Autonomic arousal detection system and method

• US 20050076908A1
• Filed: 08/17/2004
• Published: 04/14/2005
• 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 8,606,356 B2
• Time in Patent Office: Days
• US Class Current: 128/204.230
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4806 Sleep evaluation A61B5/4821 takes precedence; devices for inducing sleep A61M21/02
• CPC Class Codes: A61B 5/4809 Sleep detection, i.e. determining whether a subject is asleep or not
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 Electroencephalographic signals
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585

Abstract

Various approaches to detecting arousals from sleep involve generating signals modulated by muscle tone, brainwave activity, and/or other nervous system activity associated with a patient'"'"'s autonomic arousal response. Generating the signals and/or detecting autonomic arousals from sleep may be performed using an implantable device. Arousal information may be useful to identify sleep disorder events associated with arousals from sleep, for diagnostic purposes, and/or for therapy adjustment.

Claims

1. A method for acquiring sleep information, comprising:

sensing one or more physiological conditions modulated by a patient'"'"'s autonomic arousal response; and

detecting autonomic arousal events occurring during sleep based on the one or more sensed physiological conditions, wherein at least one of sensing the physiological conditions and detecting the autonomic arousal events is performed at least in part implantably.

2. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing muscle tone; and

detecting the autonomic arousal events comprises detecting the autonomic arousal events based on the muscle tone.

3. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing heart rate; and

detecting the autonomic arousal events comprises;

determining heart rate variability based on the sensed heart rate; and

detecting the autonomic arousal events based on the heart rate variability.

4. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing sympathetic nerve activity; and

detecting the autonomic arousal events comprises detecting the autonomic arousal events based on the sensed sympathetic nerve activity.

5. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing transthoracic impedance; and

detecting the autonomic arousal events comprises detecting the autonomic arousal events based on the sensed transthoracic impedance.

6. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing at least one physiological condition that is modulated contemporaneously with an occurrence of an autonomic arousal event; and

detecting the autonomic arousal events comprises detecting the autonomic arousal event contemporaneously with the occurrence of the autonomic arousal event.

7. The method of claim 1, wherein:

sensing the one or more physiological conditions comprises sensing at least one physiological condition that is modulated by an aggregation of the autonomic arousal events occurring over time; and

detecting the autonomic arousal events comprises detecting the aggregation of autonomic arousal events occurring over time.

8. The method of claim 1, further comprising detecting a sleep disorder event based at least in part on the detected autonomic arousal events.

9. The method of claim 1, further comprising:

detecting sleep disorder events; and

determining if the detected autonomic arousal events are associated with the sleep disorder events.

10. The method of claim 9, wherein detecting the sleep disorder events comprises detecting disordered breathing events.

11. The method of claim 1, further comprising;

determining a trend of the autonomic arousal events; and

using the autonomic arousal event trend to diagnose a medical disorder.

12. The method of claim 1, further comprising:

delivering therapy to treat sleep disorder events; and

adjusting the therapy based on the autonomic arousal events.

13. The method of claim 12, wherein the therapy comprises a cardiac electrical stimulation therapy.

14. The method of claim 12, wherein the therapy comprises an external respiration therapy.

15. A medical system for detecting autonomic arousal events occurring during sleep, comprising:

one or more sensors configured to sense one or more physiological conditions associated with a patient'"'"'s autonomic arousal response; and

an implantable arousal detector coupled to the one or more sensors, the arousal detector configured to detect autonomic arousal events based on the one or more physiological conditions.

16. The system of claim 15, wherein:

the one or more sensors are configured to generate one or more signals respectively modulated by the one or more physiological conditions; and

the arousal detector is configured to determine a characteristic signature of at least one of the signals and to detect the autonomic arousal events based on the characteristic signature.

17. The system of claim 15, wherein;

the one or more sensors comprises an EEG sensor configured to sense brain wave activity; and

the arousal detector is configured to detect autonomic arousal events based on the brain wave activity.

18. The system of claim 15, wherein the one or more sensors comprises a cardiac sensor configured to sense cardiac electrical activity.

19. The system of claim 15, wherein:

the one or more sensors comprise an EMG sensor configured to sense muscle tone; and

the arousal detector is configured to detect the autonomic arousal events based on the muscle tone.

20. The system of claim 15, further comprising a sleep disorder event detector coupled to the arousal detector and configured to detect sleep disorder events based at least in part on the detected arousals from sleep.

21. The system of claim 15, further comprising:

a sleep disorder event detector configured to detect sleep disorder events; and

a processor coupled to the sleep disorder detector and the arousal detector, the processor configured to determine if the autonomic arousal events are associated with the sleep disorder events.

22. The system of claim 15, further comprising a processor coupled to the arousal detector and configured to determine a trend of the detected autonomic arousal events, wherein the processor is configured to determine a presence of a medical disorder based on the autonomic arousal events.

23. The system of claim 15, further comprising a display device configured to display information about the autonomic arousal events.

24. The system of claim 15, further comprising a memory configured to store information about the autonomic arousal events.

25. The system of claim 15, further comprising a communication system configured to transmit information about the autonomic arousal events.

26. The system of claim 15, further comprising a therapy unit configured to deliver therapy for a sleep disorder and adjust the therapy based on the autonomic arousal events.

27. The system of claim 26, wherein the therapy comprises cardiac electrical stimulation therapy.

28. The system of claim 26, wherein the therapy comprises external respiration therapy.

29. A system for acquiring sleep information, comprising:

means for sensing one or more physiological conditions modulated by a patient'"'"'s autonomic arousal response; and

means for detecting autonomic arousal events occurring during sleep based on the one or more sensed physiological conditions, wherein at least one of sensing the physiological conditions and detecting the autonomic arousal events is performed at least in part implantably.

30. The system of claim 29, further comprising:

means for detecting sleep disorder events; and

means for determining if the detected autonomic arousal events are associated with the sleep disorder events.

31. The system of claim 29, further comprising;

means for determining a trend of the autonomic arousal events; and

means for using the autonomic arousal event trend to diagnose a medical disorder.

32. The system of claim 29, further comprising:

means for delivering therapy to treat sleep disorder events; and

means for adjusting the therapy based on the autonomic arousal events.

33. The system of claim 29, further comprising:

means for detecting a sleep disorder event;

means for adjusting therapy to treat the sleep disorder event in response to detection of the sleep disorder event; and

means for adjusting the therapy in response to detection of an autonomic arousal event.