Coordinated use of respiratory and cardiac therapies for sleep disordered breathing

• US 7,591,265 B2
• Filed: 08/31/2004
• Issued: 09/22/2009
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• 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
• Primary Examiner(s): Douglas; Steven O
• Application Number:
  US10/930,979
• Publication Number:
  US 20050061320A1
• Time in Patent Office: 1,848 Days
• Field of Search: 128/204.18, 128/204.23, 128/204.21, 128/204.22, 128/200.24, 128/204.28, 128/912, 607/3, 607/9, 607/42, 600/529, 600/26, 600/27
• US Class Current: 128/204.18
• 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 16/0009 with sub-atmospheric pressure, e.g. during expiration
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2230/00 Measuring parameters of the user
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61N 1/3601 of respiratory organs
• 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

Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.

Claims

1. An automated method for treating disordered breathing, comprising:

controlling an external respiratory therapy delivered to a patient;

controlling a cardiac therapy delivered to the patient;

sensing one or more side effect conditions affecting the patient and associated with an impact of one or more of the therapies on the patient; and

coordinating delivery of the external respiratory therapy and the cardiac therapy to adjust the impact of the one or more therapies on the patient and treat the disordered breathing by shifting disordered breathing therapy burden from the external respiratory therapy or the cardiac therapy associated with the sensed one or more side effect conditions to the other of the external respiratory therapy or the cardiac therapy.

2. The method of claim 1, wherein the one or more side effect conditions comprise one or more of patient discomfort and therapy interaction.

3. The method of claim 1, further comprising:

controlling one or more additional types of therapy delivered to the patient; and

coordinating delivery of the external respiratory therapy, the cardiac therapy and the one or more additional types of therapy to treat the disordered breathing.

4. A medical system for controlling therapy to treat disordered breathing comprising:

a respiratory therapy controller configured to control an external respiratory therapy delivered to a patient;

a cardiac therapy controller configured to control a cardiac therapy delivered to the patient;

a sensor system for sensing one or more side effect conditions associated with an impact of the therapies on the patient; and

a processor coupled to the respiratory therapy controller and the cardiac therapy controller, the processor configured to coordinate delivery of the external respiratory therapy and the cardiac therapy to treat the disordered breathing and adjust the impact of the therapies on the patient by shifting disordered breathing therapy burden from the external respiratory therapy or the cardiac therapy associated with the sensed one or more side effect conditions to the other of the external respiratory therapy or the cardiac therapy.

5. The medical system of claim 4, wherein the respiratory therapy controller is configured to control a positive airway pressure therapy.

6. The medical system of claim 4, wherein the cardiac therapy controller is configured to control a cardiac electrical stimulation therapy.

7. The medical system of claim 4, wherein the one or more side effect conditions comprise one or more of patient discomfort and therapy interaction.

8. A system for treating disordered breathing, comprising:

means for controlling an external respiratory therapy delivered to a patient;

means for controlling a cardiac therapy delivered to the patient;

means for sensing one or more side effect conditions associated with an impact of one or more of the therapies on the patient; and

means for coordinating delivery of the external respiratory therapy and the cardiac therapy to treat the disordered breathing and adjust the impact of the therapies on the patient by shifting disordered breathing therapy burden from the external respiratory therapy or the cardiac therapy associated with the sensed one or more side effect conditions to the other of the external respiratory therapy or the cardiac therapy.

9. The system of claim 8, wherein the one or more side effect conditions comprise one or more of patient discomfort and therapy interaction.

10. An automated method for treating disordered breathing, comprising:

controlling an external respiratory therapy delivered to a patient;

controlling a cardiac therapy delivered to the patient by an implantable device;

evaluating energy requirements of the cardiac therapy; and

coordinating delivery of the external respiratory therapy and the cardiac therapy to treat the disordered breathing, wherein disordered breathing treatment burden is shifted to the external respiratory therapy when the energy requirements evaluation indicates that energy requirements of the cardiac therapy may result in an excessively reduced device service life of the implantable device.

12. The method of claim 10, wherein coordinating delivery of the therapies comprises increasing the external respiratory therapy and decreasing the cardiac therapy.

13. The method of claim 10, wherein coordinating delivery of the therapies further comprises coordinating delivery of the therapies based on usage of the therapies.

14. The method of claim 10, wherein the external respiratory therapy is a positive airway pressure therapy.

15. The method of claim 10, wherein the cardiac therapy is a cardiac electrical stimulation therapy.

16. The method of claim 10, wherein the cardiac therapy is a cardiac pacing therapy.

17. The method of claim 10, wherein the cardiac therapy is a non-excitatory cardiac stimulation therapy.

18. The method of claim 10, wherein the cardiac therapy is an overdrive pacing therapy.

11. An automated method for treating disordered breathing, comprising:

controlling an external respiratory therapy delivered to a patient;

controlling a cardiac therapy delivered to the patient by an implantable device;

evaluating patient impact of the external respiratory therapy; and

coordinating delivery of the external respiratory therapy and the cardiac therapy to treat the disordered breathing, wherein disordered breathing treatment burden is shifted to the cardiac therapy when the patient impact evaluation indicates that the external respiratory therapy intensity has an undesirable impact.

19. The method of claim 11, wherein coordinating delivery of the therapies comprises decreasing the external respiratory therapy and increasing the cardiac therapy.

20. The method of claim 11, wherein coordinating delivery of the therapies further comprises coordinating delivery of the therapies based on usage of the therapies.

21. The method of claim 11, wherein coordinating delivery of the therapies further comprises coordinating delivery of the therapies based on effectiveness of the therapies.

22. The method of claim 11, further comprising:

controlling one or more additional types of therapy delivered to the patient; and

coordinating delivery of the external respiratory therapy, the cardiac therapy and the one or more additional types of therapy to treat the disordered breathing at least in part based on the energy evaluation.

23. The method of claim 11, wherein the external respiratory therapy is a positive airway pressure therapy.

24. The method of claim 11, wherein the cardiac therapy is a cardiac electrical stimulation therapy.

25. The method of claim 11, wherein the cardiac therapy is a cardiac pacing therapy.

26. The method of claim 11, wherein the cardiac therapy is a non-excitatory cardiac stimulation therapy.

27. The method of claim 11, wherein the cardiac therapy is an overdrive pacing therapy.

28. The medical of claim 11, wherein evaluating patient impact of the external respiratory therapy comprises evaluating sleep quality.

29. The method of claim 11, wherein evaluating patient impact of the external respiratory therapy comprises evaluating one or more side effect conditions associated with the external respiratory therapy.

30. The method of claim 11, wherein evaluating patient impact of the external respiratory therapy comprises evaluating one or more of patient discomfort and therapy interaction.