Method and system for providing behavioural therapy for insomnia

• US 8,979,730 B2
• Filed: 06/01/2010
• Issued: 03/17/2015
• Est. Priority Date: 06/04/2009
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Naujokat, Elke, Zhang, Hui, Devot, Sandrine Magali Laure, Rademaker, Antonius Arnoldus Johannes, Hoos, William Arthur
• Primary Examiner(s): Matthews, Christine
• Assistant Examiner(s): LANNU, JOSHUA DARYL DEANON
• Application Number:
  US13/375,325
• Publication Number:
  US 20120238800A1
• Time in Patent Office: 1,750 Days
• Field of Search: 600 26- 28
• US Class Current: 600/26
• 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 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4809 Sleep detection, i.e. determining whether a subject is asleep or not
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/6804 Garments; Clothes
• CPC Class Codes: A61B 5/6887 mounted on external non-worn devices, e.g. non-medical devices
• CPC Class Codes: A61B 5/7267 involving training the classification device
• CPC Class Codes: G09B 19/00 Teaching not covered by other main groups of this subclass teaching or practice apparatus for gun-aiming or gun-laying F41G3/26
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

The disclosed system and method provide for the automatic assessment of the presence/severity of the sleep problem and its exact nature. The assessment is based on qualitative information about sleep patterns, insomnia-related factors and daytime consequences, as well as quantitative information about sleep patterns measured by a sensor. By combining the different sources of information (subjective as well as objective data), the diagnosis gives more insight into the nature of the sleep problem and is therefore more accurate. Furthermore, the disclosed system may be used to select specific components of the system that are medically relevant to the individual and therefore create a personalized program. The system teaches a selection of self-management skills that could help the individual to better cope with sleep disturbances and target those factors that maintain the problem or make it worse by a particular individual.

Claims

1. A method of providing cognitive behavioral therapy for insomnia with a cognitive behavioral therapy system, the system comprising a communication assembly, a sensor system, one or more processing units, and a display, said method comprising the steps of:

monitoring a patient'"'"'s sleep with the communication assembly, the one or more processing units, and the sensor system, the sensor system having at least one unobstrusive sensor, said sensor system structured to detect sleeping activity data;

gathering patient input data with the one or more processing units, at least one of the one or more processing units having an input assembly configured to gather patient input data, wherein the input data indicates a severity of an effect of the patient'"'"'s insomnia on daytime activities;

creating a patient sleep profile by combining, with the one or more processing units, said patient input data and said sleeping activity data;

determining a course of therapy by analyzing, with the one or more processing units, said patient sleep profile; and

presenting said course of therapy to said patient with the display.

2. The method of claim 1 wherein said step of monitoring a patient'"'"'s sleep utilizing the sensor system having at least one unobtrusive sensor includes the steps of:

utilizing an ECG sensor a respiration sensor, and an actigraph sensor, said ECG sensor structured to detect heart rate data, said respiration sensor structured to detect respiratory rate data, said actigraph sensor structured to detect patient body movement data; and

processing, with the one or more processing units said heart rate data, respiratory rate data, and patient body movement data to determine at least one of said patient'"'"'s time in bed, said patient'"'"'s total sleep time, said patient'"'"'s total wake time, said patient'"'"'s sleep efficiency, said patient'"'"'s sleep onset latency, said patient'"'"'s awakenings after sleep onset and said patient'"'"'s snooze time.

3. The method of claim 2 wherein said step of gathering patient input data with the one or more processing units includes the steps of:

gathering data on said patient'"'"'s sleep history;

gathering data on said patient'"'"'s medical history;

having said patient complete an insomnia severity index; and

having said patient maintain a sleep log.

4. The method of claim 3 wherein said step of analyzing said patient sleep profile to determine a course of therapy with the one or more processing units includes the steps of:

analyzing said patient input data and said sleeping activity data to identify factors contributing to the patient'"'"'s insomnia; and

identifying a type of insomnia associated with the patient.

5. The method of claim 3 wherein said step of analyzing said patient sleep profile to determine a course of therapy with the one or more processing units includes the steps of:

analyzing said patient input data and said sleeping activity data to determine the severity of the patient'"'"'s insomnia;

analyzing said patient input data to determine the severity of the effect of the patient'"'"'s insomnia on daytime activities;

analyzing said patient input data to determine which type of insomnia is suffered by the patient; and

based on the severity of the patient'"'"'s insomnia, the severity of the effect of the patient'"'"'s insomnia on daytime activities, and the type of insomnia suffered by the patient, recommending to the patient one of the following;

referral to a medical professional for treatment, recommending an interactive course of therapy to said patient, and recommending no treatment.

