Method and apparatus for synchronized treatment of obstructive sleep apnea
AssigneeMedtronic, Inc.
InventorDonald J. Erickson
Life of this patent
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Abstract
A method and device is provided for stimulation of an upper airway muscle of a patient to relieve an airway obstruction in which stimulation is synchronized with the inspiratory phase of the patient's respiratory cycle. A respiratory effort waveform of the patient is monitored for a changes in slope and amplitude of the respiratory effort waveform characteristic of the inspiratory phase. Stimulation is then commenced and concluded according to the detected inspiratory phase.
Claims96
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change in slope of the respiratory effort waveform characteristic of an inspiratory turn point and for a predetermined amplitude characteristic of an inspiratory turn point;
- (c) detecting an inspiratory turn point according to the monitored first change in slope or amplitude in step (b);
- and
- (d) commencing stimulation in response to the detected inspiratory turn point.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for n change in slope of the respiratory effort waveform characteristic of an inspiratory turn point and for a predetermined amplitude characteristic of an inspiratory turn point;
- (c) detecting an inspiratory turn point according to the monitored first change in slope or amplitude in step (b);
- and
- (d) commencing stimulation in response to the detected inspiratory turn point,
- wherein the change in slope is determined by the steps of:
- (1) determining a moving average slope for the respiratory effort waveform;
- (2) determining a current slope for the respiratory effort waveform;
- and
- (3) comparing the current slope with the moving average slope.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change in slope of the respiratory effort waveform characteristic of an inspiratory turn point and for a predetermined amplitude characteristic of an inspiratory turn point;
- (c) detecting an inspiratory turn point according to the monitored first change in slope or amplitude in step (b);
- and
- (d) commencing stimulation in response to the detected inspiratory turn point,
- wherein the predetermined amplitude characteristic of an inspiratory turn point is provided by the steps of:
- (1) determining an average peak-to-valley amplitude for the waveform;
- and
- (2) determining the predetermined amplitude as a function of the peak-to-valley amplitude.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change in slope of the respiratory effort waveform characteristic of an inspiratory turn point and for a predetermined amplitude characteristic of an inspiratory turn point;
- (c) detecting an inspiratory turn point according to the monitored first change in slope or amplitude in step (b);
- and
- (d) commencing stimulation in response to the detected inspiratory turn point,
- wherein the stimulation is commenced during a next respiratory cycle following detection of the inspiratory turn point by the steps of:
- (1) determining a representative respiratory cycle time for the patient;
- (2) determining when the inspiratory turn point is detected;
- (3) determining a time for commencement of stimulation as a function of the respiratory cycle time and when the inspiratory turn point is detected.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a signal characteristic of respiratory effort of the patient;
- (b) sampling the signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) determining a moving average slope for the respiratory effort waveform;
- (d) determining a current slope for the respiratory effort waveform;
- (e) comparing the current slope with the moving average slope to detect the inspiratory phase;
- and
- (f) commencing and concluding stimulation of the upper airway muscle according to the detected inspiratory phase.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change characteristic of an inspiratory turn point;
- (c) commencing stimulation in response a detected inspiratory turn point;
- (d) monitoring elapsed time since detection of the inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an inspiratory peak;
- (f) concluding stimulation upon the earlier of (1) detection of the inspiratory peak or (2) elapse of a predetermined period of time,
- wherein the step of monitoring the respiratory effort waveform for a change characteristic of an inspiratory turn point includes the steps of:
- (1) determining a moving average slope for the respiratory effort waveform;
- (2) determining a current slope for the respiratory effort waveform;
- and
- (3) comparing the current slope with the moving average slope.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change characteristic of an inspiratory turn point;
- (c) commencing stimulation in response a detected inspiratory turn point;
- (d) monitoring elapsed time since detection of the inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an inspiratory peak;
- (f) concluding stimulation upon the earlier of (1) detection of the inspiratory peak or (2) elapse of a predetermined period of time,
