IJEEMI, Vol. 1, No.

2, November 2019, pp:50-56

DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

Apnea Monitor based on Bluetooth with Android

Interface
I Dewa Made Wirayuda, I Dewa Gede Hari Wisana , Priyambada Cahya Nugraha
Department of Electromedical Engineering Poltekkes Kemenkes, Surabaya
Jl. Pucang Jajar Timur No. 10, Surabaya, 60245, Indonesia
[email protected] , [email protected] , [email protected]

Abstract— Apnea monitor is a device that is used to give a warning if there is stop breathing. Stop breathing while sleeping is one form
of obstructive sleep apnea. This cessation of breath cannot be underestimated, this is related to the main risk factors for health implications
and increased cardiovascular disease and sudden death. The purpose of this study is to design an apnea monitor with the Android
interface. This device allows the users to get how many times sleep apnea happens while sleeping and got data to analysis before continuing
with a more expensive and advanced sleep test. This device used a flex sensor to detect the respiration rate, the sensor placed on the
abdomen or belly so it can measure expand and deflate while breathing. The microcontroller uses an Arduino chip called AT-Mega328.
Bluetooth HC-05 used to send respiration data to Android, MIT app inventor used for the android programmer, and on the android,
there are plotting of respiration value and when the device detected apnea so the android also gives a warning to the user. Based on the
results of testing and measurement then compare with another device, the results of the average% error were 3.61%. This apnea monitor
design is portable but there are needs some improvement by using another sensor for detected respiration and using a module other than
Bluetooth.

Keywords—Sleep Apnea, Apnea Monitor, Flex Sensor

I. INTRODUCTION Medicine (AASM), the apnea-hypopnea index (AHI) is used to

describe the complete number and incidence of apnea per hour
Apnea monitor is a device that is used to give a warning if of sleep to assess the severity of OSA syndrome. OSA severity
there is cessation of breath (apnea) in infants or adults who have is usually determined as follows, AHI 5-15 shows a mild risk
the risk of respiratory failure and make parents or alert level, 15-30 shows moderate, and more than 30 shows severe
companion for the condition [1]. OSA syndrome [2]. One factor in the occurrence of OSA is
Obesity. The researchers concluded that obese people should be
Sleep apnea (SA) is form of obstructive sleep apnea (OSA) evaluated to determine the occurrence of OSA even though no
in the respiratory disorder that most commonly occurs during symptoms were felt [6].
sleep (sleep apnea). Sleep apnea is characterized by the cessation
of air flow to the lungs, it called sleep apnea when breathing In premature infants apnea occurs because the immature
stops more than 10 seconds. Sleep apnea cannot be respiratory system is called apnea of prematurity (AOP). Other
underestimated, this is because it is associated with the main risk things that can cause apnea are unstable temperature,
factors for health implications and increased cardiovascular pneumonia, asphyxia and anemia. All infants born less than 34
disease and sudden death [2]. When sleep apnea occurs, there weeks should be monitored or monitored at least the first week
will be oxygen desaturation or hypoxia so the body didn’t get or until the absence of apnea episodes that occur in premature
enough oxygen [3]. infants again [7].

Sleep apnea has a serious impact for patients, especially can Based on the results of the identification of the above
cause heart problems (hypertension, coronary artery disease, and problems to diagnose sleep apnea so that it can prevent the risk
arrhythmias). In addition, sleep disorders can also have a of cardiovascular disease and complications of other diseases
negative impact on quality of life. This often causes depression, such as hypoxia and sudden death (author death), Therefore, the
fatigue during the day and drowsiness. Sleep apnea events are objective of this study is to develop apnea monitor based on
divided into 3 classes: obstructive sleep apnea (OSA), central Bluetooth with android interface.
sleep apnea (CSA), and mixed sleep apnea (MSA). This disease II. MATERIALS AND METHODS
can occur at any age and sleep apnea is often undiagnosed [4].
Hypoxia caused by OSA can result in hypertension in the lungs, A. Experimental Setup
cardiac dysfunction, and even kidney disorders [5]. This study uses male and female as a subjects aged 17-40
Statistics show that around 100 million people worldwide, years. Sampling is randomly by taking data 5 times with a total
where in the US from 18 to 50 million people, are suspected of of 10 samples.
having OSA, and among them more than 80% remain 1) Materials and Apparatus
undiagnosed. According to the American Academy of Sleep

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 IJEEMI, Vol. 1, No. 2, November 2019, pp:50-56
DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

This study uses a flex sensor which will be placed on the Start
patient's abdomen to detect the patient's breathing. Using
ATMega328 as a microcontroller, and Bluetooth to send data to
android.. Initialization

2) Experiment No
In this study the researchers measured subject’s respiration
who were randomly selected and compared the results of Bluetooth
respiration with standard. Connected?

