Feedback system and method for sleep disordered breathing therapy

• US 20050061315A1
• Filed: 06/09/2004
• Published: 03/24/2005
• Est. Priority Date: 09/18/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Granted Patent: US 7,469,697 B2
• Time in Patent Office: Days
• US Class Current: 128/200.240
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/50 Temperature
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity

Abstract

Methods and systems involve monitoring one or more patient conditions using a monitoring device that is fully or partially implantable. Feedback information is developed based on the monitored conditions and is provided to a device delivering therapy to treat sleep disordered breathing. Components of the monitoring device are disposed within an implantable housing that is separate from the housing of the therapy device. The therapy device may comprise a housing that is implantable or patient-external. The feedback information may be used to adjust the sleep disordered breathing therapy.

Claims

7-1. The method of claim 1, wherein monitoring the one or more patient conditions comprises monitoring heart rate.

31. A method, comprising:

monitoring one or more patient conditions using a monitoring device having circuitry disposed within an implantable housing;

developing feedback information for controlling sleep disordered breathing therapy based on the one or more monitored conditions;

providing the feedback information to a device delivering therapy to treat sleep disordered breathing, wherein a housing of the therapy device is separate from the implantable housing of the monitoring device; and

adjusting the sleep disordered breathing therapy using the feedback information.

32. The method of claim 31, wherein:

providing the feedback information to the device delivering therapy to treat the sleep disordered breathing comprises providing the feedback information to a nerve stimulation device delivering nerve stimulation therapy to treat the sleep disordered breathing; and

adjusting the sleep disordered breathing therapy using the feedback information comprises adjusting the nerve stimulation therapy.

33. The method of claim 31, wherein:

providing the feedback information to the device delivering therapy to treat the sleep disordered breathing comprises providing the feedback information to a muscle stimulation device delivering muscle stimulation therapy to treat the sleep disordered breathing; and

adjusting the sleep disordered breathing therapy using the feedback information comprises adjusting the muscle stimulation therapy.

34. The method of claim 31, wherein:

providing the feedback information to the device delivering therapy to treat the sleep disordered breathing comprises providing the feedback information to a drug delivery device delivering drug therapy to treat the sleep disordered breathing; and

adjusting the sleep disordered breathing therapy using the feedback information comprises adjusting the drug therapy.

35. The method of claim 31, wherein:

providing the feedback information to the device delivering therapy to treat the sleep disordered breathing comprises providing the feedback information to a respiratory therapy device delivering a patient-external respiration therapy to treat the sleep disordered breathing; and

adjusting the sleep disordered breathing therapy using the feedback information comprises adjusting the patient-external respiration therapy.

36. The method of claim 31, wherein:

providing the feedback information to the device delivering therapy to treat the sleep disordered breathing comprises providing the feedback information to a cardiac device delivering cardiac stimulation therapy to treat the sleep disordered breathing; and

adjusting the sleep disordered breathing therapy using the feedback information comprises adjusting the cardiac stimulation therapy.

37. The method of claim 31, wherein adjusting the sleep disordered breathing therapy comprises manually adjusting the sleep disordered breathing therapy.

38. The method of claim 31, wherein adjusting the sleep disordered breathing therapy comprises automatically adjusting the sleep disordered breathing therapy.

39. A medical system, comprising:

a monitoring unit having components disposed within an implantable housing, the monitoring unit configured to monitor one or more patient conditions;

a processor coupled to the monitoring unit and configured to provide feedback information related to sleep disordered breathing therapy delivered to a patient based on the one or more monitored conditions, wherein components of a therapy device delivering the disordered breathing therapy are disposed within a therapy device housing and the therapy device housing is separate from the implantable housing of the monitoring device.

40. The medical system of claim 39, wherein the monitoring unit is configured to monitor a physiological condition.

41. The medical device of claim 39, wherein the monitoring unit is configured to monitor a respiratory system condition.

42. The medical device of claim 39, wherein the monitoring unit is configured to monitor respiration patterns.

43. The medical device of claim 39, wherein the monitoring unit is configured to monitor a cardiovascular system condition.

44. The medical device of claim 39, wherein the monitoring unit is configured to monitor a cardiopulmonary condition.

45. The medical device of claim 39, wherein the monitoring unit is configured to monitor heart rate.

46. The medical device of claim 39, wherein the monitoring unit is configured to monitor a nervous system condition.

47. The medical device of claim 39, wherein the monitoring unit is configured to monitor a blood chemistry condition.

48. The medical device of claim 39, wherein the monitoring unit is configured to monitor blood pressure.

49. The medical device of claim 39, wherein the monitoring unit is configured to monitor a non-physiological condition.

50. The medical device of claim 39, wherein the monitoring unit is configured to monitor a contextual condition.

51. The medical device of claim 39, wherein the monitoring unit is configured to monitor an environmental condition.

52. The medical device of claim 39, wherein the monitoring unit further comprises a memory configured to store information associated with the one or more patient conditions.