- wherein the stimulation is commenced during a next respiratory cycle following detection of the inspiratory turn point by the steps of:
- (1) determining a representative respiratory cycle time for the patient;
- (2) determining when the inspiratory turn point is detected;
- (3) determining a time for commencement of stimulation as a function of the respiratory cycle time and when the inspiratory turn point is detected.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change characteristic of an inspiratory turn point;
- (c) commencing stimulation in response a detected inspiratory turn point;
- (d) monitoring elapsed time since detection of the inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an inspiratory peak;
- (f) concluding stimulation upon the earlier of (1) detection of the inspiratory peak or (2) elapse of a predetermined period of time,
- wherein the inspiratory peak is determined by:
- (1) identifying when the moving average slope first becomes negative;
- (2) timing out a predetermined interval;
- and
- (3) determining whether the moving average slope is negative as the predetermined interval is concluded.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient for a change characteristic of an inspiratory point;
- (c) commencing stimulation in response a detected inspiratory turn point;
- (d) monitoring elapsed time since detection of the inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an inspiratory peak;
- (f) concluding stimulation upon the earlier of (1) detection of the inspiratory peak or (2) elapse of a predetermined period of time,
- wherein the predetermined period of time is in a range of about 1.5 to 3.5 seconds.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient;
- (c) detecting a change in the respiratory effort waveform characteristic of an inspiratory turn point;
- (d) commencing stimulation in response to the detected inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an artifact not characteristic of normal respiratory activity;
- and
- (f) suppressing stimulation upon detection of the artifact.
A method for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a respiratory effort waveform of the patient;
- (b) monitoring the respiratory effort waveform of the patient;
- (c) detecting a change in the respiratory effort waveform characteristic of an inspiratory turn point;
- (d) commencing stimulation in response to the detected inspiratory turn point;
- (e) monitoring the respiratory effort waveform for an artifact not characteristic of normal respiratory activity;
- (f) detecting an artifact in the waveform;
- and
- (g) suppressing stimulation upon detection of the artifact,
- wherein the inspiratory turn point is detected by the steps of:
- (1) determining a moving average slope for the respiratory effort waveform;
- (2) determining a current slope for the respiratory effort waveform;
- and
- (3) comparing the current slope with the moving average slope.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a signal characteristic of respiratory effort of the patient;
- (b) sampling the signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) determining a moving average slope for the respiratory effort waveform;
- (d) determining a current slope for the respiratory effort waveform;
- (e) comparing the current slope with the moving average slope to determine an inspiratory turn point by a current slope that is in a range of about 1.5 to 5 times the moving average slope;
- and
- (f) commencing stimulation of the upper airway muscle according to the detected inspiratory turn point.
A method for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, the method comprising the steps of:
- (a) providing a signal characteristic of respiratory effort of the patient;
- (b) sampling the sensed signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) determining highest and lowest amplitude values of the digitized waveform for a plurality of successive respiratory cycles;
- (d) determining a difference between highest and lowest amplitude values for each of the plurality of respiratory cycles;
- (e) determining an average of the plurality of amplitude value differences;
- (f) monitoring the respiratory effort waveform;
- (g) determining an amplitude trigger value as a function of the average amplitude difference;
- (h) detecting an inspiratory turn point by attainment of the amplitude trigger value in the monitored respiratory waveform;
- and
- (i) commencing stimulation in response to the detected inspiratory turn point.
A device for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, said device comprising:
- (a) slope monitoring means for monitoring a respiratory effort waveform of the patient for a change in slope of the respiratory effort waveform characteristic of an inspiratory turn point;
- (b) amplitude monitoring means for monitoring the respiratory effort waveform for a predetermined amplitude characteristic of an inspiratory turn point;
- (c) detecting means for detecting the first inspiratory turn point according to slope or amplitude criteria;
- and
- (d) stimulation means for commencing stimulation in response to the detected inspiratory turn point.
