Implantable device employing movement sensing for detecting sleep-related disorders

• US 20050113710A1
• Filed: 09/13/2004
• Published: 05/26/2005
• 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 7,887,493 B2
• Time in Patent Office: Days
• US Class Current: 600/534
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/10 Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• 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: A61M 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration

Abstract

Methods and systems for evaluating a pathological condition include acquiring movement information, such as electromyogram (EMG) information, and sleep disordered breathing (SDB) information, and detecting the presence of a pathological condition using both movement and SDB information. Methods may involve sensing physiological signals including at least muscle movement signals. Sleep-related disorders are detected using the sensed physiological signals, the sleep-related disorders including at least an involuntary muscle movement disorder and sleep-disordered breathing. Methods and systems also provide for detecting and treating a sleep-related disorder using movement and SDB information. Cardiac, respiratory, nerve stimulation, drug, or a combination of such therapies may be delivered to treat a detected or diagnosed pathological condition.

Claims

1. A method of detecting sleep-related disorders, comprising:

sensing a plurality of physiological signals including at least muscle movement signals; and

detecting the sleep-related disorders using the sensed physiological signals, the sleep-related disorders comprising at least an involuntary muscle movement disorder and sleep-disordered breathing, wherein at least one of sensing and detecting is performed at least in part patient-internally.

2. The method of claim 1, wherein sensing the physiological signals is performed at least in part patient-internally, and detecting the sleep-related disorders is performed patient-externally.

3. The method of claim 1, wherein sensing the physiological signals is performed patient-externally, and detecting the sleep-related disorders is performed at least in part patient-internally.

4. The method of claim 1, wherein sensing and detecting are performed at least in part patient-internally.

5. The method of claim 1, wherein detecting the sleep-related disorders comprises:

detecting a first sleep-related disorder patient-internally; and

detecting a second sleep-related disorder patient-externally.

6. The method of claim 1, wherein at least some of the physiological signals comprise electromyogram signals.

7. The method of claim 6, wherein at least some of the electromyogram signals are sensed from one or more intramuscular locations.

8. The method of claim 1, wherein at least some of the physiological signals comprise transthoracic impedance signals.

9. The method of claim 1, further comprising detecting one or more sleep stages using the muscle movement signals.

10. The method of claim 1, wherein the sleep-disordered breathing comprises one or more of sleep apnea, hypopnea, and Cheyne-Stokes respiration.

11. The method of claim 1, wherein the involuntary muscle movement disorder comprises one or more of a condition associated with bruxism, a condition associated with periodic limb movement disorder, and a condition associated with restless leg syndrome.

12. The method of claim 1, further comprising communicating one or both of the physiological signals and information associated with the detected sleep-related disorders to a patient-external processing system.

13. The method of claim 1, further comprising communicating one or both of the physiological signals and information associated with the detected sleep-related disorders to an implantable medical device.

14. The method of claim 1, further comprising at least one of controlling and delivering a respiratory therapy to treat one or more of the detected sleep-related disorders.

15. The method of claim 1, further comprising at least one of controlling and delivering a cardiac pacing therapy to treat one or more of the detected sleep-related disorders.

16. The method of claim 1, further comprising at least one of controlling and delivering a drug therapy to treat one or more of the detected sleep-related disorders.

17. The method of claim 1, further comprising:

detecting onset and offset of sleep; and

detecting presence of a sleep-related disorder based at least in part on the detected onset and offset of sleep.

18. The method of claim 1, wherein information associated with the detected sleep-related disorders is at least one of stored, trended, communicated, displayed, or printed.

32. The system of claim 18, wherein the one or more movement sensors comprise one or more electromyogram (EMG) sensors.

19. A system for detecting sleep-related disorders, comprising:

one or more movement sensors configured for sensing movement of skeletal musculature;

a sleep-disordered breathing (SDB) sensor configured to sense a parameter associated with sleep-disordered breathing; and

a processor communicatively coupled to the one or more movement sensors and the SDB sensor, the processor detecting sleep-disordered breathing based on the sensed parameter and detecting an involuntary muscle movement disorder using signals produced by the one or more movement sensors.

20. The system of claim 19, wherein the processor is disposed in an implantable housing.

21. The system of claim 19, wherein the processor is disposed in a patient-external system.

22. The system of claim 19, wherein the processor is a networked processor.

23. The system of claim 19, wherein the processor is a component of an implantable cardiac rhythm management system.

24. The system of claim 19, wherein the processor is a component of a positive airway pressure device.

25. The system of claim 19, further comprising a sleep detector communicatively coupled to the processor.

26. The system of claim 19, wherein the sleep-disordered breathing comprises one or more of sleep apnea, hypopnea, and Cheyne-Stokes respiration.

27. The system of claim 19, wherein the involuntary muscle movement disorder comprises one or more of bruxism, periodic limb movement disorder, and restless leg syndrome.

28. The system of claim 19, further comprising an implantable cardiac rhythm management system configured to treat the sleep-disordered breathing.

29. The system of claim 19, further comprising a positive airway pressure device configured to treat the sleep-disordered breathing.

30. The system of claim 19, further comprising a drug delivery device configured to treat the involuntary muscle movement disorder.

31. The system of claim 19, further comprising a transcutaneous electric nerve stimulation therapy device configured to treat the involuntary muscle movement disorder.

33. A system for detecting sleep-related disorders, comprising:

means for sensing a plurality of physiological signals including at least muscle movement signals;

means for detecting an involuntary muscle movement disorder using the muscle movement signals; and

means for detecting sleep-disordered breathing using at least some of the sensed physiological signals, wherein at least one of the sensing means and respective detecting means comprises an implantable component.