B. The Diagram Block

In this research, flexible sensors were used to identify the Yes
swelling and deflection of the abdomen of the patient during
Received Data from
breathing as seen in Figure 1. The output sensor that is still in Microcontroller
the form of resistance will enter the analog signal conditioning
circuit so that it can be processed by the microcontroller. While
the breathing detected, the microcontroller will send data for Plotting of
respiration value counters to android via Bluetooth. When sleep Respiration Value
apnea occurs, the module will activate the alarm on the device
and also on android. On the Android display there is also a No
patient's respiration value in the form of plotting the graph of
respiration value. Apnea?

Patient s Breathing
Belly Indicator
Yes

Low Battery Alarm

Flex Sensor
Indicator
Mikrokontroller
Atmega 328 Stop
Analog Alarm
Signal Fig. 3. The flowchart of the android program
Conditioning
Bluetooth HC-05 C. The Flowchart
The Arduino program is based on the flowchart in Fig. 2.
After initializing the microcontroller will detect changes in input
voltage produced by the flex sensor. Furthermore, this data will
Alarm
be sent via Bluetooth to Android.
Handphone
Plotting of respiration rate The Android program flowchart can be seen in Figure Fig.3,
where after initializing, the operator needs to connect Android
Fig. 1. The diagram block of the apnea monitor to Bluetooth from the device. When breathing occurs, the value
of the patient's respiration will appear, and when its one minute
Start there will be an update to plot the graph of respiration value on
the android display.
Initialization D. The Analog Circuit
The most important part of the design is the analog signal
conditioning circuit, as shown in figure 4 which is a voltage
Detecting Respiration by
divider circuit, the difference amplifier circuit and filter in
Flex Sensor
Figure 5. This circuit serves to process analog signals so that the
output is ready to be processed by a microcontroller.
Sending Data via 1) Voltage Divider
Blueooth to Android The circuit shown in Figure 4 is a voltage divider circuit,
where this circuit will experience a change in output voltage
Stop when the flex sensor changes the curve caused by the breathing
process of the patient.
Fig. 2. The flowchart of the arduino program

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DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

Fig. 6. Bluetooth connection

III. RESULTS
In this study, a trial has been carried out on the tool module
by measuring breathing in patients directly and taking
measurements to determine the accuracy of the module
Fig. 4. Voltage divider

2) Difference Amplifier adn Filter

The difference amplifier circuit shown in Figure 5 using
LM358 as the OP-Amp, is a circuit that serves to amplify the
output from voltage divider, so that the difference in voltage
when the patient is breathing can be seen more clearly,
difference amplifier also used to setting sensitivity from the
sensor to detected breathing. Furthermore, there is a low pass
filter with frequency cut off 1 Hz. The function of low pass filter
is to eliminate noise that does not originate from breathing.

Fig. 7. Apnea monitor design

Fig. 5. Difference amplifier

For the reinforcement of the difference amplifier it can be

calculated using the formula:
If (R6=R9, R4=R3) then,
𝑅6
Vout = (− ) ∗ (𝑉𝑖𝑛𝑣𝑒𝑟𝑡𝑖𝑛𝑔 − 𝑉𝑛𝑜𝑛𝑛𝑣𝑒𝑟𝑡𝑖𝑛𝑔) (1)
𝑅3

𝑅𝑓 𝑅6
Gain = (− ) = (− ) (2)
𝑅𝑖𝑛 𝑅3
Fig. 8. Result of apnea monitor design
3) Bluetooth Connection
The Bluetooth circuit is connected to the ATMega328
microcontroller by connecting the AT-Mega 328 TX pin to the
RX Bluetooth pin, and the RX AT-Mega 328 pin to the
Bluetooth TX pin.

