Method and apparatus for adjusting desired pressure in positive airway pressure devices
First Claim
1. A method for adjusting a desired pressure in a positive airway pressure device, the method comprising:
- a) providing a breathing gas under positive pressure to a patient via a positive airway pressure device based at least in part on a current desired pressure;
b) monitoring a characteristic of the breathing gas that is indicative of respiration;
c) creating a breathing cycle signal with a first level associated with inhalation and a second level different from the first level and associated with exhalation, the breathing cycle signal being based at least in part on the monitored respiration characteristic;
d) performing one or more abnormal breathing checks based at least in part on the monitored respiration characteristic and the breathing cycle signal, wherein one or more abnormal breathing checks comprises a hypopnea check, the hypopnea check comprising;
creating a filtered respiration signal based at least in part on bandpass filtering the monitored respiration characteristic;
monitoring the breathing cycle signal;
clearing a positive surge counter and a negative surge counter each time the breathing cycle signal transitions from the second level to the first level to reset the hypopnea check at a start of each breathing cycle;
creating a triggered respiration signal with a first level associated with a positive surge and a second level different from the first level and associated with a negative surge, the triggered respiration signal being based at least in part on the filtered respiration signal;
monitoring the triggered respiration signal;
incrementing the positive surge counter each time the triggered respiration signal transitions from the second level to the first level to count a positive surge after an initial positive surge associated with inhalation;
incrementing the negative surge counter each time the triggered respiration signal transitions from the first level to the second level to count a negative surge;
reading the positive surge counter and the negative surge counter each time the breathing cycle signal transitions from the first level to the second level;
determining if the positive surge count is not equal to zero or the negative surge count is not equal to one; and
if either the positive surge count is not equal to zero or the negative surge count is not equal to one, abnormal breathing is detected based on the hypopnea check; and
e) if abnormal breathing is detected, increasing the current desired pressure by a first increment until a maximum desired pressure is reached, otherwise, decreasing the current desired pressure by a second increment until a minimum desired pressure is reached.
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Abstract
Systems and methods for adjusting a desired pressure in a positive airway pressure (PAP) device are provided. In one embodiment, the method includes: a) providing breathing gas under positive pressure to a patient via a PAP device based on current desired pressure, b) monitoring a characteristic of the breathing gas, patient, or PAP device indicative of respiration, c) creating a breathing cycle signal having a first level associated with inhalation and a second level associated with exhalation, the signal being based on the monitored respiration characteristic, d) performing an abnormal breathing check based on the monitored respiration characteristic and the breathing cycle signal, and e) if abnormal breathing is detected, increasing the current desired pressure until a maximum desired pressure is reached, otherwise, decreasing the current desired pressure until a minimum desired pressure is reached. Several embodiments of an apparatus associated with the method are also provided.
217 Citations
43 Claims
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1. A method for adjusting a desired pressure in a positive airway pressure device, the method comprising:
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a) providing a breathing gas under positive pressure to a patient via a positive airway pressure device based at least in part on a current desired pressure; b) monitoring a characteristic of the breathing gas that is indicative of respiration; c) creating a breathing cycle signal with a first level associated with inhalation and a second level different from the first level and associated with exhalation, the breathing cycle signal being based at least in part on the monitored respiration characteristic; d) performing one or more abnormal breathing checks based at least in part on the monitored respiration characteristic and the breathing cycle signal, wherein one or more abnormal breathing checks comprises a hypopnea check, the hypopnea check comprising; creating a filtered respiration signal based at least in part on bandpass filtering the monitored respiration characteristic; monitoring the breathing cycle signal; clearing a positive surge counter and a negative surge counter each time the breathing cycle signal transitions from the second level to the first level to reset the hypopnea check at a start of each breathing cycle; creating a triggered respiration signal with a first level associated with a positive surge and a second level different from the first level and associated with a negative surge, the triggered respiration signal being based at least in part on the filtered respiration signal; monitoring the triggered respiration signal; incrementing the positive surge counter each time the triggered respiration signal transitions from the second level to the first level to count a positive surge after an initial positive surge associated with inhalation; incrementing the negative surge counter each time the triggered respiration signal transitions from the first level to the second level to count a negative surge; reading the positive surge counter and the negative surge counter each time the breathing cycle signal transitions from the first level to the second level; determining if the positive surge count is not equal to zero or the negative surge count is not equal to one; and if either the positive surge count is not equal to zero or the negative surge count is not equal to one, abnormal breathing is detected based on the hypopnea check; and e) if abnormal breathing is detected, increasing the current desired pressure by a first increment until a maximum desired pressure is reached, otherwise, decreasing the current desired pressure by a second increment until a minimum desired pressure is reached. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A method for adjusting a desired pressure in a positive airway pressure device, the method comprising:
