# US 2014/0150793 A1 · Mechanical ventilation in the presence of sleep disordered breathing > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0150793 A1 - Document ID: US20140150793A1 - Status: Published application - Kind: A1 - Application number: 14/176,677 - Filed: 2014-02-10 - Published: 2014-06-05 - Earliest claimed: 2007-03-14 - Assignees: ResMed Limited - Applicants: ResMed Limited - Inventors: Robert Douglas; Anthony John Ujhazy; Glenn Richards; Mark David Buckley; Klaus Henry Schindhelm - Web page: https://patentgrep.com/patent/US20140150793A1 ## CPC - A61M 16/0051: {with alarm devices} - A61B 5/4818: {Sleep apnoea} - A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)} - A61M 16/0066: {Blowers or centrifugal pumps} - A61M 16/0069: {the speed thereof being controlled by respiratory parameters, e.g. by inhalation} - A61M 16/024: {including calculation means, e.g. using a processor} - A61M 16/06: Respiratory or anaesthetic masks - A61M 16/0875: {Connecting tubes} - A61M 2016/0021: {with a proportional output signal, e.g. from a thermistor} - A61M 2016/0027: {pressure meter} - A61M 2016/0039: {in the inspiratory circuit} - A61M 2205/15: Detection of leaks - 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)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A method for controlling operation of a CPAP apparatus. The apparatus has a blower, a patient interface, an air delivery conduit for delivering air from the blower to the patient interface, a sensor for determining the pressure in the patient interface, and a control mechanism that causes air to be delivered at a desired pressure to the patient interface and that detects transitions between inhalation and exhalation of a respiratory cycle of a patient in order to synchronise the blower output with the patient's efforts. In one form the CPAP apparatus provides pressure in accordance with a bi-level waveform with at least one characterising parameter of the waveform being automatically adjusted in accordance with indications of sleep disordered breathing. The indications of sleep disordered breathing can be one or more of snoring, apnea, hypopnea, and flow limitation. ## Claims ### Claim at position 1 1-30. (canceled) ### Claim 31 A method for treating sleep disordered breathing with a ventilatory device; said device including a controller, a blower, a patient interface, and a flow sensor; comprising the steps of: sensing leaks from the patient interface, the flow of air to the patient through the patient interface, and transitions between inspiration and expiration of the patient's breathing cycle with said flow sensor; detecting the pressure in the patient interface with said controller, determining with said controller the presence of a first event and a second event based upon detected information, the first and second events being different indications of sleep disordered breathing; and setting with said controller a first pressure as a function of the occurrence of the first event and adjusted for any leak, and setting a second pressure as a function of the occurrence of the second event and adjusted for any leak, the first pressure being used to determine the treatment pressure provided during the expiratory phase of the patient's breathing cycle and the second pressure being used to determine the treatment pressure provided during the inspiratory phase of the patient's breathing cycle. ### Claim 32 (depends on 31) The method of claim 31 wherein said first event indicative of the presence of sleep disordered breathing is one or more of apnea, hypopnea and snoring. ### Claim 33 (depends on 31) The method of claim 31 wherein said second event indicative of the presence of sleep disordered breathing is a flow limitation. ### Claim 34 (depends on 31) The method of claim 31 wherein said first pressure is an EPAP or EEP pressure. ### Claim 35 (depends on 31) The method of claim 31 wherein said second pressure is an IPAP pressure. ### Claim 36 (depends on 31) The method of claim 31 wherein said second pressure is greater than or equal to the first pressure. ### Claim 37 (depends on 36) The method of claim 36 wherein there is a predetermined maximum pressure difference between said first pressure and said second pressure. ### Claim 38 (depends on 36) The method of claim 36 wherein said first pressure and said second pressure have a maximum value of about 25 cm H2O. ### Claim 39 (depends on 31) The method of claim 31 wherein said first pressure has a minimum value of about 4 cm H2O. ### Claim 40 (depends on 31) The method of claim 31 wherein said controller causes said blower to provide the supply of air at positive pressure in accordance with a pressure-time template. ### Claim 41 (depends on 40) The method of claim 40 wherein said pressure-time template is a square wave. ### Claim 42 (depends on 40) The method of claim 40 wherein said pressure-time template is a shark-fin wave. ### Claim 43 (depends on 40) The method of claim 40 wherein said pressure-time template is stored in look-up tables or arrays. ### Claim 44 (depends on 31) The method of claim 31 wherein said controller further causes the blower to decrease the first pressure in the absence of the detection of first events. ### Claim 45 (depends on 31) The method of claim 31 wherein said controller further causes the blower to decrease the second pressure in the absence of the detection of second events. ### Claim 46 An apparatus adapted for treatment of sleep disordered breathing comprising: a blower for providing to a patient a supply of air at a treatment pressure in phase with the patient's respiratory breathing cycle, the respiratory breathing cycle including an expiratory phase and an inspiratory phase; a patient interface, an air delivery conduit for delivering air from the blower to the patient interface, and a controller for detecting the pressure in the patient interface, leaks from the patient interface, the flow of air to the patient through the patient interface, and transitions between inspiration and expiration of the patient's breathing cycle; said controller further determining the presence of a first event and a second event based upon detected information, the first and second events being different indications of sleep disordered breathing; and setting a first pressure as a function of the occurrence of the first event and adjusted for any leak, and setting a second pressure as a function of the occurrence of the second event and adjusted for any leak, the first pressure being used to determine the treatment pressure provided during the expiratory phase of the patient's breathing cycle and the second pressure being used to determine the treatment pressure provided during the inspiratory phase of the patient's breathing cycle. ### Claim 47 (depends on 46) The apparatus of claim 46 wherein the first event indicative of the presence of sleep disordered breathing is one or more of apnea, hypopnea and snoring. ### Claim 48 (depends on 46) The apparatus of claim 46 wherein the second event indicative of the presence of sleep disordered breathing is flow limitation. ### Claim 49 (depends on 46) The apparatus of claim 46 wherein the first pressure is an EPAP or EEP pressure. ### Claim 50 (depends on 46) The apparatus of claim 46 wherein the second pressure is an IPAP pressure. ### Claim 51 (depends on 46) The apparatus of claim 46 wherein the second pressure is greater than or equal to the first pressure. ### Claim 52 (depends on 51) The apparatus of claim 51 wherein there is a predetermined maximum pressure difference between the first pressure and the second pressure. ### Claim 53 (depends on 51) The apparatus of claim 51 wherein the first pressure and the second pressure have a maximum value of about 25 cm H2O. ### Claim 54 (depends on 46) The apparatus of claim 46 wherein the first pressure has a minimum value of about 4 cm H2O. ### Claim 55 (depends on 46) The apparatus of claim 46 wherein the controller causes the blower to provide the supply of air at positive pressure in accordance with a pressure-time template. ### Claim 56 (depends on 55) The apparatus of claim 55 wherein the pressure-time template is a square wave. ### Claim 57 (depends on 55) The apparatus of claim 55 wherein the pressure-time template is a shark-fin wave. ### Claim 58 (depends on 55) The apparatus of claim 55 wherein the pressure-time template is stored in look-up tables or arrays. ### Claim 59 (depends on 46) The apparatus of claim 46 wherein the controller further causes the blower to decrease the first pressure in the absence of the detection of first events. ### Claim 60 (depends on 46) The apparatus of claim 46 wherein the controller further causes the blower to decrease the second pressure in the absence of the detection of second events.