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DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

Serial.println (nafasmanual);
beat=0; } }}

//======mengirim data RR setelah 1 menit==========

if (milidetik3>60003){
nafasmenit=nafasmanual;
Serial.print ("b");Serial.println(nafasmenit);
nafasmanual=0;
milidetik3=0; }

//================deteksi apnea============
if(flex<hold){
Fig. 9. Display mit app for apnea monitor if (detik>10000){
if (kirim==0){
1) The Apnea Monitor Design Serial.print("c");Serial.println(1);
The analog signal conditioning circuit and microcontroller digitalWrite (buzzer,HIGH);
for Apnea Monitor are shown in figure 7. This design consists kirim=1;}}
of a series of voltage dividers, a difference amplifier circuit, and
an LPF filter. The difference amplifier circuit uses the LM358 if(flex>hold){
IC which has two op-amp. In the voltage distribution circuit if (milidetik>10000){
there is multi-turn (50k) which serves to adjust the sensitivity of if (kirim==0){
the flex sensor readings. For the microcontroller this tool uses Serial.print("c");Serial.println(1);
ATMega328 as a control and uses the Bluetooth HC-05 module digitalWrite (buzzer,HIGH);
as the sender of data through the microcontroller to android. kirim=1;}}
2) The Listing Program for ATMega328 Apnea Monitor
In this study, the software was divided into two parts, namely
for ATMega328 and for MIT APP Inventor. For the 3) The Listing Program for Mit App Inventor
ATMega328 listing program shown in the Program Listing 1. It In Listing Program 2 it explains the program for receiving
contains a sensor reading program and sending data to android data sent Bluetooth from the microcontroller by android. Where
via Bluetooth HC-05. the data is divided into 3 parts. The first part beginning with the
letter "a" is the counter value data for RR. Data beginning with
Listing program 1. Program to send the RR data To Android the letter "b" is data for plotting graphics, and data beginning
//=======pencarianReferensi (Autoreferensi)======== with the letter "c" to trigger an alarm in the MIT App Inventor.
Flex = AnalogRead (A0);
if(ref<=flex) {ref=flex;} Listing Program 2. Program for MIT App Inventor
else {ref=ref; hold=(ref*0.8);}

//===========pembacaan nilai respirasi===========

if (flex>hold){
beat=1; detik=0; kirim=0;
digitalWrite (buzzer,LOW);
digitalWrite (ledPernapasan, LOW); }

//=============mengirim data Counter RR=========

if (flex<(hold*0.8)) {
milidetik=0;

if (beat==1){
kirim=0;
digitalWrite (ledPernapasan, HIGH);
if (waktumonostabil>delayMonostabil){
detak++;
nafasmanual++;
waktumonostabil=0;
Serial.print ("a");

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DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

5. The Respiration Signal

Respiration signal are measured two times with two
difference point from the placement of flex sensor first point on
right of umbilical region and the second point on the left of
umbilical region. This measurement is done to find out the point
that produces a signal with a higher amplitude.

(a) (b)
Fig. 10. Sensor placement to measured the respiration (a) left (b) right side

Fig. 11. Respiration signal on the right of umblical region (Subject 1)

Fig. 12. Respiration signal on the left of umblical region (Subject 1)

4. Timer
The timer is used to calculate the time of stopping the breath,
and when the breath stops more than 10 seconds the tool will
give a warning by activating the alarm.

TABLE I. THE DIFFERENCE BETWEEN TIMER AND STANDARD

Design Standard Difference

(Second) (Second) (Second)
10 10.22 0.22 Fig. 13. Respiration signal on the right of umblical region (Subject 2)

10 10.20 0.20
10 10.08 0.08
10 10.16 0.16
10 10.20 0.20

After testing the timer there are the difference between timer
and standard. The biggest difference is 0.22 seconds and the
smallest difference is 0.08.