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a) providing a breathing gas under positive pressure to a patient via a positive airway pressure device based at least in part on a current desired pressure; b) monitoring a characteristic of the breathing gas, a characteristic of the patient, or a characteristic of the positive airway pressure device that is indicative of respiration; c) creating a breathing cycle signal having a first level associated with inhalation and a second level different from the first level and associated with exhalation, the breathing cycle signal being based at least in part on the monitored respiration characteristic; d) performing an abnormal breathing check based at least in part on the monitored respiration characteristic and the breathing cycle signal, wherein performing the abnormal breathing check comprises; creating a processed respiration signal based at least in part on the monitored respiration characteristic; monitoring the breathing cycle signal; creating a triggered respiration signal with a first level associated with a positive surge and a second level different from the first level and associated with a negative surge, the triggered respiration signal being based at least in part on the processed respiration signal; monitoring the triggered respiration signal; incrementing a peak counter each time the triggered respiration signal transitions from the second level to the first level; reading the peak counter each time the breathing cycle signal transitions from the first level to the second level; comparing the peak counter to a threshold level; and based on the comparing, determining if abnormal breathing is detected; and e) if abnormal breathing is detected, increasing the current desired pressure by a first increment until a maximum desired pressure is reached, otherwise, decreasing the current desired pressure by a second increment until a minimum desired pressure is reached. - View Dependent Claims (24, 25, 26, 27, 28, 29)
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30. An apparatus for adjusting a desired pressure in a positive airway pressure device, the apparatus comprising:
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a breathing gas flow path in operative communication with a closed loop control logic, the breathing gas flow path and closed loop control logic being adapted to provide a breathing gas under positive pressure to a patient based at least in part on a current desired pressure; a respiration characteristic monitoring logic in operative communication with the breathing gas flow path to monitor a characteristic of the breathing gas, a characteristic of the patient, or a characteristic of the apparatus that is indicative of respiration; a breathing cycle signal logic in operative communication with the respiration characteristic monitoring logic to create a breathing cycle signal having a first level associated with inhalation and a second level different from the first level and associated with exhalation, the breathing cycle signal being based at least in part on the monitored respiration characteristic; an abnormal breathing check logic in operative communication with at least one of the breathing cycle signal logic and the respiration characteristic monitoring logic to perform an abnormal breathing check based at least in part on the monitored respiration characteristic and the breathing cycle signal, wherein the abnormal breathing check logic comprises; logic for creating a processed respiration signal based at least in part on the monitored respiration characteristic; logic for monitoring the breathing cycle signal; logic for creating a triggered respiration signal with a first level associated with a positive surge and a second level different from the first level and associated with a negative surge, the triggered respiration signal being based at least in part on the processed respiration signal; logic for monitoring the triggered respiration signal; logic for incrementing a first counter based on a transition of the triggered respiration signal from the second level to the first level to count a rising edge; logic for incrementing a second counter based on a transition of the triggered respiration signal from the first level to the second level to count a falling edge; logic for reading the first counter and the second counter each time the breathing cycle signal transitions from the first level to the second level; logic for comparing the first counter and second counter to one or more threshold levels; and based on the comparing, logic for determining if abnormal breathing is detected; and a desired pressure adjustment logic in operative communication with the abnormal breathing check logic, breathing cycle signal logic, and closed loop control logic to increase the current desired pressure by a first increment until a maximum desired pressure is reached, if abnormal breathing is detected and to decrease the current desired pressure by a second increment until a minimum desired pressure is reached if abnormal breathing is not detected. - View Dependent Claims (31, 32, 33, 34, 35, 36)
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37. A method for adjusting a desired pressure in a positive airway pressure device, the method comprising:
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a) providing a breathing gas under positive pressure to a patient via a positive airway pressure device based at least in part on a current desired pressure; b) monitoring a characteristic of the breathing gas that is indicative of respiration; c) creating a breathing cycle signal with a first level associated with inhalation and a second level different from the first level and associated with exhalation, the breathing cycle signal being based at least in part on the monitored respiration characteristic; d) performing one or more abnormal breathing checks based at least in part on the monitored respiration characteristic and the breathing cycle signal, wherein one or more abnormal breathing checks comprises a hypopnea check, the hypopnea check comprising; creating a processed respiration signal based at least in part on the monitored respiration characteristic; monitoring the breathing cycle signal; creating a triggered respiration signal with a first level associated with a positive surge and a second level different from the first level and associated with a negative surge, the triggered respiration signal being based at least in part on the processed respiration signal; monitoring the triggered respiration signal; incrementing a first counter based on a transition of the triggered respiration signal from the second level to the first level to count a rising edge; incrementing a second counter based on a transition of the triggered respiration signal from the first level to the second level to count a falling edge; reading the first counter and the second counter each time the breathing cycle signal transitions from the first level to the second level; comparing the first counter and second counter to one or more threshold levels; and based on the comparing, determining if abnormal breathing is detected based on the hypopnea check; and e) if abnormal breathing is detected, increasing the current desired pressure by a first increment until a maximum desired pressure is reached, otherwise, decreasing the current desired pressure by a second increment until a minimum desired pressure is reached. - View Dependent Claims (38, 39, 40, 41, 42, 43)
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Specification