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Controlled Clinical Trial
. 2009 Nov;32(11):1521-7.
doi: 10.1093/sleep/32.11.1521.

Thermal infrared imaging: a novel method to monitor airflow during polysomnography

Jayasimha N Murthy  1 , Johan van Jaarsveld, Jin Fei, Ioannis Pavlidis, Rajesh I Harrykissoon, Joseph F Lucke, Saadia Faiz, Richard J Castriotta
Affiliations
Controlled Clinical Trial

Thermal infrared imaging: a novel method to monitor airflow during polysomnography

Jayasimha N Murthy et al. Sleep. 2009 Nov.

Abstract

Study objectives: This is a feasibility study designed to evaluate the accuracy of thermal infrared imaging (TIRI) as a noncontact method to monitor airflow during polysomnography and to ascertain the chance-corrected agreement (K) between TIRI and conventional airflow channels (nasal pressure [Pn], oronasal thermistor and expired CO2 [P(E)CO2]) in the detection of apnea and hypopnea.

Design: Subjects were recruited to undergo polysomnography for 1 to 2 hours, during which simultaneous recordings from electroencephalography, electrooculography, electromyography, respiratory impedance plethysmography, conventional airflow channels, and TIRI were obtained.

Setting: University-affiliated, American Academy of Sleep Medicine-accredited sleep disorders center.

Patients or participants: Fourteen volunteers without a history of sleep disordered breathing and 13 patients with a history of obstructive sleep apnea were recruited.

Measurements and results: In the detection of apnea and hypopnea, excellent agreement was noted between TIRI and thermistor (kappa = 0.92, Bayesian Credible Interval [BCI] 0.86, 0.96; pkappa = 0.99). Good agreement was noted between TIRI and Pn (kappa = 0.83, BCI 0.70, 0.90; pkappa = 0.98) and between TIRI and P(E)CO2 (kappa = 0.80, BCI 0.66, 0.89; pkappa = 0.94).

Conclusions: TIRI is a feasible noncontact technology to monitor airflow during polysomnography. In its current methodologic incarnation, it demonstrates a high degree of chance-corrected agreement with the oronasal thermistor in the detection of apnea and hypopneas but demonstrates a lesser degree of chance-corrected agreement with Pn. Further overnight validation studies must be performed to evaluate its potential in clinical sleep medicine.

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Figures

Figure 1
Figure 1
(a) Thermal snapshot of a sleeping subject's face. (b) Region of interest that is being tracked. (c) Thermal color map.
Figure 2
Figure 2
Delineation of the measurement region by segmentation algorithm of the thermal infrared imaging (TIRI). The measurement region fits the nostril area only; this is a subset of the tracking region (see Figure 1), which is broader.
Figure 3
Figure 3
Example of a 60-second epoch from a subject with a previous history of severe sleep apnea demonstrating concordant events (obstructive apnea [OA]) in thermal infrared imaging (TIRI), nasal pressure (Pn), oronasal thermistor and expired CO2 waveform (PECO2). Other leads depicted are left-eye electrooculography (LOC-A2), right-eye electrooculography (ROC-A1), chin electromyography (chin EMG), central electroencephalography (C3-A2, C4-A1), occipital electroencephalography (O1-A2, O2-A1), electrocardiography (EKG), digital pulse oximetry (SpO2), acoustic monitoring of snoring (snore mic), and respiratory inductance plethysmography (RIP) of chest and abdomen along with the summation signal (RIP sum).
See this image and copyright information in PMC

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