METHOD AND APPARATUS FOR DETECTION AND TREATMENT OF RESPIRATORY DISORDER BY IMPLANTABLE DEVICE

• US 20100152553A1
• Filed: 02/25/2010
• Published: 06/17/2010
• Est. Priority Date: 02/20/2004
• Status: Active Grant

• Current Assignee: ResMed Pty Ltd. (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: UJHAZY, Anthony John, Brewer, Gregory Newton
• Granted Patent: US 9,050,024 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61N 1/3601 of respiratory organs

Abstract

Methods and apparatus for detection and treatment of respiratory disorders using implanted devices are described. In one form, afferent nerves are electrically or electro-mechanically stimulated to increase the tone of upper airway muscles. Detection of respiratory disorders is carried out using electrodes implanted in sub-pectoral regions. Open and closed airway apneas are distinguished using a combination of acoustic detectors and electrical transducers

Claims

1-31. -31. (canceled)

32. A method for identifying a respiratory disorder in a patient using a device implanted in the patient, comprising the steps of:

determining the likelihood of said patient being asleep,

sensing patient sounds,

analyzing said patient sounds,

measuring said patient'"'"'s transthoracic impedance changes and thoracic movement, and

identifying a respiratory disorder based upon the likelihood of said patient being asleep, the frequency and amplitude of sensed patient sounds, transthoracic impedance change, and thoracic movement;

said device implanted in the patient including a sleep sensor, an acoustic transducer to sense patient sounds, a processor to analyze the frequency and amplitude of the sensed patient sounds, a movement detector to detect thoracic movement, and an impedance detector to detect transthoracic impedance change by

     1) emitting high frequency electrical pulses to traverse the transthoracic cavity,

     2) calculating instantaneous transthoracic impedance across said transthoracic cavity, and

     3) comparing said instantaneous transthoracic impedance to a recent average of instantaneous transthoracic impedances.

33. The method of claim 32 wherein said sleep sensor is comprised of a real time clock and a postural sensor, and the likelihood of said patient being asleep is determined based upon the combined determination of time of day and postural state.

34. The method of claim 32 wherein said acoustic transducer further senses signals indicative of patient snoring which are used to determine the potential onset of sleep disordered breathing.

35. The method of claim 32 wherein the type of sleep disordered breathing is determined from a group consisting of obstructive sleep apnea, central sleep apnea, and Cheyne-Stokes respiration.

36. The method of claim 32 wherein transthoracic impedance is calculated by measuring current and voltage and by using Ohm'"'"'s Law.

37. The method of claim 32 wherein said high frequency electrical pulses are at an energy level below the level required to stimulate excitable tissue.

38. An implantable apparatus for determining the presence of sleep disordered breathing in a patient comprising:

a sleep sensor,

an impedance detector to detect transthoracic impedance change by

     1) emitting high frequency electrical pulses to traverse the transthoracic cavity,

     2) calculating instantaneous transthoracic impedance across said transthoracic cavity, and

     3) comparing said instantaneous transthoracic impedance to a recent average of instantaneous transthoracic impedances,

a movement detector to detect thoracic movement,

an acoustic transducer to capture signals representing patient sounds, and

a processor for determining the presence of sleep disordered breathing;

wherein said processor determines the presence of sleep disordered breathing by determining the likelihood of said patient being asleep, analyzing said patient-sound signals for frequency and amplitude, measuring said patient'"'"'s transthoracic impedance change and thoracic movement, and determining the presence of a respiratory disorder based upon the likelihood of said patient being asleep, the frequency and amplitude of patient-sound signalss, transthoracic impedance change, and the patient'"'"'s thoracic movement.

39. The apparatus of claim 38 wherein said sleep sensor includes a real time clock and a postural sensor, and the likelihood of said patient being asleep is determined based upon the combined determination of time of day and postural state.

40. The apparatus of claim 38 wherein said acoustic transducer captures signals indicative of patient snoring which are used by said processor to identify the presence of sleep disordered breathing.

41. The apparatus of claim 38 wherein the type of sleep disordered breathing is determined from a group consisting of obstructive sleep apnea, central sleep apnea, and Cheyne-Stokes respiration.

42. The apparatus of claim 38 wherein transthoracic is calculated by measuring current and voltage and by using Ohm'"'"'s Law.

43. The apparatus of claim 38 wherein said high frequency electrical pulses are at an energy level below the level required to stimulate excitable tissue.

44. A method for identifying a respiratory disorder in a patient using a device coupled to the patient, comprising the steps of:

determining the likelihood of said patient being asleep,

receiving signals associated with patient sounds,

analyzing said signals,

measuring said patient'"'"'s transthoracic impedance change and thoracic movement, and

determining the presence of a respiratory disorder based upon said patient'"'"'s likelihood of being asleep, the frequency and amplitude of patient sounds, the patient'"'"'s transthoracic impedance change, and the patient'"'"'s thoracic movement;

said device coupled to the patient including a sleep sensor, a receiver for receiving signals representative of patient sounds, a processor to determine the frequency and amplitude of patient sounds, a movement detector to detect thoracic movement, and an impedance detector to detect transthoracic impedance changes by

     1) emitting high frequency electrical pulses to traverse the transthoracic cavity,

     2) calculating instantaneous transthoracic impedance across said transthoracic cavity, and

     3) comparing said instantaneous transthoracic impedance to a recent average of instantaneous transthoracic impedances.

45. The method of claim 44 wherein said sleep sensor is comprised of a real time clock and a postural sensor, and the likelihood of said patient being asleep is determined based upon the combined determination of time of day and postural state.

46. The method of claim 44 wherein said receiver further receives signals indicative of patient snoring which are used to determine the potential onset of sleep disordered breathing.

47. The method of claim 44 further determining the type of sleep disordered breathing from a group consisting of obstructive sleep apnea, central sleep apnea, and Cheyne-Stokes respiration.

48. The method of claim 44 wherein transthoracic impedance is calculated by measuring current and voltage and by using Ohm'"'"'s Law.

49. The method of claim 44 wherein said high frequency electrical pulses are at an energy level below the level required to stimulate excitable tissue.

50. An apparatus for determining the presence of sleep disordered breathing in a patient comprising:

a sleep sensor,

an impedance detector to detect transthoracic impedance change by

     1) emitting high frequency electrical pulses to traverse the transthoracic cavity,

     2) calculating instantaneous transthoracic impedance across said transthoracic cavity, and

     3) comparing said instantaneous transthoracic impedance to a recent average of instantaneous transthoracic impedances,

a movement detector to detect thoracic movement,

a receiver for receiving signals representing patient sounds, and

a processor for processing said signals;

wherein said device determines the presence of sleep disordered breathing based upon the likelihood that the patient is asleep, the patient'"'"'s transthoracic impedance change, the patient'"'"'s thoracic movement, and the frequency and amplitude of patient sounds.

51. The apparatus of claim 50 wherein said sleep sensor includes a real time clock and a postural sensor, and the likelihood that the patient is asleep is determined based upon the combined determination of time of day and postural state.

52. The apparatus of claim 50 wherein said receiver receives signals indicative of patient snoring which are used by said processor to identify the presence of sleep disordered breathing.

53. The apparatus of claim 50 wherein the type of sleep disordered breathing is determined from a group consisting of obstructive sleep apnea, central sleep apnea, and Cheyne-Stokes respiration.

54. The apparatus of claim 50 wherein transthoracic impedance is calculated by measuring current and voltage and by using Ohm'"'"'s Law.

55. The apparatus of claim 50 wherein said high frequency electrical pulses are at an energy level below the level required to stimulate excitable tissue.