Device and method of neuromodulation to effect a functionally restorative adaption of the neuromuscular system
First Claim
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1. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
- implanting a neurostimulatory device in a diaphragm of the patient;
stimulating the diaphragm with the neurostimulatory device to establish an automatic, reflexive, or synchronized breathing mechanism;
evaluating the patient'"'"'s diaphragm by electromyographic (EMG) methodology to determine an effectiveness of establishment of the automatic, reflexive, or synchronized breathing mechanism;
evaluating the patient by polysomnographic (PSG) methodology to assess diminishment of sleep disordered breathing; and
using one or more of the evaluation by EMG methodology and the evaluation by PSG methodology to adapt the breathing pattern of the patient by modulating the stimulation of the diaphragm.
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Abstract
Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.
225 Citations
18 Claims
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1. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
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implanting a neurostimulatory device in a diaphragm of the patient; stimulating the diaphragm with the neurostimulatory device to establish an automatic, reflexive, or synchronized breathing mechanism; evaluating the patient'"'"'s diaphragm by electromyographic (EMG) methodology to determine an effectiveness of establishment of the automatic, reflexive, or synchronized breathing mechanism; evaluating the patient by polysomnographic (PSG) methodology to assess diminishment of sleep disordered breathing; and using one or more of the evaluation by EMG methodology and the evaluation by PSG methodology to adapt the breathing pattern of the patient by modulating the stimulation of the diaphragm. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
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implanting a neurostimulatory device in a diaphragm of the patient; stimulating the diaphragm with the neurostimulatory device to establish an automatic, reflexive, or synchronized breathing mechanism; evaluating the patient'"'"'s diaphragm by electromyographic (EMG) methodology to determine an effectiveness of establishment of the automatic, reflexive, or synchronized breathing mechanism; using the evaluation by EMG methodology to adapt the breathing pattern of the patient by modulating the stimulation of the diaphragm; determining onset of sleep; determining a sensory threshold intensity, wherein the sensory threshold intensity is a stimulation intensity where the patient first senses that stimulation is being applied; and ramping the stimulation intensity up to the sensory threshold intensity before onset of sleep. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15)
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16. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
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implanting a neurostimulatory device in a diaphragm of the patient; stimulating the diaphragm with the neurostimulatory device to establish an automatic, reflexive, or synchronized breathing mechanism; evaluating the patient'"'"'s diaphragm by electromyographic (EMG) methodology to determine an effectiveness of establishment of the automatic, reflexive, or synchronized breathing mechanism; using the evaluation by EMG methodology to adapt the breathing pattern of the patient by modulating the stimulation of the diaphragm; determining a movement threshold intensity, wherein the movement threshold intensity is a stimulation intensity when diaphragm movement is visualized or palpated; and waiting for a predetermined sleep onset time before ramping the stimulation intensity up to a movement threshold intensity, wherein the predetermined sleep onset time is selected from the group consisting of approximately 5 minutes, 10 minutes, 20 minutes and 30 minutes.
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17. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
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initiating a sleep onset process prior to onset of sleep, wherein the sleep onset process comprises ramping a stimulation to a first level that does not exceed a level at which sleep is interrupted; determining onset of sleep; stimulating a diaphragm of the patient in a therapeutic regime after onset of sleep by gradually ramping the stimulation over time to reach a steady state level of stimulation to establish an automatic, reflexive, or synchronized breathing mechanism; evaluating the patient'"'"'s diaphragm by electromyographic (EMG) methodology to determine an effectiveness of establishment of the automatic, reflexive, or synchronized breathing mechanism; and using the evaluation by EMG methodology to adapt the breathing pattern of the patient by modulating the stimulation of the diaphragm.
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18. A method for adapting a breathing pattern of a patient with disordered breathing toward a more healthful state to improve sleep, the method comprising:
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initiating a sleep onset process prior to onset of sleep, wherein the sleep onset process comprises ramping a diaphragm stimulation to a first level that does not exceed a level at which sleep is interrupted; determining onset of sleep; and stimulating a diaphragm of the patient in a therapeutic regime after onset of sleep by gradually ramping the stimulation over time to reach a steady state level of stimulation.
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Specification