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Assessment of Time and Frequency Domain Entropies to Detect Sleep Apnoea in Heart Rate Variability Recordings from Men and Women
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Entropy 2015, 17(1), 231-243; doi:10.3390/e17010231

Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing

1
Department of Electrical Engineering, National Dong Hwa University, Hualien, 97401, Taiwan
2
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
3
Sleep Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
4
Department of Emergency Medicine, E-Da hospital, I-Shou University College of Medicine, Kaohsiung, 82445, Taiwan
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 29 October 2014 / Accepted: 7 January 2015 / Published: 12 January 2015
(This article belongs to the Special Issue Entropy and Cardiac Physics)
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Abstract

Obstructive sleep apnea (OSA) is an independent cardiovascular risk factor to which autonomic nervous dysfunction has been reported to be an important contributor. Ninety subjects recruited from the sleep center of a single medical center were divided into four groups: normal snoring subjects without OSA (apnea hypopnea index, AHI < 5, n = 11), mild OSA (5 ≤ AHI < 15, n = 10), moderate OSA (15 ≤ AHI < 30, n = 24), and severe OSA (AHI ≥ 30, n = 45). Demographic (i.e., age, gender), anthropometric (i.e., body mass index, neck circumference), and polysomnographic (PSG) data were recorded and compared among the different groups. For each subject, R-R intervals (RRI) from 10 segments of 10-minute electrocardiogram recordings during non-rapid eye movement sleep at stage N2 were acquired and analyzed for heart rate variability (HRV) and sample entropy using multiscale entropy index (MEI) that was divided into small scale (MEISS, scale 1–5) and large scale (MEILS, scale 6–10). Our results not only demonstrated that MEISS could successfully distinguish normal snoring subjects and those with mild OSA from those with moderate and severe disease, but also revealed good correlation between MEISS and AHI with Spearman correlation analysis (r = −0.684, p < 0.001). Therefore, using the two parameters of EEG and ECG, MEISS may serve as a simple preliminary screening tool for assessing the severity of OSA before proceeding to PSG analysis. View Full-Text
Keywords: multiscale entropy; scale factor; obstructive sleep dyspnea; polysomnography; heart rate variability multiscale entropy; scale factor; obstructive sleep dyspnea; polysomnography; heart rate variability
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Pan, W.-Y.; Su, M.-C.; Wu, H.-T.; Lin, M.-C.; Tsai, I.-T.; Sun, C.-K. Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing. Entropy 2015, 17, 231-243.

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