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DOI: 10.35882/ijeeemi.v1i2.1 ISSN:2656-8624

Fig. 14. Respiration signal on the left of umblical region (Subject 2)

Fig. 20. Respiration signal on the left of umblical region (Subject 5)

TABLE II. THE AMPLITUDE OF THE RESPIRATION SIGNAL

Fig. 15. Respiration signal on the right of umblical region (Subject 3)
Right Side Left Side
No
(Volt) (Volt)
1 2.56 2.16
2 1.92 1.16
3 2.4 2.24
4 3.24 2.36
5 2.88 1.64
6 1.60 0.76
Fig. 16. Respiration signal on the left of umblical region (Subject 3) 7 1.80 1.44
8 3.04 2.24
9 3.60 2.88
10 2.16 1.24
Average 2.52 1.812

6. The Error of Respiration Rate

Accuracy of the respiration rate value on the MIT app
inventor display with the standard comparison apparatus.
Fig. 17. Respiration signal on the right of umblical region (Subject 4)

TABLE III. THE ERROR OF RESPIRATION RATE ON DESIG

Average
Number Device STDEV Ua Error
(RR)
Standard 11.2 0.45 0.20
1 3.57%
Design 10.8 0.84 0.37

Fig. 18. Respiration signal on the left of umblical region (Subject 4)

Standard 19.6 0.89 0.40
2 5.10%
Design 18.6 2.07 0.93
Standard 12.6 0.89 0.40
3 4.76%
Design 12.0 1.00 0.45
Standard 17.2 1.30 0.58
4 6.98%
Design 16.0 2.35 1.05
Standard 13.0 2.00 0.89
5 3.08%
Design 12.6 1.95 0.87
Fig. 19. Respiration signal on the right of umblical region (Subject 5) 6 Standard 18.8 2.17 0.97 2.13%

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[7] S. Sunit, R. Pallab, J. L. Mathew, M. Jayashree, and Dhanalakshmi,

Design 18.4 2.88 1.29 “Apnea in New Born,” Indian J. Pediatr., vol. 75, no. 1, p. 57, 2008.
Standard 15.0 2.00 0.89
7 1.33%
Design 14.8 2.17 0.97
Standard 23.4 2.30 1.03
8 5.98%
Design 22.0 2.55 1.14
Standard 18.8 1.48 0.66
9 3,.19%
Design 18.2 1.92 0.86
Standard 19.0 1.41 0.63
10 0.00%
Design 19.0 1.41 0.63
The measurement results from the patient's Respiration Rate
compared to the standard. The results are shown in table 2.
IV. DISCUSSION
The apnea monitor design has been examined and tested
completely in this study. Based on the result after measuring
respiration signal from 10 subject, as seen above in the table can
be conclude that the average of amplitude from the right side is
2.52 Volt and the average from the left side is 1.812, so the right
side is better to place the sensor.
Furthermore, based on the results after compared
measurement using standard there are differences in the
measurement results. The biggest error value is 6.98% and the
smallest is 0.00%. The average error is 3.61%. The uncertainty
value is obtained because there are still other factors that
influence the measurement results, such as the location of the
flex sensor at the time of measurement, and respiration from the
respondent is not always stable. So the value of uncertainty must
also be calculated. The biggest value is 1.29 and the smallest
value is 0.20.
V. CONCLUSION
This study has demonstrated the development of the apnea
monitor to monitoring the respiration of the patient’s while
sleeping. This study was built based on Bluetooth with android
interface. After testing the design, there are needs to
improvement by using other sensor for detected respiration and
using module other than Bluetooth.
REFERENCES
[1] Kementerian Kesehatan, “Keputusan Menteri Kesehatan Republik
Indonesia Nomor 118/MENKES/SK/IV/2014,” pp. 33–34, 2014.
[2] N. Maske and A. Gaikwad, “Monitoring Of Obstructive Sleep Apnea
Using Mobile,” Int. J. Ind. Electron. Electr. Eng. ISSN, vol. 4, no. 4, pp.
71–75, 2016.
[3] K. Sneha, “Detection of Sleep Apnea using Pressure Sensor,” Int. Res. J.
Eng. Technol., vol. 03, no. 10, pp. 709–712, 2016.
[4] Dipti Patil, V. M. Wadhai, S. Gujar, K. Surana, P. Devkate, and S.
Waghmare, “APNEA Detection on Smart Phone,” Int. J. Comput. Appl.,
vol. 59, no. 7, pp. 15–19, 2012.
[5] R. M. Taylor-Gjevre, “Obstructive sleep apnea, hypoxia and
inflammatory arthritis: How may they be linked?,” Int. J. Clin. Rheumtol.,
vol. 10, no. 4, pp. 219–222, 2015.
[6] G. J. Rossini, “O bstructive S leep A pnea A nd O besity,” J. Lancaster
Gen. Hosp., vol. 4, no. 4, pp. 139–142, 2009.

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