Method and apparatus for the treatment of obstructive sleep apnea

• US RE35,339 E
• Filed: 08/28/1992
• Issued: 10/01/1996
• Est. Priority Date: 12/22/1987
• Status: Expired due to Term

• Current Assignee: New York University
• Original Assignee: New York University
• Inventors: Rapoport, David M.
• Primary Examiner(s): Lewis, Aaron J.
• Application Number:
  US07/936,675
• Time in Patent Office: 1,495 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/205.25, 128/205.24, 128/207.13
• US Class Current: 128/204.18
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0683 Holding devices therefor
• CPC Class Codes: A61M 16/0825 with ball-sockets
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2210/0618 Nose

Abstract

A method and apparatus for the treatment of obstructive sleep apnea wherein a continuous positive pressure is supplied to a nose mask from a threshold valve via a flexible tube, and air is discharged from the mask via vent holes in the mask for rapid discharge of exhaled air.

Claims

1. An assembly for treatment of obstructive sleep apnea comprising:

a nose mask adapted to be fitted over the nose of a patient;

supply means coupled to said mask for supplying air with continuous positive pressure to said mask suited to maintain the nasopharynegeal airway of a patient open when said supply means is supplied with gas at positive pressure, said supply means comprising an elongated flexible tube coupled at one end to said mask and having an opposite and remote from said mask that is connected to inlet means for receiving pressurized air and delivering air to said flexible tube to establish within the mask a predetermined range of pressures;

venting means located on the nose mask for continuously venting patient expiratory flow while said positive pressure is applied to said mask via said supply means; and

a threshold valve mounted at said opposite end of the flexible tube and adjustable for maintaining a positive pressure within said mask in the range of about 5 to 15 centimeters water at all times when said mask is fitted over the nose of a patient for respiration.

2. An assembly as claimed in claim 1 wherein said venting means comprises in the mask at least one vent hole spaced from the coupling of the tube to the mask.

3. An assembly as claimed in claim 2 wherein said gas is air and said at least one vent hole vents air in the range of 5-15 liters/minute for internal mask pressures in the range of 5-15 centimeters water.

4. An assembly as claimed in claim 3 wherein said at least one vent hole comprises two vent holes each venting air in the range of about 5-7 liters/minute for internal mask pressures in the range of 5-15 centimeters water.

5. An assembly as claimed in claim 4 wherein said vent holes are each closable by means of a plug.

6. In the method for the treatment of obstructive sleep apnea comprising supplying air of a continuous positive pressure within a pressure range of 5-15 centimeters water via a long flexible tube to a nose mask to maintain the nasopharyngeal airway of a patient open, the improvement comprising controlling the pressure in the nose mask by means of a threshold valve connected to the tube at a position remote from the mask, and continuously venting air, including patient expiratory air, directly from said mask via at least one hole in said mask, at a rate of 5-15 liters/minute.

7. A method as claimed in claim 6 wherein when the pressure in the nose mask is controlled by the threshold valve to a value in the range of =b 5-7 centimeters water, the continuous venting step is carried out at a rate of approximately 10-12 liters/minute, and when the pressure in the nose mask is increased to a value in the range of 10-15 centimeters water, the continuous venting is of the order of 5-7 liters/minute. .Iadd.

8. An assembly for treatment of obstructive sleep apnea comprising:

a nose mask adapted to be fitted over the nose of a patient;

supply means coupled to said mask for supplying air with continuous positive pressure to said mask suited to maintain the nasopharyngeal airway of a patient open when said supply means is supplied with gas at positive pressure, said supply means comprising an elongated flexible tube coupled at one end to said mask and having an opposite end remote from said mask that is connected to inlet means for receiving pressurized air and delivering air to said flexible tube to establish within the mask a predetermined range of pressures;

venting means located on the nose mask for continuously venting patient expiratory flow while said positive pressure is applied to said mask via said supply means; and

means mounted at said opposite end of the flexible tube and adjustable for maintaining a positive pressure within said mask in the range of about 5 to 15 centimeters water at all times when said mask is fitted over the nose of a patient for respiration..Iaddend..Iadd.