A device for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle, comprising:
- (a) sensing means for sensing a signal characteristic of respiratory effort of the patient;
- (b) sampling means for sampling the signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) slope average determining means for determining a moving average slope for the respiratory effort waveform;
- (d) slope determining means for determining a current slope for the respiratory effort waveform;
- (e) comparison means for comparing the current slope with the moving average slope;
- (f) phase detecting means for detecting the inspiratory phase according to the slope comparison;
- and
- (g) stimulation means for commencing and concluding stimulation of the upper airway muscle according to the detected inspiratory phase.
A device for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle comprising:
- (a) turn point monitoring means for monitoring a respiratory effort waveform of the patient for a change characteristic of an inspiratory turn point;
- (b) stimulation commencing means for commencing stimulation in response to a detected inspiratory turn point;
- (c) time monitoring means for monitoring elapsed time since detection of the inspiratory turn point;
- (d) peak monitoring means for monitoring the respiratory effort waveform for an inspiratory peak;
- (e) stimulation concluding means for concluding stimulation upon the earlier of (1) detection of the inspiratory peak or (2) elapse of a predetermined period of time.
A device for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle comprising:
- (a) waveform monitoring means for monitoring a respiratory effort waveform of the patient;
- (b) turn point detection means for detecting a change in the respiratory effort waveform characteristic of an inspiratory turn point;
- (c) stimulation commencement means for commencing stimulation in response to a detected inspiratory turn point;
- (d) artifact monitoring means for monitoring the respiratory effort waveform for an artifact not characteristic of normal respiratory activity;
- and
- (e) stimulation suppressing means for suppressing stimulation upon detection of the artifact.
A device for controlling stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle comprising:
- (a) waveform monitoring means for monitoring a respiratory effort waveform of the patient;
- (b) turn point detection means for detecting a change in the respiratory effort waveform characteristic of an inspiratory turn point;
- (c) stimulation commencement means for commencing stimulation in response to the detected inspiratory turn point;
- (d) artifact monitoring means for monitoring the respiratory effort waveform for an artifact not characteristic of normal respiratory activity;
- (e) artifact detecting means for detecting an artifact in the waveform;
- and
- (f) stimulation suppressing means for suppressing stimulation upon detection of the artifact,
- wherein the turn point detection means comprises:
- (1) average slope determining means for determining a moving average slope for the respiratory effort waveform;
- (2) current slope determining means for determining a current slope for the respiratory effort waveform;
- and
- (3) comparison means for comparing the current slope with the moving average slope.
A device for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle comprising:
- (a) sensing means for sensing a signal characteristic of respiratory effort of the patient;
- (b) sampling means for sampling the signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) average slope determining means for determining a moving average slope for the respiratory effort waveform;
- (d) current slope determining means for determining a current slope for the respiratory effort waveform;
- (e) turn point determining means for comparing the current slope with the moving average slope to determine an inspiratory turn point by a current slope that is in a range of about 1.5 to 5 times the moving average slope;
- and
- (g) stimulation commencement means for commencing stimulation of the upper airway muscle according to the detected inspiratory turn point.
A device for providing stimulation of an upper airway muscle of a patient to relieve an airway obstruction, said patient having a respiratory cycle with an inspiratory phase, said stimulation synchronized with the inspiratory phase of the patient's respiratory cycle comprising:
- (a) sensing means for sensing a signal characteristic of respiratory effort of the patient;
- (b) sampling means for sampling the sensed signal at a predetermined interval to provide a digitized respiratory effort waveform;
- (c) amplitude determining means for determining highest and lowest amplitude values of the digitized waveform for a plurality of successive respiratory cycles;
- (d) difference determining means for determining a difference between highest and lowest amplitude values for each of the plurality of respiratory cycles;
- (e) average determining means for determining an average of the plurality of amplitude value differences;
- (f) trigger value determining means for determining an amplitude trigger value as a function of the average amplitude difference;
- (g) turn point determining means for detecting an inspiratory turn point by attainment of the amplitude trigger value in the respiratory effort waveform;
- and
- (h) stimulation commencement means for commencing stimulation in response to the detected inspiratory turn point.
Dependencies are inferred from the claim text.