Apnea type determining apparatus and method

• US 9,538,954 B2
• Filed: 01/14/2013
• Issued: 01/10/2017
• Est. Priority Date: 06/22/2006
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Patangay, Abhilash, Pu, Yachuan
• Primary Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US13/741,209
• Publication Number:
  US 20130131522A1
• Time in Patent Office: 1,457 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 5/0538 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 first respiration sensor configured to receive cyclic information indicative of inhalation or exhalation;

a different second non-respiration sensor configured to receive non-respiration information other than information indicative of inhalation or exhalation;

an apnea detection module, coupled to the first respiration sensor and to the different second non-respiration sensor, configured to recognize an apnea and distinguish a type of the recognized apnea from multiple different apnea types using the cyclic information indicative of inhalation or exhalation from the first respiration sensor and using the non-respiration information from the different second nonrespiration sensor; and

a therapy generation circuit configured to enable generation of a therapy based on the apnea type distinguished by the apnea detection module.

2. The system of claim 1, wherein the different second non-respiration sensor is configured to receive information other than cyclic information, and wherein the apnea detection module is configured to recognize the apnea using the information other than the cyclic information.

3. The system of claim 1, wherein the first respiration sensor includes an impedance sensor configured to detect impedance information that is indicative of inhalation or exhalation.

4. The system of claim 1, wherein the first respiration sensor includes a blood pressure sensor configured to detect blood pressure information that is indicative of inhalation or exhalation.

5. The system of claim 1, wherein the different second non-respiration sensor includes a blood pressure sensor configured to be located in association with a ventricle and to measure a ventricular pressure, and wherein the apnea detection module is configured to recognize the apnea using information from the first respiration sensor and the blood pressure sensor.

6. The system of claim 5, wherein the blood pressure sensor is configured to sense a left ventricle end diastolic pressure (LVEDP), and wherein the apnea detection module is configured to recognize the apnea using information from the first respiration sensor and information about the LVEDP.

7. The system of claim 1, comprising an apnea classifier module configured to distinguish between an apnea and a hypopnea using the information received from the first respiration sensor and the information received from the different second non-respiration sensor.

8. The system of claim 1, comprising an apnea classifier module configured to distinguish between Obstructive Sleep Apnea (OSA) and central sleep apnea (CSA) using the information received from the first respiration sensor and information received from the different second non-respiration sensor.

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

10. The system of claim 9, wherein the periodic respiration detector circuit is configured to identify Cheyne-Stokes respiration using information from both the first respiration sensor and the different second non-respiration sensor.

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

12. The system of claim 1, wherein the therapy generation circuit is configured to enable a phrenic nerve therapy during a recognized apnea.

13. The system of claim 1, wherein the therapy generation circuit is configured to enable a hypoglossal nerve therapy during a recognized apnea.

14. A method comprising:

receiving first physiological information from a first respiration sensor, the first physiological information indicative of inhalation or expiration;

receiving second non-respiration physiological information from a different second non-respiration sensor, the second non-respiration physiological information indicative of respiration other than cyclical information indicative of inhalation or expiration;

distinguishing, using a processor circuit, an apnea type, from among multiple different apnea types, using the first physiological information indicative of inhalation or expiration and the second non-respiration physiological information other than cyclical information indicative of inhalation or expiration; and

enabling generation of a therapy by a therapy generation circuit, the therapy based on the distinguished apnea type.

15. The method of claim 14, wherein the receiving the first physiological information indicative of inhalation or expiration includes receiving cyclical information indicative of inhalation or expiration, and wherein the distinguishing, using the processor circuit, the apnea type includes distinguishing the apnea using the cyclical information.

16. The method of claim 14, wherein the distinguishing, using the processor circuit, the apnea type includes recognizing a hypopnea using the first physiological information indicative of inhalation or expiration and using the second non-respiration physiological information other than the cyclical information indicative of inhalation or expiration.

17. The method of claim 14, wherein the receiving the second non-respiration physiological information other than cyclical information indicative of inhalation or expiration includes receiving ventricular pressure information from a blood pressure sensor configured to be located in association with a ventricle;

and

wherein the distinguishing, using the processor circuit, the apnea type includes using the ventricular pressure information.

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

receive first information from a first respiration sensor, the first information indicative of inhalation or exhalation;

receive physiological information from a different second non-respiration sensor, the physiological information other than cyclical information indicative of inhalation or exhalation;

recognize an apnea using the first information from the first respiration sensor;

distinguish an apnea type for the recognized apnea, from among multiple apnea types, using the physiological information from the different second non-respiration sensor; and

enable generation of a therapy by a therapy generation circuit and based on the distinguished apnea type for the recognized apnea.