53. The medical device of claim 39, wherein the monitoring unit further comprises a sleep detector, the sleep detector configured to detect sleep based on the one or more monitored conditions and the processor is configured to develop the feedback information based on the detection of sleep.

54. The medical device of claim 39, wherein the monitoring unit is configured to detect therapy interactions based on the one or more monitored conditions and the processor is configured to develop the feedback information based on the detected therapy interactions.

55. The medical device of claim 39, wherein the monitoring unit is configured to determine therapy effectiveness based on the one or more monitored conditions and the processor is configured to develop the feedback information based on the therapy effectiveness.

56. The medical device of claim 39, wherein the monitoring unit is configured determine an impact of the therapy on the patient based on the one or more monitored conditions and the processor is configured to develop the feedback information based on the therapy impact.

57. The medical device of claim 39, wherein the monitoring unit further comprises a disordered breathing detector configured to detect disordered breathing events based on the one or more patient conditions and to determine one or more characteristics of the disordered breathing events and the processor is configured to develop the feedback information based on the one or more characteristics of the disordered breathing events.

58. The medical device of claim 57, wherein the disordered breathing detector is configured to determine a severity of the disordered breathing events.

59. The medical device of claim 57, wherein the disordered breathing detector is configured to determine a frequency of the disordered breathing events.

60. The medical device of claim 57, wherein the disordered breathing detector is configured to determine a duration of the disordered breathing events.

61. The medical device of claim 39, wherein the monitoring unit is configured to calculate an apnea/hypopnea index and the processor is configured to develop the feedback information based on the apnea/hypopnea index.

62. The medical device of claim 39, wherein the monitoring unit is configured to determine trends of the one or more monitored conditions and the processor is configured to develop the feedback information based on the trends.

63. A medical system, comprising:

a monitoring unit having components disposed within an implantable housing, the monitoring unit configured to monitor one or more patient conditions;

a therapy device having components disposed within a housing that is separate from the implantable housing of the monitoring device, the therapy device configured to deliver sleep disordered breathing therapy; and

a processor coupled to the monitoring unit and the therapy device, the processor configured to provide feedback information related to the sleep disordered breathing therapy based on the one or more patient conditions.

64. The medical system of claim 63, further comprising a transmitter configured to transmit the feedback information from the processor to the therapy device.

65. The medical system of claim 63 wherein the processor is disposed within the implantable housing of the monitoring device.

66. The medical system of claim 63, wherein the therapy device is configured to use the feedback information to adjust the sleep disordered breathing therapy.

67. The medical system of claim 63, wherein the therapy device comprises a nerve stimulation device.

68. The medical system of claim 63, wherein the therapy device comprises a muscle stimulation device.

69. The medical system of claim 63, wherein the therapy device comprises a drug therapy device.

70. The medical system of claim 63, wherein the therapy device comprises a patient-external breathing therapy device.

71. The medical system of claim 63, wherein the therapy device comprises a cardiac stimulation device.

72. A system for controlling sleep disordered breathing therapy, comprising:

means for monitoring one or more patient conditions using a monitoring device having circuitry disposed within an implantable housing;

means for developing feedback information for controlling sleep disordered breathing therapy based on the one or more monitored conditions; and

means for providing the feedback information to a device delivering therapy to treat sleep disordered breathing, wherein a housing of the therapy device is separate from the implantable housing of the monitoring device.

73. The system of claim 72, further comprising:

means for detecting sleep disordered breathing events based on the one or more patient conditions;

means for determining one or more characteristics of the sleep disordered breathing events; and

means for developing the feedback information based on the one or more characteristics of the sleep disordered breathing events.

74. The system of claim 73, further comprising:

means for determining a severity of the; and

means for developing feedback information based on the severity of the sleep disordered breathing events.

75. A medical system, comprising:

means for monitoring one or more patient conditions using a monitoring device having circuitry disposed within an implantable housing;

means for developing feedback information for controlling sleep disordered breathing therapy based on the one or more monitored conditions;

means for providing the feedback information to a device delivering therapy to treat sleep disordered breathing, wherein a housing of the therapy device is separate from the implantable housing of the monitoring device; and

means for adjusting the sleep disordered breathing therapy using the feedback information.