Technical Report: Insider-Resistant Context-Based Pairing for Multimodality Sleep Apnea Test

TL;DR

This paper introduces SIENNA, a novel device pairing protocol for sleep apnea testing that resists insider attacks by leveraging respiration pattern identification and friendly jamming, ensuring secure and reliable device pairing in multi-user environments.

Contribution

SIENNA is the first protocol to combine JADE-ICA, fuzzy commitment, and friendly jamming for insider-resistant device pairing in sleep apnea testing systems.

Findings

Achieves over 90% success rate in noisy environments.

Robust against attackers with full context knowledge.

Ensures secure pairing in multi-user settings.

Abstract

The increasingly sophisticated at-home screening systems for obstructive sleep apnea (OSA), integrated with both contactless and contact-based sensing modalities, bring convenience and reliability to remote chronic disease management. However, the device pairing processes between system components are vulnerable to wireless exploitation from a non-compliant user wishing to manipulate the test results. This work presents SIENNA, an insider-resistant context-based pairing protocol. SIENNA leverages JADE-ICA to uniquely identify a user's respiration pattern within a multi-person environment and fuzzy commitment for automatic device pairing, while using friendly jamming technique to prevents an insider with knowledge of respiration patterns from acquiring the pairing key. Our analysis and test results show that SIENNA can achieve reliable (> 90% success rate) device pairing under a noisy environment and is robust against the attacker with full knowledge of the context information.