目前睡眠呼吸暫止症(OSA)標準檢測方式為利用多重睡眠生理檢查儀(PSG)，然而，此項設備卻無法應用於普及化的檢查(約有20個頻道)；而目前為止大量文獻說明單一頻道的血氧濃度可以做為呼吸暫止症預測，較於PSG屬於相當簡化的系統；然而其缺乏腦波資訊，故其預測結果無法很接近PSG系統的結果；因此本文嘗試使用兩個頻道(血氧濃度以及腦波)來提升AHI(臨床上評估呼吸暫止症嚴重程度的指標)預測效能，企圖取代PSG。本文整理相關文獻並提出以中值濾波器建立血氧訊號基線，再將血氧濃度訊號在移除基線之後才計算特徵可以得到更好的效能；同時探討引入腦波清醒時期資訊對於呼吸暫止症預測是否能有效提升。
在本文的研究中，血氧濃度訊號在移除基線(由90秒中值濾波器得來)之後，依下降幅度2%以上，以及持續3秒以上做為血氧濃度下降事件指標(Oxyhemoglobin Desaturation Index)，發現與AHI高達0.9218的相關性，而再引入腦波清醒時期資訊，將血氧濃度訊號屬於清醒時期部分移除，可以再將血氧特徵與AHI的相關性推到0.9425；而進行AHI≧5(罹患呼吸暫止症)以及AHI<5(正常無呼吸暫止症)分級時可得93.78%正確率，95.94%敏感度，以及78.87%明確度的結果，使得以血氧濃度頻道做為簡化呼吸暫止症預測的可能性大幅提高。

The diagnosis of obstructive sleep apnea (OSA) syndrome is overnight PSG (mutli-channel system). But it’s hard to be popularized for the general population (about twenty channel signals). In recent decades, several researches were devoted to a replacement system with only one channel signal (oxyhemoglobin saturation). However, it’s hard to match PSG system’s report without EEG wake information. Consequently, two channels (oxyhemoglobin saturation and EEG) were used of this study to enhance the AHI (estimation index for sleep apnea) prediction performance. After surveying the most recent studies, this work proposes a new basleline removal technique for oxygen saturation signal (SpO2) by using median filter. It was proved this technique improves the diagnostic accuracy for OSA. Furthermore, it is also found that by removing the wake periods, diagnostic accuracy can be improved further.
By counting the number of times that the desaturation level has dropped more than 2% for at least 3 seconds, the correlation coefficient between AHI and proposed feature is 0.9218. In addition, by removing the wake period, this correlation increases to 0.9425. By using this feature to classify patients with AHI value larger than 5, the proposed approach achieves 93.78% accuracy, 95.94% sensitivity, 78.87% specificity f. Such results demonstrate the feasibility of using single SpO2 channel system for OSA diagnosis.

目錄 I
表目錄 III
圖目錄 VII
摘要 XIII
Abstract XIV
Abbreviations XV
第一章 緒論 1
1.1 引言 1
1.1.1 睡眠疾病與睡眠醫學 1
1.2 文獻回顧 4
1.3 研究動機與目的 5
第二章 相關研究背景 7
2.1 睡眠障礙 7
2.1.1 睡眠呼吸暫止 8
2.2睡眠呼吸暫止症診斷方式 12
2. 3 血氧飽和濃度訊號與睡眠呼吸暫止症 16
第三章 血氧濃度特徵與呼吸暫止症 20
3.1 相關文獻 20
3.2 血氧濃度時域特徵 21
3.2.1測試資料庫簡介與血氧濃度訊號假像(Artifact) 21
3.2.2簡易血氧濃度時域特徵 24
3.2.3 Oxyhemoglobin Desaturation Index(ODI) 26
3.2.4 Complexity 30
3.3 頻域血氧特徵 35
第四章 血氧濃度特徵的改善 39
4.1 新血氧基線定義 40
4.2 引入EEG頻道對血氧特徵的影響 52
4.3 血氧特徵在AHI分級的效能評比 68
4.4錯誤血氧特徵的原因 77
第五章 結論與討論 82
5.1 本文的貢獻與討論 82
5.2 未來展望 83
參考文獻 85
附錄I 艾普渥斯嗜睡度量表 (Epworth sleepiness scale, ESS) 91

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