Automatic Detection of Hot Flash Occurrence and Timing from Skin Conductance Activity

Hot flashes (HF) are intense, transient feelings of heat usually accompanied with flushed skin and sweating that are experienced by women around the time of menopause. HFs are associated with poor quality of life and increased cardiovascular risk. Automatic detection of HF occurrence and precise timing of HF onset could provide unique insight into the physiology of the HF and its effect on the cardiovascular system. A novel automatic algorithm is proposed for the detection of HFs occurrence and timing from the sternal skin conductance signal that is robust to noise and artifacts. The method is based on the gold standard rule (2μS rise in skin conductance within 30 s) and considers several conditions based on the skin conductance level and its derivative to reject unwanted events. ECG-derived heart rate pattern variations are studied prior to the detected HF onset. The algorithm is validated against expert detected HFs over 200 hours of sleep data collected from 12 perimenopausal women. It achieved a total accuracy of 93% and a total error of 3% in HF detection. It was observed that heart rate increased before the onset of 80% of the HFs occurring in undisturbed sleep. Application of this algorithm along with fusion of other simultaneously recorded physiological measures has the potential to advance understanding of the HF.