleep

Tracheal respiratory sound analysis is a simple and non-invasive way to study the pathophysiology of the upper airways; it has recently been used for acoustical flow estimation and sleep apnea diagnosis. However in none of the previous studies, the accuracy of acoustical flow estimation was investigated neither during sleep nor in people with obstructive sleep apnea (OSA). In this study, we recorded tracheal sound, flow rate and head position from 11 individuals with OSA during sleep and wakefulness. We investigated two approaches for calibrating the parameters of acoustical flow estimation model based on the known data recorded during wakefulness and sleep. The results show that the acoustical flow estimation parameters change from wakefulness to sleep. Therefore, if the model is calibrated based on the data recorded during wakefulness, although the estimated flow follows the relative variations of the recorded flow, the quantitative flow estimation error would be high during sleep. On the other hand, when the calibration parameters are extracted from tracheal sound and flow recordings during sleep, the flow estimation error is less than 5%. These results confirm the reliability of acoustical methods for estimating breathing flow during sleep and detecting the partial or complete obstructions of the upper airways during sleep.