Stimulation device for sleep apnea prevention, detection and treatment

• US 20030153953A1
• Filed: 02/14/2002
• Published: 08/14/2003
• Est. Priority Date: 02/14/2002
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Koh, Steve, Bornzin, Gene A., Park, Euljoon
• Granted Patent: US 6,928,324 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

An implantable cardiac stimulation device comprises a metabolic demand sensor, an activity sensor, and one or more pulse generators. The metabolic demand sensor and activity sensor can sense metabolic demand and physical activity parameters, respectively. The pulse generators can generate cardiac pacing pulses with timing based on a comparison of the metabolic demand and physical activity parameters. The timed cardiac pacing pulses can prevent a sleep apnea condition.

Claims

1. An implantable cardiac stimulation device for implantation in a body comprising:

a metabolic demand sensor that is capable of sensing a parameter indicative of the body'"'"'s metabolic demand;

an activity sensor that is capable of sensing a parameter indicative of physical activity of the body;

circuitry connected to the respective sensors and that is operative to process signals from the respective sensors to detect a potential sleep apnea condition; and

one or more pulse generators that are capable of generating cardiac pacing pulses, wherein the circuitry is responsive to detection of a potential sleep apnea condition to control the one or more pulse generators according to a sleep apnea prevention pacing mode.

2. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that detects a sleep condition and controls the one or more pulse generators to generate pacing pulses with a timing based on the on the comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter that is capable of preventing a sleep apnea condition.

3. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that detects a sleep condition upon a determination that the metabolic demand-indicative parameter and the physical activity-indicative parameter are at low resting levels and detects a sleep apnea condition upon a determination that the metabolic demand-indicative parameter diverges to a lower level relative to the physical activity-indicative parameter.

4. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that detects a sleep apnea condition and controls the one or more pulse generators with a timing based on one or more of the metabolic demand-indicative parameter and the physical activity-indicative parameter that is capable of treating the detected sleep apnea condition.

5. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that distinguishes between a sleeping condition and a waking condition of a patient, and controls the one or more pulse generators to generate pacing pulses with a timing based on the on the comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter that is capable of preventing sleep apnea.

6. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that controls the one or more pulse generators to pace at a rate selected from among at least a sleeping rate, a resting rate, and an exercising rate, the executable control logic being capable of distinguishing between a sleeping condition and a waking condition based on comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter, and controlling the one or more pulse generators to pace at a rate greater than the resting rate in response to detection of a sleeping condition.

7. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that detects a sleep apnea condition based on one or more of the metabolic demand-indicative parameter and the physical activity-indicative parameter;

and

a neurostimulator that is capable of coupling to respiratory muscles of the body'"'"'s upper airways or diaphragm and generating neurostimulation pulses terminating a sleep apnea condition.

8. An implantable cardiac stimulation device according to claim 1 wherein the circuitry comprises a controller coupled to the one or more pulse generators and to the metabolic demand and activity sensors, the controller including an executable control logic that detects a sleep apnea condition based on one or more of the metabolic demand-indicative parameter and the physical activity-indicative parameter, and controls the one or more pulse generators to generate cardiac pulses with a timing that tends to terminate the detected sleep apnea condition;

and

a neurostimulator that is capable of coupling to respiratory muscles of the body'"'"'s upper airways or diaphragm and generating neurostimulation pulses for terminating a sleep apnea condition if the generation of cardiac pulses fails to terminate the sleep apnea condition.

9. An implantable cardiac stimulation device according to claim 1 further comprising:

a transthoracic impedance sensor that is capable of sensing a respiration parameter and functioning as the metabolic demand sensor; and

an accelerometer that is capable of sensing a physical activity parameter and functioning as the activity sensor.

10. An implantable cardiac stimulation device according to claim 1 further comprising:

a physiological sensor that measures blood oxygen concentration and wherein the circuitry activates sleep apnea preventive pacing when blood oxygen concentration is depressed during sleep.

11. An implantable cardiac stimulation device according to claim 1 further comprising:

a physiological sensor that measures blood carbon dioxide concentration and wherein the circuitry activates sleep apnea preventive pacing when blood carbon dioxide concentration is elevated during sleep.

