Interhemispheric asynchrony correlates with severity of respiratory disturbance index in patients with sleep apnea

Obstructive sleep apnea (OSA) hypopnea syndrome is a disorder characterized by airway obstructions during sleep; full obstructions are known as apnea and partial obstructions are called hypopnea. Sleep in OSA patients is significantly disturbed with frequent apnea/hypopnea and arousal events. We illustrate that these events lead to functional asymmetry of the brain as manifested by the interhemispheric asynchrony (IHA) computed using EEG recorded on the scalp. In this paper, based on the higher order spectra of IHA time series, we propose a new index [interhemispheric synchrony index (IHSI)], for characterizing brain asynchrony in OSA. The IHSI computation does not depend on subjective criteria and can be completely automated. The proposed method was evaluated on overnight EEG data from a clinical database of 36 subjects referred to a hospital sleep laboratory. Our results indicated that the IHSI could classify the patients into OSA/non-OSA classes with an accuracy of 91% (ρ = 0.0001), at the respiratory disturbance index threshold of 10, suggesting that the brain asynchrony carries vital information on OSA.