Distinguishing severe sleep apnea from habitual snoring using a neck-wearable piezoelectric sensor and deep learning: A pilot study

This study explores the development of a deep learning model using a neck-wearable piezoelectric sensor to accurately distinguish severe sleep apnea syndrome (SAS) from habitual snoring, addressing the underdiagnosis of SAS in adults. From 2018 to 2020, 60 adult habitual snorers underwent polysomnography while wearing a neck piezoelectric sensor that recorded snoring vibrations (70-250 Hz) and carotid artery pulsations (0.01-1.5 Hz). The initial dataset comprised 1167 silence, 1304 snoring, and 399 noise samples from 20 participants. Using a hybrid deep learning model comprising a one-dimensional convolutional neural network and gated-recurrent unit, the model identified snoring and apnea/hypopnea events, with sleep phases detected via pulse wave variability criteria. The model's efficacy in predicting severe SAS was assessed in the remaining 40 participants, achieving snoring detection rates of 0.88, 0.86, and 0.92, with respective loss rates of 0.39, 0.90, and 0.23. Classification accuracy for severe SAS improved from 0.85 for total sleep time to 0.90 for partial sleep time, excluding the first sleep phase, demonstrating precision of 0.84, recall of 1.00, and an F1 score of 0.91. This innovative approach of combining a hybrid deep learning model with a neck-wearable piezoelectric sensor suggests a promising route for early and precise differentiation of severe SAS from habitual snoring, aiding guiding further standard diagnostic evaluations and timely patient management. Future studies should focus on expanding the sample size, diversifying the patient population, and external validations in real-world settings to enhance the robustness and applicability of the findings.