Sleep detection using an adjustable threshold

• US 8,535,222 B2
• Filed: 03/13/2007
• Issued: 09/17/2013
• Est. Priority Date: 12/04/2002
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ni, Quan, Hajenga, Zoe, Daum, Douglas R., Stahmann, Jeff E., Hatlestad, John D., Lee, Kent
• Primary Examiner(s): Thomson, Bill
• Assistant Examiner(s): Archer, Marie
• Application Number:
  US11/717,561
• Publication Number:
  US 20070161873A1
• Time in Patent Office: 2,380 Days
• Field of Search: 600300-301, 600363-365, 600372-374, 600377-379, 600382-384, 600386-394, 600/481, 600/485, 600500-503, 600/508, 600515-519, 600529-531, 600544-547, 600/549, 600587-595, 607 1-156
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/4809 Sleep detection, i.e. determining whether a subject is asleep or not
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7271 Specific aspects of physiological measurement analysis A61B5/316, A61B5/349 and A61B5/374 take precedence
• 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: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleep-related signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.

Claims

1. A method of detecting sleep, comprising:

sensing a plurality of sleep-related signals, the sleep-related signals comprising at least two of a cardiac signal, a respiratory signal, and a patient activity signal;

adjusting a sleep criterion associated with a specified sleep-related signal of the plurality of sleep-related signals using one of the sleep-related signals other than the specified signal;

comparing the specified signal to the adjusted sleep criterion;

detecting sleep based on the comparison;

generating an output signal indicative of an outcome of the sleep detection; and

transmitting the output signal to another device capable of operating responsively to the output signal;

wherein at least one of sensing, adjusting, comparing, and detecting is performed at least in part implantably and effectuated at least in part by a processor.

2. The method of claim 1, further comprising establishing the sleep criterion.

3. The method of claim 2, wherein the sleep criterion is established based on clinical data.

4. The method of claim 2, wherein establishing the sleep criterion comprises establishing a sleep threshold associated with the specified one of the sleep-related signals.

5. The method of claim 2, wherein establishing the sleep criterion further comprises modifying the sleep criterion.

6. The method of claim 2, wherein establishing the sleep criterion further comprises adjusting a sensitivity of the sleep criterion.

7. The method of claim 2, further comprising adjusting the sleep criterion associated with the activity signal using another one of the cardiac signal and the respiratory signal.

8. The method of claim 1, wherein at least one of the sleep-related signals is a non-physiological signal.

9. A sleep detection device, comprising:

sensors, including cardiac electrodes configured to sense cardiac electrical signals, configured to sense a plurality of sleep-related signals; and

an implantable sleep processor coupled to the sensors, the sleep processor configured to adjust a sleep criterion associated with a first sleep-related signal using a second sleep-related signal of the plurality of sleep-related signals, compare the first sleep-related signal to the adjusted sleep criterion;

detect sleep based on the comparison, generate an output signal indicative of an outcome of the sleep detection, and transmit the output signal to another device capable of receiving the output signal.

10. The device of claim 9, wherein the sleep processor is configured to determine a relationship between at least two of the sleep-related signals based on patient data.

11. The device of claim 9, wherein the sleep processor is configured to determine a relationship between at least two of the sleep-related signals based on clinical data.

12. The device of claim 9, wherein the sensors include an accelerometer configured to sense patient activity and transthoracic impedance sensor configured to sense respiration.

13. The device of claim 9, wherein at least one of the sensors is external of the patient.

14. The device of claim 9, wherein the sleep processor is a component of an implantable cardiac therapy device.

15. A sleep detection system, comprising:

sensors, including cardiac electrodes configured to sense cardiac electrical signals, configured to detect a plurality of sleep-related signals;

means for adjusting a sleep criterion associated with a first sleep-related signal using a second sleep-related signal of the plurality of sleep-related signals;

means for comparing the first sleep-related signal to the adjusted sleep criterion;

means for implantably detecting sleep based on the comparison; and

means for transmitting an output signal to another device capable of receiving the output signal, the output signal indicative of an outcome of the sleep detection.

16. The system of claim 15, further comprising means for determining a relationship between at least two of the sleep-related signals to establish the sleep criterion.

17. The system of claim 15, further comprising means for establishing the sleep criterion based on at least one of the sleep-related signals.

18. The system of claim 17, further comprising means for adjusting a sensitivity of the sleep criterion.

19. The system of claim 15, further comprising means for modifying the sleep criterion.