Device and method to treat flow limitations

• US 20080154330A1
• Filed: 12/21/2007
• Published: 06/26/2008
• Est. Priority Date: 12/22/2006
• Status: Active Grant

• Current Assignee: RMX, LLC (ASHINC Corp.)
• Original Assignee: RMX, LLC (ASHINC Corp.)
• Inventors: Tehrani, Amir J., Province, Rose, Ligon, David
• Granted Patent: US 8,280,513 B2
• Time in Patent Office: Days
• US Class Current: 607/42
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/395 Details of stimulation, e.g. nerve stimulation to elicit EMG response
• CPC Class Codes: A61N 1/3601 of respiratory organs

Abstract

A device and method for detecting and treating airflow limitations in a subject is provided. Levels of flow limited breathing may be differentiated. Obstruction versus flow limited breathing may be differentiated as well. The EMG complex characteristics may be used to detect obstruction or flow limited breathing. The power spectral density plot of the EMG may be used to detect obstruction or flow limited breathing.

Claims

1. A method for treating a subject comprising the steps of:

sensing one or more characteristic of breathing;

detecting flow limited breathing from the sensed one or more characteristic of breathing; and

providing electrical stimulation to elicit a diaphragm response to thereby reduce flow limited breathing.

2. The method of claim 1 wherein the step of detecting flow limited breathing from the sensed one or more characteristic of breathing comprises:

detecting a diaphragm EMG having one or more components corresponding to flow limited breathing.

3. The method of claim 2 wherein the step of detecting flow limited breathing from the sensed one or more characteristic of breathing comprises:

detecting a diaphragm EMG complex having a frequency content corresponding to flow limited breathing.

4. The method of claim 2 wherein the step of detecting flow limited breathing from the sensed one or more characteristic of breathing comprises:

detecting a diaphragm EMG envelope having a flattened morphology corresponding to flow limited breathing.

5. The method of claim 2 wherein the step of detecting flow limited breathing from the sensed one or more characteristic of breathing comprises:

detecting a diaphragm EMG complex having an increased width corresponding to flow limited breathing.

6. The method of claim 1 wherein the step of detecting flow limited breathing from at least one EMG parameter comprises:

detecting a diaphragm EMG complex having an increased density of spikes corresponding to flow limited breathing.

7. The method of claim 1 wherein the step of detecting flow limited breathing from at least one EMG parameter comprises:

detecting a diaphragm EMG complex having an increased rising slope corresponding to flow limited breathing.

8. The method of claim 2 wherein the step of detecting flow limited breathing from the sensed one or more characteristic of breathing comprises:

detecting a diaphragm EMG complex having an increased amplitudes of a plurality of corresponding to flow limited breathing.

9. The method of claim 1 wherein the step of providing electrical stimulation to elicit a diaphragm contraction response comprises providing electrical stimulation to elicit a biased lung volume.

10. The method of claim 1 wherein the step of providing electrical stimulation to elicit a diaphragm contraction response comprises providing electrical stimulation to manipulate inspiration duration with respect to duration of a corresponding respiratory cycle.

11. The method of claim 1 wherein the step of providing electrical stimulation to elicit a diaphragm contraction response comprises providing electrical stimulation to inhibit central respiratory drive and to provide therapeutic breathing control.

12. The method of claim 1 wherein the step of providing electrical stimulation to elicit a diaphragm contraction response comprises providing electrical stimulation to manipulate tidal volume.

13. The method of claim 1 further comprising the steps of detecting an imminent disordered event and adjusting the stimulation in response.

14. The method of claim 13 wherein the step of detecting an imminent disordered event comprises detecting a physiological parameter corresponding to a precursor to onset of a disordered event;

and wherein the step of adjusting stimulation comprises providing a stimulation directed to preventing onset of the disordered event.

15. The method of claim 14 wherein the step of providing a stimulation directed to preventing onset of the disordered event comprises providing stimulation to elicit a lung volume bias.

16. The method of claim 1 further comprising the steps of detecting onset of a disordered event and adjusting the stimulation in response.

17. The method of claim 16 wherein the step of detecting onset of a disordered event comprises detecting an airway obstruction;

and wherein the step of adjusting stimulation comprises turning off stimulation.

18. The method of claim 16 wherein the step of detecting onset of a disordered event comprises detecting central apnea;

and wherein the step of adjusting stimulation comprises delivering g paced breathing stimulation.

19. The method of claim 1 further comprising:

setting a detection level for flow limited breathing based on data from the patient.

20. The method of claim 1 further comprising setting a detection level for flow limited breathing based on a degree of flow limitation.

21. The method of claim 1 further comprising setting a detection level for flow limited breathing based on a number of flow limited episodes that are observed in a period of time.

22. The method of claim 1 wherein the step of detecting flow limited breathing comprises:

sensing EMG complex of a subject'"'"'s diaphragm; and

detecting flow limited breathing from determination of a parameter corresponding to an area under a power spectral density plot of the EMG complex.

23. A method for detecting a flow limitation comprising the steps of:

sensing EMG of a subject'"'"'s diaphragm;

detecting a flow limitation from at least one EMG parameter wherein the at least one EMG parameter comprises a frequency content of an EMG complex.

24. The method of claim 23 wherein the step of detecting the flow limitation comprises detecting flow limited breathing.

25. The method of claim 23 wherein the step of detecting the flow limitation comprises detecting and airway obstruction.

26. The method of claim 23 wherein the step of detecting the flow limitation from at least one EMG parameter further comprises:

detecting a diaphragm EMG envelope having a flattened morphology corresponding to a flow limited breathing.

27. The method of claim 23 wherein the step of detecting the flow limitation from at least one EMG parameter further comprises:

detecting a diaphragm EMG complex having an increased width corresponding to flow limited breathing.

28. The method of claim 23 wherein the step of detecting the flow limitation from at least one EMG parameter further comprises:

detecting a diaphragm EMG complex having an increased amplitudes of a plurality of spikes corresponding to flow limited breathing.

29. The method of claim 23 wherein the step of detecting the flow limitation from at least one EMG parameter further comprises:

detecting a diaphragm EMG complex having an increased density of spikes corresponding to flow limited breathing.

30. The method of claim 23 wherein the step of detecting the flow limitation from at least one EMG parameter comprises:

detecting a diaphragm EMG complex having an increased rising slope corresponding to flow limited breathing.

31. A device for treating a subject comprising:

an electrical stimulator configured to stimulate a subject to elicit diaphragm muscle contraction to thereby reduce flow limited breathing; and

a detector configured to sense one or more characteristic of breathing;

wherein the detector is configured to detect flow limited breathing from the sensed one or more characteristic of breathing.