Method and apparatus for rectifying obstructive apnea

• US 4,506,666 A
• Filed: 12/03/1982
• Issued: 03/26/1985
• Est. Priority Date: 12/03/1982
• Status: Expired due to Term

• Current Assignee: Sunrise Medical Hhg Incorporated (Sunrise Medical Incorporated), Tritec Industries Incorporated
• Original Assignee: Kircaldie Randall and Mcnab
• Inventors: Durkan, Gerald
• Primary Examiner(s): Recla, Henry J.
• Application Number:
  US06/446,543
• Time in Patent Office: 844 Days
• Field of Search: 128/28, 128/204.21, 128/204.22, 128/204.23, 128/204.24, 128/204.25, 128/204.26, 128/204.28, 128/205.24, 128/205.25, 128/419 G , 128/205.14, 128/205.15, 128/205.16, 128/205.18, 128/716, 128/721, 128/724
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0677 Gas-saving devices therefor
• CPC Class Codes: A61M 16/0841 for sampling
• CPC Class Codes: A61M 16/0858 Pressure sampling ports
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0024 with an on-off output signal, e.g. from a switch
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61N 1/3601 of respiratory organs

Abstract

Upon the detection of an appropriate apnea event, respirating gas supply apparatus according to various embodiments supply stimulus to the upper airway passages of an in vivo respiratory system in an effort to dislodge any occlusion or obstruction in the upper airway passages. In one embodiment the stimulus applied is a high pressure pulse of gas. In another embodiment an electrical signal is applied to an electromyographic electrode (270) positioned in proximity to a nerve controlling a muscle or organ which may obstruct the upper airway passage.

Claims

1. An apparatus for sensing, negative pressure indicative of inspiration in an in vivo respiratory system and for supplying gas to said in vivo respiratory system, said apparatus comprising:

means for sensing negative pressure in said in vivo system;

valve means operable for selectively supplying said gas to said in vivo system;

control means responsive to said sensing means for operating said valve means whereby said gas is supplied to said in vivo system for at least a portion of the time duration of an occurrence of sensed negative pressure;

first timer means connected to said sensing means for determining when a first predetermined time interval has elapsed since the last occurrence of negative pressure in said in vivo system; and

,

means responsive to said first timer means for stimulating a nerve associated with upper airway in vivo neuro-muscular tissue that will displace said tissue when stimulated whereby an upper airway passage in said in vivo respiratory system is not occluded, said stimulation occurring upon the elapse of said predetermined time interval.

2. The apparatus of claim 1, wherein said in vivo tissue is a tongue.

3. The apparatus of claim 2, wherein said in vivo tissue comprises pharyngeal muscles.

4. The apparatus of claim 1 further comprising second timer means connected to said sensing means for determining when a second predetermined time interval less than said first predetermined time interval has elapsed since the last occurrence of negative pressure in said in vivo system without a further occurrence of negative pressure in said in vivo system;

and,

counter means for counting the number of events wherein the time interval between successive occurrences of negative pressure in said in vivo system is greater than said second predetermined time interval.

5. The apparatus of claim 1, wherein said airway is the oropharyngeal airway.

6. The apparatus of claim 1, wherein said nerve is the hypoglossal nerve.

18. The method of claim 1, wherein said in vivo tissue is a tongue.

7. A method for supplying gas to an in vivo respiratory system and for monitoring the condition of said in vivo respiratory system, said method comprising the steps of:

sensing negative pressure in said in vivo respiratory system;

using valve means to selectively supply gas to said in vivo system;

controlling the operation of said valve means whereby gas is supplied to said in vivo system for at least a portion of the time duration of an occurrence of sensed negative pressure;

determining when a first predetermined time interval has elapsed since the last occurrence of negative pressure in said in vivo system; and

,

stimulating a nerve associated with upper airway in vivo neuro-muscular tissue that will displace said tissue when stimulated whereby an upper airway passage in said in vivo respiratory system is not occluded, said stimulation occurring upon the elapse of said first predetermined time interval.

8. The method of claim 7, wherein said in vivo organ is a tongue.

9. The method of claim 7, wherein said in vivo organ comprises pharyngeal muscles.

10. The apparatus of claim 7, wherein said airway is the oropharyngeal airway.

11. The apparatus of claim 7, wherein said nerve is the hypoglossal nerve.

12. An apparatus for detecting an apnea event in an in vivo respiratory system and for removing an upper airway obstruction associated with an obstructive apnea event, said apparatus comprising:

means for sensing negative pressure in said in vivo system;

first timer means connected to said sensing means for determining when a predetermined time interval has elapsed since the last occurrence of negative pressure in said in vivo system; and

,

means responsive to said first timer means for simulating a nerve associated with upper airway neuro-muscular tissue that will displace said tissue when stimulated to dislodge an occlusion of an upper airway passage in said in vivo respiratory system, said stimulation occurring upon the detection of the elapse of said predetermined time interval.

13. The apparatus of claim 12, wherein said in vivo tissue is a tongue.

14. The apparatus of claim 12, wherein said in vivo tissue comprises pharyngeal muscles.

15. The apparatus of claim 12, wherein said airway is the oropharyngeal airway.

16. The apparatus of claim 12, wherein said nerve is the hypoglossal nerve.

17. A method of detecting an apnea event in an in vivo respiratory system and of removing an upper airway obstruction associated with an obstructive apena event, said method comprising the steps of:

sensing negative pressure in said in vivo respiratory system;

determining when a predetermined time interval has elapsed since the last occurrence of negative pressure in said in vivo system; and

,

stimulating a nerve associated with upper airway neuro-muscular tissue that will displace said tissue when stimulated to dislodge an occlusion of an upper airway passage in said vido respiratory system, said stimulation occurring upon the elapse of said first predetermined time interval.

19. The method of claim 17, wherein said in vivo tissue comprises pharyngeal muscles.

20. The apparatus of claim 17, wherein said airway is the oropharyngeal airway.

21. The apparatus of claim 17, wherein said nerve is the hypoglossal nerve.