# US 11,896,388 B2 · Method for detecting and discriminating breathing patterns from respiratory signals

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- Number: US 11,896,388 B2
- Document ID: US11896388B2
- Status: Granted
- Kind: B2
- Application number: 17/336,917
- Filed: 2021-06-02
- Published: 2021-11-18
- Granted: 2024-02-13
- Earliest claimed: 2004-12-23
- Assignees: ResMed Pty Ltd
- Applicants: ResMed Pty Ltd
- Inventors: Jeffrey Peter Armitstead
- Web page: https://patentgrep.com/patent/US11896388B2

## CPC

- A61B 5/4818: {Sleep apnoea}
- A61B 5/087: Measuring breath flow
- A61B 5/7267: {involving training the classification device}
- A61B 5/145: Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value {; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue} (non-radiation detecting or locating of foreign bodies in blood A61B5/06)
- A61B 5/7232: {involving compression of the physiological signal, e.g. to extend the signal recording period}
- A61B 5/726: {using Wavelet transforms}
- A61M 16/021: {operated by electrical means (A61M16/202 – A61M16/205 take precedence)}
- A61M 2230/40: Respiratory characteristics
- G16H 50/70: for mining of medical data, e.g. analysing previous cases of other patients
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A Cheyne-Stokes (CS) diagnosis system classifies periods of CS-like breathing by examining a signal indicative of a respiratory parameter. For example, nasal flow data is processed to classify it as unambiguously CS breathing or nearly so and to display the classification Processing may detect and display: apnoeas, hypopnoeas, flow-limitation and snore. The signal may be split into equal length epochs and event features are extracted. Statistics are applied to these primary feature(s) to produce secondary feature(s) representing the entire epoch. Each secondary feature is grouped with other feature(s) extracted from the entire epoch rather than from the epoch events. This final group of features is the epoch pattern. The epoch pattern is classified to produce a probability for possible event classes (e.g., Cheyne-Stokes breathing, OSA, etc.). The epoch is assigned to the class with the highest probability, which may both be reported as an indication of disease state.

## Claims

### Claim 1

A method for a controlled ventilatory apparatus to automatically determine an absence or a presence of Cheyne-Stokes breathing in a person, the method comprising:
accessing, with one or more processors, a signal indicative of respiration of a person derived from a sensor;
detecting, with the one or more processors, a plurality of events from the signal, wherein each one of the detected events comprises an apnea or a hypopnea, followed by a hyperpnoea;
deriving, with the one or more processors, a jump feature for each one of the detected events, wherein the deriving comprises calculating, for each one of the detected events, a maximum increase from multiple increases of the respective hyperpnoea, and wherein each one of the multiple increases is determined from a predetermined time interval in a period of the respective hyperpnoea between its beginning and its maximum;
determining, with the one or more processors, a peak in a frequency spectrum of the signal;
determining, with the one or more processors and a trained classifier, the absence of Cheyne-Stokes breathing based on a first jump feature of the plurality of derived jump features, wherein the trained classifier is of a supervised machine learning type, and wherein the trained classifier was provided with a data set during training that comprised a plurality of jump features and corresponding diagnoses;
determining, with the one or more processors and the trained classifier, the presence of Cheyne-Stokes breathing based on a combination of the peak in the frequency spectrum and a second jump feature of the plurality of derived jump features, wherein the first jump feature is greater than the second jump feature such that the first jump feature characterizes a hyperpnoea typical of obstructive sleep apnea and the second jump feature characterizes a hyperpnoea typical of Cheyne-Stokes breathing; and
issuing a report based on probability of an epoch being assigned to a class based on the determined absence or presence of Cheyne-Stokes breathing.

### Claim 2 (depends on 1)

The method of claim 1, wherein the signal indicative of respiration is a ventilation signal.

### Claim 3 (depends on 2)

The method of claim 2 further comprising processing, with the one or more processors, the ventilation signal to derive an envelope of the ventilation signal during a hyperpnoea of one of the detected events.

### Claim 4 (depends on 3)

The method of claim 3, wherein the envelope is derived by a droopy-peak detector.

### Claim 5 (depends on 4)

The method of claim 4 further comprising interpolating, with the one or more processors, the envelope.

### Claim 6 (depends on 5)

The method of claim 5, wherein at least one of the plurality of jump features is derived from the envelope.

### Claim 7 (depends on 3)

The method of claim 3, wherein deriving the jump feature for each one of the detected events further comprises scaling the respective maximum increase by a mean value of the ventilation signal.

### Claim 8 (depends on 2)

The method of claim 2, wherein the ventilation signal is an absolute value of a nasal flow signal.

### Claim 9 (depends on 1)

The method of claim 1, wherein the signal indicative of respiration comprises oxygen saturation.

