Methods and apparatus for apnea therapy stimulation

• US 9,586,048 B2
• Filed: 03/04/2015
• Issued: 03/07/2017
• Est. Priority Date: 04/04/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ternes, David J., Thakur, Pramodsingh Hirasingh, Ruble, Stephen B.
• Primary Examiner(s): Johnson, Nicole F
• Application Number:
  US14/638,221
• Publication Number:
  US 20150283383A1
• Time in Patent Office: 734 Days
• Field of Search: 607/18, 607/20
• 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 5/4818 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: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36078 Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy

Abstract

Disclosed herein, among other things, are methods and apparatus related to apnea therapy. One aspect of the present subject matter provides a method for apnea directed therapy. The method includes receiving a signal indicative of a real-time determination of type of an apnea event for a patient during the apnea event, and using the signal to select appropriate therapy to be applied to the patient during the apnea event to treat the apnea event, and to withhold inappropriate therapy. The therapy is applied in a closed loop system, in various embodiments. In various embodiments, the signal includes a determination of whether the apnea event is primarily an obstructive sleep apnea (OSA) event or primarily a central sleep apnea (CSA) event.

Claims

1. A method for apnea directed therapy, the method comprising:

receiving a signal indicative of a real-time or near real-time apnea event for a patient;

processing the signal to classify the apnea event as a mixed central sleep apnea (CSA)/obstructive sleep apnea (OSA) event;

using the classified apnea event to select appropriate electrical stimulation therapy to be applied to the patient during the apnea event to treat the classified apnea event; and

applying the electrical stimulation therapy in a closed loop system.

2. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily OSA event, wherein applying electrical stimulation therapy includes applying hypoglossal nerve stimulation when the classified apnea event is the primarily OSA event.

3. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily OSA event, wherein applying electrical stimulation therapy includes applying vagal nerve stimulation (VNS) when the classified apnea event is the primarily OSA event.

4. The method of claim 3, wherein applying VNS includes applying laryngeal stimulation.

5. The method of claim 3, wherein applying VNS includes applying laryngeal stimulation using selective fiber stimulation.

6. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily OSA event, wherein applying electrical stimulation therapy includes applying hypoglossal nerve stimulation in combination with applying VNS when the classified apnea event is the primarily OSA event.

7. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily CSA event, wherein applying electrical stimulation therapy includes applying phrenic nerve stimulation when the classified apnea event is the primarily CSA event.

8. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily CSA event, wherein applying electrical stimulation therapy includes using a cardiac rhythm management (CRM) device when the classified apnea event is the primarily CSA event.

9. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily CSA event, wherein applying electrical stimulation therapy includes applying phrenic nerve stimulation in combination with using a CRM device when the classified apnea event is the primarily CSA event.

10. The method of claim 1, further comprising processing the signal to classify another apnea event as a primarily CSA event, wherein applying electrical stimulation therapy includes applying VNS reflex cough stimulation when the classified apnea event is the primarily CSA event.

11. The method of claim 1, wherein applying electrical stimulation therapy includes applying stimulation to treat CSA and applying stimulation to treat OSA when the classified apnea event is the mixed CSA/OSA event.

12. The method of claim 11, wherein applying stimulation to treat CSA and applying stimulation to treat OSA after applying stimulation to treat CSA when the classified apnea event is the mixed CSA/OSA event.

13. The method of claim 11, wherein applying stimulation to treat CSA includes stimulating a diaphragm.

14. The method of claim 13, wherein applying stimulation to treat OSA includes stimulating to correct mechanical timing between the diaphragm and throat.