System and method for diagnosis and treatment of a breathing pattern of a patient

• US 9,533,115 B2
• Filed: 02/09/2016
• Issued: 01/03/2017
• Est. Priority Date: 08/14/2003
• Status: Expired due to Term

• Current Assignee: New York University
• Original Assignee: New York University
• Inventors: Rapoport, David M., Norman, Robert G.
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US15/019,347
• Publication Number:
  US 20160151593A1
• Time in Patent Office: 329 Days
• US Class Current: 1/1
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• 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 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/7267 involving training the classification device
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/40 Respiratory characteristics

Abstract

Described is a system including a sensor and a processing arrangement. The sensor measures data corresponding to a patient'"'"'s breathing patterns. The processing arrangement analyzes the breathing patterns to determine whether the breathing patterns are indicative of a REM sleep state. In another embodiment, the processing arrangement analyzes the breathing patterns to determine whether the breathing patterns are indicative of one of the following states: (i) a wake state and (ii) a sleep state. In another embodiment, a neural network analyzes the data to determine whether the breathing patterns are indicative of one of the following states: (i) a REM sleep state, (ii) a wake state and (iii) a sleep state. In another embodiment, the processing arrangement analyzes the data to determine whether the breathing pattern is indicative of an arousal.

Claims

1. A positive airway pressure system which delivers of a flow of breathable gas at a positive treatment pressure with respect to ambient air pressure to an entrance of a patient'"'"'s airways in order to assist in treating a sleeping disorder, the positive airway pressure system comprising:

a flow generator which generates a flow of breathable gases to be supplied to a patient;

a flow sensor measuring data indicative of the patient'"'"'s breathing patterns; and

at least one hardware processor which receives the measured data corresponding to the flow of breathable gases from the flow sensor and analyzes the data, the hardware processor determines whether to alter the pressure supplied by the flow generator to the airway of the patient based, at least in part, on the indication of the patient'"'"'s breathing patterns, wherein the hardware processor automatically increases a pressure supplied to the patient when the hardware processor determines that an indication of the patient'"'"'s breathing patterns representative of a change from an awake state to an asleep state has occurred, the indication of the patient'"'"'s breathing patterns representative of a change from an awake state to an asleep state including at least one of a regularity of breathing or a regular period of obstructions.

2. The system of claim 1, wherein the regular period of obstructions are a repetitive obstructive event.

3. The system of claim 1, wherein the regular period of obstructions are three or more obstructions.

4. The system of claim 3, wherein the obstructions are apneas.

5. The system of claim 3, wherein the obstructions are hypopneas.

6. The system of claim 3, wherein the obstructions are elevated upper airway resistance.

7. The system of claim 1, wherein the flow sensor is an airflow sensor.

8. The system of claim 1, wherein the flow sensor is a pressure sensor.

9. The system of claim 1, wherein when the hardware processor determines during an asleep state that the patient is experiencing a breathing pattern indicative of an elevated upper airway resistance, the hardware processor increases the pressure applied to the airway of the patient.

10. The system of claim 1, wherein when the hardware processor determines during an asleep state that the patient is experiencing a breathing pattern indicative of a hypopnea event, the hardware processor increases the pressure applied to the airway of the patient.

11. The system of claim 1, wherein when the hardware processor determines during an asleep state that the patient is experiencing a breathing pattern indicative of an apnea event, the hardware processor increases the pressure applied to the airway of the patient.

12. The system of claim 1, wherein when the hardware processor determines that the patient is experiencing a breathing pattern indicative of a transition to an awake state from an asleep state, the hardware processor lowers the pressure applied to the airway of the patient.

13. The system of claim 12, wherein the awake state is a troubled wakefulness state.

14. The system of claim 1, wherein the pressure is increased using a ramp procedure.

15. A positive airway pressure system for delivery of a flow of breathable gas at a positive treatment pressure with respect to ambient air pressure delivered to an entrance of a patient'"'"'s airways in order to assist in treating a sleeping disorder, the positive airway pressure system comprising:

a flow generator which generates a flow of breathable gases to be supplied to a patient;

a flow sensor measuring data corresponding to the flow of breathable gases directed to the patient and indicative of the patient'"'"'s breathing patterns; and