### Claim 10 (depends on 1)

The method of claim 1, wherein determining the peak in the frequency spectrum of the signal comprises calculating a spectrogram of the signal and determining the peak from the spectrogram.

### Claim 11 (depends on 1)

The method of claim 1 further comprising determining, with the one or more processors, whether the peak is in a frequency range of 0 Hz to 0.075 Hz.

### Claim 12 (depends on 1)

The method of claim 1, wherein determining the peak in the frequency spectrum of the signal comprises calculating a Fourier transform of the signal.

### Claim 13 (depends on 1)

The method of claim 1 further comprising calculating, with the one or more processors, a shape of the signal and utilizing the shape as an indication of central apnea.

### Claim 14 (depends on 1)

The method of claim 1, wherein issuing the report comprises generating an output as a display on an epoch-by-epoch basis that represents the determined absence and/or presence of Cheyne-Stokes breathing.

### Claim 15 (depends on 1)

The method of claim 1, wherein the predetermined time interval is on an order of time of a breath.

### Claim 16 (depends on 1)

The method of claim 1, wherein the predetermined time interval is a two second time interval.

### Claim 17

A system for automatically detecting an absence or a presence of Cheyne-Stokes breathing in a person, the system comprising:
a sensor for sensing a signal indicative of respiration of a person; and
one or more processors configured to:
(a) determine a peak in a frequency spectrum of the signal;
(b) detect a plurality of events from the signal, wherein each one of the detected events comprises an apnea or a hypopnea followed by a hyperpnoea;
(c) derive a jump feature for each one of the detected events, wherein the deriving comprises calculating, for each one of the detected events, a maximum increase from multiple increases of the respective hyperpnoea, and wherein each one of the multiple increases is determined from a predetermined time interval in a period of the respective hyperpnoea between its beginning and its maximum;
(d) determine, with a trained classifier, the absence of Cheyne-Stokes breathing based on a first jump feature of the plurality of derived jump features, wherein the trained classifier is of a supervised machine learning type, and wherein the trained classifier was provided with a data set during training that comprised a plurality of jump features and corresponding diagnoses;
(e) determine, with the trained classifier, the presence of Cheyne-Stokes breathing based on a combination of the peak in the frequency spectrum and a second jump feature of the plurality of derived jump features, wherein the first jump feature is greater than the second jump feature such that the first jump feature characterizes a hyperpnoea typical of obstructive sleep apnea and the second jump feature characterizes a hyperpnoea typical of Cheyne-Stokes breathing; and
(f) issue a report based on probability of an epoch being assigned to a class based on the determined absence or presence of Cheyne-Stokes breathing.

### Claim 18 (depends on 17)

The system of claim 17, wherein the sensor is a respiratory pressure sensor, and wherein the signal indicative of respiration is a ventilation signal.

### Claim 19 (depends on 18)

The system of claim 18, wherein the one or more processers are further configured to process the ventilation signal to derive an envelope of the ventilation signal during a hyperpnoea of one of the detected events, and wherein at least one of the plurality of jump features is derived from the envelope.

### Claim 20 (depends on 18)

The system of claim 18, wherein deriving the jump feature for each of the detected events further comprises scaling the respective maximum increase by a mean value of the ventilation signal.

### Claim 21 (depends on 18)

The system of claim 18, wherein the ventilation signal is an absolute value of a nasal flow signal.

### Claim 22 (depends on 17)

The system of claim 17, wherein the sensor is a pulse oximeter, and wherein the signal indicative of respiration comprises oxygen saturation.

### Claim 23 (depends on 17)

The system of claim 17, wherein the predetermined time interval is on an order of time of a breath.

### Claim 24 (depends on 17)

The system of claim 17, wherein the predetermined time interval is a two second time interval.

### Claim 25 (depends on 17)

The system of claim 17, wherein the data set further comprised hypopnea lengths, hyperpnoea lengths, and shape features.

### Claim 26 (depends on 17)

The system of claim 17, wherein the trained classifier comprises a discriminant function that generates a probability estimate for a class representing presence of Cheyne-Stokes breathing and a class representing absence of Cheyne-Stokes breathing.

### Claim 27 (depends on 17)

The system of claim 17, wherein a portable device comprises the sensor, and wherein the sensor is a respiratory pressure sensor or a pulse oximeter.

### Claim 28 (depends on 27)

The system of claim 27, wherein issuing the report comprises generating an output a display on an epoch-by-epoch basis that represents the determined absence and/or presence of Cheyne-Stokes breathing.

### Claim 29 (depends on 27)

The system of claim 27, wherein the portable device further comprises a nasal cannula, and wherein the sensor is a respiratory pressure sensor.

### Claim 30 (depends on 27)

The system of claim 27, wherein the portable device is a hand-held device that is battery powered.