PASITHEA: An Integrated Monitoring and Therapeutic System for Sleep Apnea Syndromes Based on Adaptive Kinesthetic Stimulation

Sleep apnea syndromes are characterized by repeated episodes of breathing pauses (apnea) or significant reductions in respiratory amplitude (hypopnea) during the patient's sleep. These episodes significantly alter the sleep structure of the patient and provoke acute cardiorespiratory responses that may be deleterious in the long term. Continuous positive airway pressure (CPAP) therapy is the gold-standard treatment for SAS, but patient compliance to this therapy is low. This paper presents a new system for real-time detection, monitoring and treatment of SAS, based on triggered kinesthetic stimulation. The system is composed of 3 components: i) a cardio-respiratory recorder, ii) a kinesthetic stimulator and iii) a real-time processing application, integrating an “on–off” control method to trigger the kinesthetic stimulation as a function respiratory event detections. A preliminary evaluation of the system, performed on 46 patients suffering from severe SAS is also presented. This evaluation is focused on i) the performance characterization of the real-time respiratory event detector and ii) a qualitative description of the effect of the therapy. A satisfactory real-time respiratory event detection performance (sensitivity = 89.2%, positive predictive value = 59%) was obtained with the proposed detector, when evaluated retrospectively using the acquired data. Three case reports, describing the cardiorespiratory response to the therapy of a responder, a partially-responder and a non-responder patients are also presented. These preliminary results are very encouraging and warrant further developments, in particular for novel control stimulation strategies.