Apnea type determining apparatus and method

• US 8,360,983 B2
• Filed: 06/29/2011
• Issued: 01/29/2013
• Est. Priority Date: 06/22/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Patangay, Abhilash, Pu, Yachuan
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): D'ANGELO, MICHAEL J
• Application Number:
  US13/172,332
• Publication Number:
  US 20120029362A1
• Time in Patent Office: 580 Days
• Field of Search: 600/484, 600/485, 600/506, 600/529
• US Class Current: 600/484
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• 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 5/113 occurring during breathing
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0526 Head electrodes A61N1/0551 takes precedence
• CPC Class Codes: A61N 1/0548 Oral electrodes
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

An apnea classification system provides for apnea monitoring and differentiation based on several sleep apnea related parameters for diagnostic and therapeutic purposes. Monitoring of such sleep apnea related parameters allows the apnea classification system to differentiate among the different types of apnea and hypopnea and to identify an occurrence of periodic respiration. This information may then be used to determine the best method of therapy, or adjust current therapy parameters to more effectively treat a subject.

Claims

1. A system comprising:

a respiration-based apnea detector configured to receive cyclic information indicative of inhalation or exhalation;

a non-respiration-based apnea detector configured to receive information other than cyclic information indicative of inhalation or exhalation; and

an apnea classifier module, coupled to the respiration-based and non-respiration-based apnea detectors, configured to distinguish between sleep apnea and hypopnea using information from both the respiration-based and non-respiration-based apnea detectors.

2. The system of claim 1, wherein the respiration-based apnea detector includes a respiration sensor configured to sense cyclic information indicative of inhalation or exhalation.

3. The system of claim 2, wherein the respiration sensor includes at least one of an impedance sensor configured to detect impedance information or a blood pressure sensor configured to detect blood pressure information;

and

wherein the respiration-based apnea detector is configured to receive the cyclic information indicative of inhalation or exhalation from at least one of the impedance information or the blood pressure information.

4. The system of claim 3, wherein the blood pressure sensor is configured to sense a left ventricle end diastolic pressure (LVEDP);

and

wherein the apnea classifier module is configured to distinguish between apnea and hyperpnea using an increase in magnitude of a sensed LVEDP during a detected apnea.

5. The system of claim 1, wherein the non-respiration-based second apnea detector includes a blood pressure sensor configured to be located in association with a ventricle and to measure a ventricular pressure;

and

wherein the apnea classifier module is configured to distinguish between apnea and hyperpnea using respiration information from the first respiration-based first apnea detector and ventricular pressure information from the non-respiration-based second apnea detector.

6. The system of claim 1, wherein the apnea classifier module is further configured to distinguish between Obstructive Sleep Apnea (OSA) and central sleep apnea (CSA) using the information from both the respiration-based and non-respiration-based apnea detectors.

7. The system of claim 1, comprising a periodic respiration detector circuit configured to identify periodic respiration using the information from both the respiration-based and non-respiration-based apnea detectors, and the sleep apnea indication or the hypopnea indication, wherein the periodic respiration comprises a duration of normal or increased respiration and a subsequent duration of diminished respiration.

8. The system of claim 7, wherein the periodic respiration detector circuit is configured to identify Cheyne-Stokes respiration using information from both the respiration-based and non-respiration-based apnea detectors.

9. The system of claim 7, wherein the periodic respiration comprises a first duration of hyperpnea and a second duration of hypopnea.

10. The system of claim 1, comprising a therapy generation circuit configured to enable therapy during a duration of sleep apnea or inhibit therapy generation during a duration of hypopnea.

11. The system of claim 10, wherein the therapy generation circuit is configured to enable phrenic nerve therapy during a duration of central sleep apnea using information from both the respiration-based and non-respiration-based apnea detectors.

12. The system of claim 10, wherein the therapy generation circuit is configured to enable a hypoglossal nerve therapy during a duration of obstructive sleep apnea using information from both the respiration-based and non-respiration-based apnea detectors.

13. A method comprising:

receiving cyclical information indicative of inhalation or expiration;

receiving physiological information indicative of respiration other than cyclical information indicative of inhalation or exhalation; and

distinguishing, using a processor, between sleep apnea and hypopnea using the cyclical information indicative of inhalation or expiration and the information other than cyclical information indicative of inhalation or exhalation.

14. The method of claim 13, including detecting apnea using the cyclical information indicative of inhalation or expiration;

wherein the receiving information other than cyclical information indicative of inhalation or exhalation includes receiving ventricular pressure information from a blood pressure sensor configured to be located in association with a ventricle; and

wherein the distinguishing between OSA and CSA includes using the ventricular pressure information during the detected apnea.

15. The method of claim 14, wherein the receiving ventricular pressure information includes receiving a left ventricle end diastolic pressure (LVEDP);

and

wherein the distinguishing between OSA and CSA includes using an increase in magnitude of the LVEDP during the detected apnea.

16. The method of claim 13, comprising identifying periodic respiration using the information from both the respiration-based and non-respiration-based apnea detectors, and the sleep apnea indication or the hypopnea indication, wherein the periodic respiration comprises a duration of normal or increased respiration and a subsequent duration of diminished respiration.

17. The method of claim 13, comprising a enabling therapy during a duration of sleep apnea or inhibiting therapy generation during a duration of hypopnea.

18. The method of claim 13, comprising enabling phrenic nerve therapy during a duration of central sleep apnea using information from both the respiration-based and non-respiration-based apnea detectors.

19. The method of claim 13, comprising enabling hypoglossal nerve therapy during a duration of obstructive sleep apnea using information from both the respiration-based and non-respiration-based apnea detectors.

20. A non-transitory processor-readable medium comprising instructions that, when executed by the processor, cause the processor to:

receive cyclical information indicative of inhalation or expiration;

receive physiological information indicative of respiration other than cyclical information indicative of inhalation or exhalation; and

distinguish between sleep apnea and hypopnea using the cyclical information indicative of inhalation or expiration and the information other than cyclical information indicative of inhalation or exhalation.