12. An implantable cardiac stimulation device for implantation in a body comprising:

a metabolic demand sensor that is capable of sensing a parameter indicative of the body'"'"'s metabolic demand;

an activity sensor that is capable of sensing a parameter indicative of physical activity of the body;

one or more pulse generators that are capable of generating cardiac pacing pulses with a timing based on a comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter, the timed cardiac pacing pulses for treating a first level of sleep apnea; and

a neurostimulator that is capable of coupling to respiratory muscles of the body'"'"'s upper airways or diaphragm and generating neurostimulation pulses treating a second level of sleep apnea.

13. An implantable cardiac stimulation device according to claim 12 further comprising:

a controller coupled to the one or more pulse generators, the metabolic demand and activity sensors, and the neurostimulator, the controller including an executable control logic that detects a sleep condition and a sleep apnea condition based on one or more of the metabolic demand-indicative parameter and the physical activity-indicative parameter.

14. An implantable cardiac stimulation device according to claim 12 further comprising:

a controller coupled to the one or more pulse generators, the metabolic demand and activity sensors, and the neurostimulator, the controller including an executable control logic that distinguishes between a sleeping condition, a waking condition, and a sleep apnea condition of a patient, and controls the one or more pulse generators to generate pacing pulses with a timing based on the on the comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter that is capable of treating the sleep apnea condition.

15. An implantable cardiac stimulation device according to claim 12 further comprising:

a controller coupled to the one or more pulse generators, the metabolic demand and activity sensors, and the neurostimulator, the controller including an executable control logic that controls the one or more pulse generators to pace at a rate selected from among at least a sleeping rate, a resting rate, and an exercising rate, the executable control logic being capable of distinguishing between a sleeping condition, a waking condition, and a sleep apnea condition based on comparative analysis of the metabolic demand-indicative parameter and the physical activity-indicative parameter, and controlling the one or more pulse generators to pace at a rate greater than the resting rate in response to detection of a sleeping condition and a further increased rate in response to detection of a sleep apnea condition.

16. An implantable cardiac stimulation device according to claim 12 further comprising:

a transthoracic impedance sensor that is capable of sensing a respiration parameter and functioning as the metabolic demand sensor; and

an accelerometer of piezoelectric crystal sensor that is capable of sensing a physical activity parameter and functioning as the activity sensor.

17. A method of operating an implantable cardiac stimulation device comprising:

generating cardiac pacing pulses at a predetermined rate;

sensing a parameter indicative of a body'"'"'s metabolic demand;

sensing a parameter indicative of physical activity of the body;

analyzing a plurality of sensed metabolic demand parameters and a plurality of sensed physical activity parameters to determine if a potential sleep apnea condition exists; and

controlling the cardiac pacing pulses according to a sleep apnea prevention mode to prevent sleep apnea when a potential sleep apnea condition is detected.

18. A method according to claim 17 further comprising:

analyzing a sequence of sensed metabolic demand parameters in comparison with a sequence of sensed physical activity parameters to determine a sleep condition.

19. A method according to claim 17 further comprising:

analyzing a sequence of sensed metabolic demand parameters in comparison with a sequence of sensed physical activity parameters to determine a sleep apnea condition.

20. A method according to claim 17 further comprising:

detecting a sleep condition upon a determination that the metabolic demand-indicative parameter and the physical activity-indicative parameter are at low resting levels.

21. A method according to claim 17 further comprising:

detecting a sleep apnea condition upon a determination that the metabolic demand-indicative parameter diverges to a lower level relative to the physical activity-indicative parameter.

22. A method according to claim 17 further comprising:

generating neurostimulation pulses in the body'"'"'s upper airways or diaphragm for terminating a sleep apnea condition.

23. An implantable cardiac stimulation device comprising:

means for sensing a parameter indicative of the body'"'"'s metabolic demand;

means for sensing a parameter indicative of physical activity of the body;

means for generating cardiac pacing pulses; and

means for determining a potential sleep apnea condition based on the respective means for sensing; and

means for controlling the means for generating according to a sleep apnea prevention mode when the a potential sleep apnea condition is detected.

24. An implantable cardiac stimulation device according to claim 23 further comprising:

means for detecting a sleep condition upon a determination that the metabolic demand-indicative parameter and the physical activity-indicative parameter are at low resting levels.

25. An implantable cardiac stimulation device according to claim 23 further comprising:

means for detecting a sleep apnea condition upon a determination that the metabolic demand-indicative parameter diverges to a lower level relative to the physical activity-indicative parameter.

26. An implantable cardiac stimulation device according to claim 23 further comprising:

means for generating neurostimulation pulses in the body'"'"'s upper airways or diaphragm for treating a sleep apnea condition.