6. The method of claim 5 wherein, responsive to an interactive course of therapy being recommended, said steps of analyzing said patient sleep profile to determine a course of therapy with the one or more processing units and presenting said course of therapy to said patient with the display include the steps of:

providing a plurality of interactive therapeutic instruction modules, wherein individual said modules are related to an aspect of insomnia;

based on said patient sleep profile, determining which of said interactive therapeutic instruction modules are relevant to the patient'"'"'s insomnia;

determining a sequence of said interactive therapeutic instruction modules to be presented to said patient; and

presenting in said sequence, said interactive therapeutic instruction modules to said patient on the display.

7. The method of claim 6 wherein said plurality of interactive therapeutic instruction modules include a sleep scheduling module, an association bed-sleep module, a cognitive restructuring module, a coping strategy module, a relaxation module, and a lifestyle module.

8. The method of claim 7 wherein, responsive to said sleep scheduling module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of;

providing a sleep scheduling assessment structured to determine a first and a second sleep scheduling score;

determining the patient'"'"'s first and second sleep scheduling scores;

determining whether the patient has an irregular sleep schedule;

responsive to patient'"'"'s first sleep scheduling score being greater that a first sleep scheduling threshold value, providing sleep schedule coaching; and

responsive to the patient having an irregular sleep schedule and the patient'"'"'s second sleep scheduling score being greater than a second sleep scheduling threshold value, providing sleep schedule coaching.

9. The method of claim 7 wherein, responsive to said association bed-sleep module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of;

providing an association bed-sleep assessment structured to determine an association bed-sleep score; and

responsive to the patient'"'"'s association bed-sleep score being greater than an association bed-sleep threshold value, providing association bed-sleep coaching.

10. The method of claim 7 wherein, responsive to said cognitive restructuring module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of:

providing a first sleep concept assessment structured to determine a first sleep concept score;

responsive to the patient'"'"'first sleep concept score being greater than a first sleep concept threshold value, performing a second sleep concept assessment to determine an amplification score, a perceived control score, and an expectation score;

responsive to the patient'"'"'s amplification score greater than an amplification threshold value, providing amplification coaching;

responsive to the patient'"'"'s perceived control score being greater than a perceived control threshold value, providing perceived control coaching; and

responsive to the patient'"'"'s expectation score being greater than an expectation threshold value, providing expectation coaching.

11. The method of claim 7 wherein, responsive to said coping strategy module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of:

providing a first coping strategy assessment structured to determine a coping strategy score; and

responsive to the patient'"'"'s coping strategy score being greater than a coping strategy threshold value, providing coping strategy coaching.

12. The method of claim 7 wherein, responsive to said relaxation module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of:

providing a relaxation assessment structured to determine a transition time score, a worry time score, and a behavioral score;

responsive to the patient'"'"'s transition time score being greater than a transition time threshold value, providing transition time coaching;

responsive to the patient'"'"'s worry time score being greater than a worry time threshold value, providing worry time coaching; and

responsive to the patient'"'"'s behavioral score being greater than a behavioral threshold value, providing behavioral coaching.

13. The method of claim 7 wherein, responsive to said lifestyle module being recommended to the patient, said method of providing cognitive behavioral therapy for insomnia includes the further steps of:

providing a lifestyle assessment structured to determine a physical activity score, an alcohol score, a caffeine score, a napping score, a nicotine score. an intake score, and an environment score;

responsive to the patient'"'"'s physical activity score being greater than a physical activity threshold value, providing physical activity coaching;

responsive to the patient'"'"'s alcohol score being greater than an alcohol threshold value, providing alcohol coaching;

responsive to the patient'"'"'s caffeine score being greater than a caffeine threshold value, providing caffeine coaching;

responsive to the patient'"'"'s napping score being greater than a napping threshold value, providing napping coaching;

responsive to the patient'"'"'s nicotine score being greater than a nicotine threshold value, providing nicotine coaching;

responsive to the patient'"'"'s intake score being greater than an intake threshold value, providing intake coaching; and

responsive to the patient'"'"'s environment score being greater than an environment threshold value, providing environment coaching.

14. The method of claim 6 wherein said step of analyzing said patient'"'"'s sleep profile to determine a course of therapy with the one or more processing units includes the steps of:

updating the patient'"'"'s patient sleep profile with data from said patient input data and said sleeping activity data; and

repeating the steps of;

analyzing said patient input data and said sleeping activity data to determine the severity of the patient'"'"'s insomnia;

analyzing said patient input data to determine the severity of the effect of the patient'"'"'s insomnia on daytime activities;

analyzing said patient input data to determine the type of insomnia suffered by the patient; and

based on the severity of the patient'"'"'s insomnia, the severity of the effect of the patient'"'"'s insomnia on daytime activities, and the type of insomnia suffered by the patient, recommending to the patient one of the following;

referral to a medical professional for treatment, recommending an interactive course of therapy to said patient, and recommending no treatment.

15. The method of claim 6 wherein said steps of analyzing said patient sleep profile to determine a course of therapy with the one or more processing units include at least one of the steps of:

having a medical professional review the sleep pattern data, the patient input data and the a patient sleep profile; and

having said medical professional provide direct feedback to the patient via an electronic communications network.