Variations in respiratory sounds in relation to fluid accumulation in the upper airways

Obstructive sleep apnea (OSA) is a common disorder due to recurrent collapse of the upper airway (UA) during sleep that increases the risk for several cardiovascular diseases. Recently, we showed that nocturnal fluid accumulation in the neck can narrow the UA and predispose to OSA. Our goal is to develop non-invasive methods to study the pathogenesis of OSA and the factors that increase the risks of developing it. Respiratory sound analysis is a simple and non-invasive way to study variations in the properties of the UA. In this study we examine whether such analysis can be used to estimate the amount of neck fluid volume and whether fluid accumulation in the neck alters the properties of these sounds. Our acoustic features include estimates of formants, pitch, energy, duration, zero crossing rate, average power, Mel frequency power, Mel cepstral coefficients, skewness, and kurtosis across segments of sleep. Our results show that while all acoustic features vary significantly among subjects, only the variations in respiratory sound energy, power, duration, pitch, and formants varied significantly over time. Decreases in energy and power over time accompany increases in neck fluid volume which may indicate narrowing of UA and consequently an increased risk of OSA. Finally, simple discriminant analysis was used to estimate broad classes of neck fluid volume from acoustic features with an accuracy of 75%. These results suggest that acoustic analysis of respiratory sounds might be used to assess the role of fluid accumulation in the neck on the pathogenesis of OSA.