a hardware processor which receives the measured data corresponding to the flow of breathable gases from the flow sensor and analyzes the data for an indication of the patient'"'"'s breathing patterns, the hardware processor determines whether to alter a pressure supplied by the flow generator to the airway of the patient based, at least in part, on the indication of the patient'"'"'s breathing patterns, wherein the hardware processor analyzes the indication of the patient'"'"'s breathing patterns for a pattern indicative of a transition between an awake state and an asleep state, wherein the pattern indicative of a transition between an awake state and an asleep state is at least one of a regularity of breathing or a regular period of obstructions, wherein when the hardware processor determines a pattern indicative of a transition between an awake state and an asleep state has occurred, the hardware processor increases the pressure supplied by the flow generator to the airway of the patient.

16. The system of claim 15, wherein the obstructions are one or more of apneas, hypopneas or elevated upper airway resistance.

17. The system of claim 15, wherein the regular period of obstructions are three or more obstructions.

18. The system of claim 15, wherein when the hardware processor determines during an asleep state that the indication of the patient'"'"'s breathing patterns is indicative of the patient experiencing an elevated upper airway resistance, the hardware processor increases the pressure applied to the airway of the patient.

19. The system of claim 15, wherein the awake state is a troubled wakefulness state.

20. The system of claim 15, wherein the pressure is increased using a ramp procedure.

21. A method for treatment of a sleeping disorder in a patient using a positive airway pressure delivery system that delivers a flow of breathable gases at a positive treatment pressure with respect to ambient air pressure, the flow of breathable gases being delivered to an airway of a patient, the method comprising:

supplying a flow of breathable gases to an airway of a patient using a flow generator which generates a flow of gases to produce a positive pressure at or above a pressure at ambient air pressure;

measuring, using a sensor, data indicative of the patient'"'"'s breathing patterns;

determining, using a hardware processor, one or more indications of the patient'"'"'s breathing patterns based on the data indicative of the patient'"'"'s breathing patterns, the indications including a regularity of breathing or a regular period of obstructions indicative of an asleep state;

applying no pressure or a low pressure, using the flow generator, when the patient is in an awake state; and

increasing an applied pressure to an elevated pressure when the hardware processor determines that the patient has transitioned from the awake state to the asleep state based on the one or more indications of the patient'"'"'s breathing patterns.

22. The method of claim 21, wherein the obstructions include at least one or more of an apnea, hypopnea or elevated upper airway resistance.

23. The method of claim 21, wherein a regular period of obstructions comprises at least three obstructions.

24. The method of claim 21, further comprising:

increasing a previously provided pressure supplied to a patient when the patient is in an asleep state and an obstruction is detected in the one or more indications of the patient'"'"'s breathing patterns.

25. The method of claim 21, wherein applying no pressure or a low pressure when the patient is in an awake state comprises lowering a pressure when the one or more indications of the patient'"'"'s breathing patterns indicate the patient is in a troubled wakefulness state.

26. The method of claim 21, further comprising:

ramping the applied pressure when the applied pressure is increased.

27. A positive airway pressure system for delivery of a flow of breathable gas at a positive treatment pressure with respect to ambient air pressure delivered to an entrance of a patient'"'"'s airways in order to assist in treating a sleeping disorder, the positive airway pressure system comprising:

a flow generator which generates a flow of breathable gases to be supplied to a patient;

a flow sensor measuring data corresponding to the flow of breathable gases directed to the patient and indicative of the patient'"'"'s breathing patterns; and

a hardware processor which receives the measured data corresponding to the flow of breathable gases from the flow sensor and analyzes the data to determine the patient'"'"'s breathing patterns, the hardware processor also determines whether to alter a pressure supplied by the flow generator to the airway of the patient based, at least in part, on the determined breathing patterns of the patient, wherein the hardware processor analyzes the breathing patterns for indications of a transition between an awake state and an asleep state, the indications being a regularity of breathing, wherein when the hardware processor determines a regularity of breathing has occurred, the hardware processor increases the pressure supplied by the flow generator to the airway of the patient.

28. The system of claim 27, wherein increasing the pressure is performed by a ramping procedure.

29. The system of claim 27, wherein the hardware processor further increases pressure when one or more obstructions is detected during an asleep state.

30. The system of claim 27, wherein the regularity of breathing is a regular pattern of breathing over a time period.