無線居家睡眠多項生理監測儀之基於安全網路連線的遠端監測系統開發

Abstract

阻塞性睡眠呼吸中止症(OSA)與睡眠障礙的臨床診斷過程，要求受測者在睡眠檢查中心配戴多項生理監測儀(PSG)進行訊號記錄。然而，常見白袍症、睡眠適應的影響下，睡眠技師無法採用此數據，進而影響診斷之正確性，為此，家用型 PSG因應而生。其具備操作簡便、價格低廉優點，但卻仍有其診斷限制，例如，離線資料記錄之完整性、受測環境不確定性、電極鬆脫、非正常中斷檢測等診斷限制。 許多研究團隊已投入諸多資源來克服上述限制，並期待提升功能後以利睡眠技師的即時介入。基於此研究課題與診斷需求，本研究將整合TCP Socket Connection功能，研發一套家用型PSG遠端監測系統。其中亦考量個人生理健康狀況與檢測隱私之保護，連線係是採用數位彌封結合數位簽章技術，確保資料即時傳送之保密性與完整性。 在與上一版本之PSG系統的量測結果評估上，我們得到的很高的相似係數(98.25%)，表示新版本的PSG系統在置換掉原系統的軟體部分後，還是保持著很高的量測效能。而新版本的PSG系統在自身的效能評估上，亦有很好的實驗結果。1) PSG Client量測到之生理訊號在傳輸到PSG Server過程中，擁有0%的資料丟失率，2) 具安全性的網路連線在CPU負載上只較一般的網路連線增加5.18%的負載，3) 實際所佔用的網路頻寬也只增加4.82%，4) 網路資料的竊聽者幾乎無法竊取傳送中的生理訊號，5) 達成資訊安全目標中的資料機密性與資料完整性。基於以上的實驗結果，我們可以證明所提出的PSG系統擁有很好的效能及安全性。此外，為了建置與睡眠中心更相似的睡眠檢測環境，我們重新設計了軟體架構，使其達到多重PSG Client的目的，讓PSG Server可同時監測多台PSG Client的訊號量測，就像在睡眠中心裡睡眠技師在控制室中監測多個病房裡各個受測者之量測結果的情境。 在傳統家用型PSG的使用上存在著諸多的診斷限制，而本研究為了克服這些診斷限制所提出的基於安全網路連線的家用型PSG遠端監測系統，根據我們的實驗結果，確實可讓睡眠技師跨越空間的障礙，對於受測者量測之生理訊號作即時且安全的監控。本研究成果可應用在居家睡眠的長期追蹤研究，提供家用PSG的使用者更高品質的睡眠檢測。 期許本研究可對長期患有睡眠障礙之患者作出一定程度之貢獻。

The diagnosis of Obstructive Sleep Apnea (OSA) and sleep apnea, subject is required to use polysomnography (PSG) recording the bio-signal. However, base on the influence of white coat syndrome and unfamiliar environment, sleep physician can’t adopt the data. It will affect the accuracy of diagnosis. Therefore household PSG is produced for above reason. Household PSG has the advantages of less technical complexity and lower cost. But it still exist diagnostic limitations (e.g. integrity of off-line data, uncertain experimental environment, electrode loose, abnormal terminate of examination, etc.) There are many research teams invest much resources to overcome above limitations, and expect that it can let sleep intervene the examination immediately after the function upgraded. Base on this research issue and requirement of diagnosis, in this study, we will research and develop a household PSG remote monitoring system that integrated TCP Socket Connection. Base on the protection of personal privacy and state of health, the connection combined Digital Envelope with Digital Signature. It ensures the data confidentiality and data integrity.

To compare with last PSG system, we obtain a very highly correlation coefficient (98.25%) on the evaluation of measurement results. It means new proposed PSG system keep a highly performance of measurement after replace the software of last PSG system. And on itself performance evaluation of new proposed PSG system, it also obtain a very well experimental results. 1) Transmission has 0% data lose, 2) CPU loading only increases 5.18%, 3) actual average occupied bandwidth just increases 4.82%, 4) the eavesdropper can’t eavesdrop the bio-signal almost and 5) it achieve the goals of information security: data confidentiality and data integrity. Base on above experimental results, we could confirm our proposed PSG system that have very well performance and security. Besides, in order to set up a similar examination environment, we improve our software to the multiple client architecture. This architecture let PSG Server can monitor several PSG Clients simultaneously just like sleep physician in control room supervises patients in individual rooms in sleep laboratory. There exist many diagnostic limitations on using traditional household PSG. In this study in order to overcome the diagnostic limitations, we propose a household PSG remote monitoring system over secure network connection. According to our experimental results, it’s truly let sleep physician strides across the barriers of space to supervise the bio-signal recording by subject immediately and safely. Our study can serve for a long-term tracing and research of personal sleep monitoring at home, and provide patient have a more high-quality sleep examination. Wish our study could have some contribution for patient suffer from sleep apnea.