Deep learning-based multi-level airway collapse site localization on obstructive sleep apnea patients based on snoring sounds

Objective This study evaluated deep learning models, specifically ResNet-50 and Audio Spectrogram Transformer (AST), to identify multi-level upper airway collapses in obstructive sleep apnea (OSA) patients using snoring sounds. Methods Snoring recordings from 37 subjects undergoing drug-induced sleep endoscopy (DISE) between 2020 and 2021 were used to train models for two multi-label tasks: identifying obstructions at the Velum (V), Oropharynx (O), Tongue-base (T), and Epiglottis (E) levels, and the retropalatal (RP) vs. retroglossal (RG) levels. Results The AST model significantly outperformed ResNet-50 (P <0.05 after Bonferroni correction), effectively identifying V-, O-, and RP-level obstructions (F1-score: 0.59-0.87, Matthews Correlation Coefficient: 0.50-0.80, and AUC: 0.87-0.97). However, the performance of both models at the T, E, and RG levels remained limited due to small sample sizes, even with the Synthetic Minority Over-sampling Technique. A full-night recording analysis further demonstrated the feasibility of acoustic profiling for airway dynamics. Conclusion The AST models can effectively identify airway obstruction at V, O, and RP levels via snoring sounds. The proposed models offer a promising non-invasive tool for tracking overnight airway dynamics and assisting in clinical treatment planning.