Neuromodulation device

An apparatus for modulating neural activity of at least one of a CSC, SCG or postganglionic branch of a subject, the apparatus comprising:

• at least two neural interfacing elements comprising one or more transducers, each neural interfacing element configured to apply an independently selected signal, wherein one of the at least two neural interfacing elements is configured to be in signaling contact with at least one of a left cervical sympathetic chain (CSC), a left superior cervical ganglion (SCG) or postganglionic branch thereof to induce change in a first parameter associated with sleep apnea, and wherein the other one of the at least two neural interfacing elements is configured to be in signaling contact with at least one of a right cervical sympathetic chain (CSC), a right superior cervical ganglion (SCG) or postganglionic branch thereof to induce change in a second parameter associated with sleep apnea that is different from the first parameter;
• and
• a controller operably coupled to the at least two neural interfacing elements to provide differential stimulation, the controller controlling the signals to be applied by each of the at least two neural interfacing elements, such that the signals applied by the at least one neural interfacing element stimulates increased localized sympathetic activity in at least one of the CSC, SCG or postganglionic branch in the subject, and wherein the signals cause improvements in the first parameter and the second parameter.

A method for increasing sympathetic activity of a subject comprising:

• applying to the subject at least a portion of an apparatus for modulating (a) the neural activity of at least one of a left CSC, a left SCG or postganglionic branch of the subject or (b) the neural activity of at least one of a right CSC, a right SCG or postganglionic branch of the subject, the apparatus comprising:
• i. at least two neural interfacing elements for providing differential stimulation, each neural interfacing element comprising one or more transducers, wherein one of the at least two neural interfacing elements is configured to apply a signal to at least one of the left CSC, the left SCG or postganglionic branch thereof of the subject and is placed in signaling contact with at least one of the left CSC, the left SCG or postganglionic branch thereof to induce a change in a first parameter associated with sleep apnea, and further wherein the other one of the at least two neural interfacing elements is configured to apply a selected signal to at least one of a right CSC, a right SCG or postganglionic branch thereof and is placed in signaling contact with at least one of a right CSC, the right SCG or postganglionic branch thereof to induce a change in a second parameter associated with sleep apnea;
• and
• ii. a controller operably coupled to the at least two neural interfacing elements, the controller controlling the signals to be applied by each of the at least two neural interfacing elements, such that at least one neural interfacing element stimulates increased localized sympathetic activity;
• positioning one of the at least two neural interfacing elements of the apparatus in signaling contact with at least one of the left CSC, left SCG or postganglionic branch thereof of the subject;
• positioning one of the at least two neural interfacing elements neural interfacing elements of the apparatus in signaling contact with at least one of the right CSC, right SCG or postganglionic branch thereof of the subject;
• and
• activating the apparatus to cause an improvement in at least two of the following:
• a decrease in duration of apneic episodes, a decrease in frequency of apneic episodes, a decrease in blood pressure, a decrease in respiratory rate, an increase in tidal volume, a decrease in upper airway resistance, an increase in diaphragmatic muscle activity, an increase in genioglossus muscle activity, and an increase in central respiratory drive.