Respiration rate and volume measurements using wearable strain sensors

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Abstract

Current methods for continuous respiration monitoring such as respiratory inductive or optoelectronic plethysmography are limited to clinical or research settings; most wearable systems reported only measures respiration rate. Here we introduce a wearable sensor capable of simultaneously measuring both respiration rate and volume with high fidelity. Our disposable respiration sensor with a Band-Aid© like formfactor can measure both respiration rate and volume by simply measuring the local strain of the ribcage and abdomen during breathing. We demonstrate that both metrics are highly correlated to measurements from a medical grade continuous spirometer on participants at rest. Additionally, we also show that the system is capable of detecting respiration under various ambulatory conditions. Because these low-powered piezo-resistive sensors can be integrated with wireless Bluetooth units, they can be useful in monitoring patients with chronic respiratory diseases in everyday settings.

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Based on a review of literature and consensus, the Portable Monitoring Task Force of the American Academy of Sleep Medicine (AASM) makes the following recommendations: unattended portable monitoring (PM) for the diagnosis of obstructive sleep apnea (OSA) should be performed only in conjunction with a comprehensive sleep evaluation. Clinical sleep evaluations using PM must be supervised by a practitioner with board certification in sleep medicine or an individual who fulfills the eligibility criteria for the sleep medicine certification examination. PM may be used as an alternative to polysomnography (PSG) for the diagnosis of OSA in patients with a high pretest probability of moderate to severe OSA. PM is not appropriate for the diagnosis of OSA in patients with significant comorbid medical conditions that may degrade the accuracy of PM. PM is not appropriate for the diagnostic evaluation of patients suspected of having comorbid sleep disorders. PM is not appropriate for general screening of asymptomatic populations. PM may be indicated for the diagnosis of OSA in patients for whom in-laboratory PSG is not possible by virtue of immobility, safety, or critical illness. PM may also be indicated to monitor the response to non-CPAP treatments for sleep apnea. At a minimum, PM must record airflow, respiratory effort, and blood oxygenation. The airflow, effort, and oximetric biosensors conventionally used for in-laboratory PSG should be used in PM. The Task Force recommends that PM testing be performed under the auspices of an AASM-accredited comprehensive sleep medicine program with written policies and procedures. An experienced sleep technologist/technician must apply the sensors or directly educate patients in sensor application. The PM device must allow for display of raw data with the capability of manual scoring or editing of automated scoring by a qualified sleep technician/technologist. A board certified sleep specialist, or an individual who fulfills the eligibility criteria for the sleep medicine certification examination, must review the raw data from PM using scoring criteria consistent with current published AASM standards. Under the conditions specified above, PM may be used for unattended studies in the patient's home. Afollow-up visit to review test results should be performed for all patients undergoing PM. Negative or technically inadequate PM tests in patients with a high pretest probability of moderate to severe OSA should prompt in-laboratory polysomnography.

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Author and article information

Contributors

Michelle Khine: + (949) 824-4051 , mkhine@uci.edu

Journal

Journal ID (nlm-ta): NPJ Digit Med

Journal ID (iso-abbrev): NPJ Digit Med

Title: NPJ Digital Medicine

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2398-6352

Publication date (Electronic): 13 February 2019

Publication date PMC-release: 13 February 2019

Publication date Collection: 2019

Volume: 2

Electronic Location Identifier: 8

Affiliations

[1 ]ISNI 0000 0001 0668 7243, GRID grid.266093.8, Department of Biomedical Engineering, , University of California, ; Irvine, CA USA

[2 ]ISNI 0000 0001 0668 7243, GRID grid.266093.8, Department of Chemical Engineering, , University of California, ; Irvine, CA USA

[3 ]ISNI 0000 0001 0668 7243, GRID grid.266093.8, Bren School of Information and Computer Sciences, , University of California, ; Irvine, CA USA

[4 ]ISNI 0000 0001 0668 7243, GRID grid.266093.8, Pediatric Exercise and Genomics Research Center, School of Medicine, , University of California, ; Irvine, CA USA

[5 ]ISNI 0000 0000 9950 8111, GRID grid.413731.3, Department of Pediatrics, , Rambam Medical Center, ; Haifa, Israel

Article

Publisher ID: 83

DOI: 10.1038/s41746-019-0083-3

PMC ID: 6550208

PubMed ID: 31304358

SO-VID: 45565070-c5b4-480b-81ed-21c4ac5a14ce

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 9 September 2018

Date accepted : 15 January 2019

Funding

Funded by: FundRef https://doi.org/10.13039/100000050, U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI);

Award ID: 4U54HL119893-04

Award Recipient : Michael Chu Vaibhav Pandey Hoang N. Pham Shlomit Radom-Aizik Dan M. Cooper Michelle Khine