9. An assembly for treatment of obstructive sleep apnea comprising:

a nose means adapted to be fitted to the nose of a patient for sealing off the nose;

supply means coupled to said nose means for supplying air with continuous positive pressure to said nose means suited to maintain the nasopharyngeal airway of a patient open when said supply means is supplied with gas at positive pressure, said supply means comprising an elongated flexible tube coupled at one end to said nose means and having an opposite end remote from said nose means that is connected to inlet means for receiving pressurized air and delivering air to said flexible tube to establish within the nose means a predetermined range of pressures;

venting means located on the nose means for continuously venting patient expiratory flow while said positive pressure is applied to said nose means via said supply means; and

means mounted at said opposite end of the flexible tube and adjustable for maintaining a positive pressure within said nose means in the range of about 5 to 15 centimeters water at all times when said nose means is fitted to the nose of a patient for respiration..Iaddend..Iadd.10. An assembly for treatment of obstructive sleep apnea comprising;

a nose means adapted to be fitted to the nose of a patient for sealing off the nose;

supply means coupled to said nose means for supplying air with continuous positive pressure to said nose means suited to maintain the nasopharyngeal airway of a patient open when said supply means is supplied with gas at positive pressure, said supply means comprising an elongated flexible tube coupled at one end to said nose means and having an opposite end remote from said nose means that is connected to inlet means for receiving pressurized air and delivering air to said flexible tube to establish within the nose means a predetermined range of pressures;

venting means located on the nose means for continuously venting patient expiratory flow while said positive pressure is applied to said nose means via said supply means; and

means mounted at said opposite end of the flexible tube and adjustable for maintaining a positive pressure within said nose means all times when said nose means is fitted to the nose of a patient for respiration..Iaddend..Iadd.11. An assembly for treatment of obstructive sleep apnea, comprising;

a nose fitting for sealing off the nose of a patient;

an air supply coupled to said nose fitting for supplying air with continuous positive pressure to said nose fitting suited to maintain the nasopharyngeal airway of a patient open when said air supply is supplied with air at a positive pressure, said air supply comprising an elongated flexible tube coupled at one end to said nose fitting and having an opposite end that is connected to an inlet for receiving pressurized air and delivering air to said flexible tube to establish within said nose fitting a predetermined range of pressures;

at least one vent associated with said nose fitting for continuously venting patient expiratory flow while said positive pressure is applied to said nose fitting via said air supply; and

a pressure controller located at said opposite end of said flexible tube and adjustable for continuously maintaining a positive pressure within said nose fitting when said nose fitting is fitted to the nose of a patient for respiration..Iaddend..Iadd.12. An assembly for treatment of obstructive sleep apnea, comprising;

a nose fitting for the nose of a patient for sealing off the nose;

an air supply coupled to said nose fitting for supplying air with continuous positive pressure to said nose fitting suited to maintain the nasopharyngeal airway of a patient open when said air supply is supplied with air at a positive pressure, said air supply comprising an elongated flexible tube coupled at one end to said nose fitting and having an opposite end that is connected to an inlet for receiving pressurized air and delivering air to said flexible tube to establish within said nose fitting a predetermined range of pressures;

at least one vent associated with said nose fitting for continuously venting patient expiratory flow while said positive pressure is applied to said nose fitting via said air supply; and

a pressure controller located at said opposite end of said flexible tube and adjustable for continuously maintaining a positive pressure within said nose fitting in the range of about 5 to 15 centimeters water when said nose fitting is fitted to the nose of a patient for

10. respiration..Iaddend..Iadd.13. An assembly for treatment of obstructive sleep apnea comprising:

a nose mask adapted to be fitted over the nose of a patient;

supply means coupled to said mask for supplying air with continuous positive pressure to said mask suited to maintain the nasopharynegeal airway of a patient open when said supply means is supplied with gas at positive pressure, said supply means comprising an elongated flexible tube coupled at one end to said mask and having an opposite end remote from said mask that is connected to inlet means for receiving pressurized air and delivering air to said flexible tube to establish within the mask a predetermined range of pressures;

a pressure controller mounted at said opposite end of the flexible tube and adjustable for maintaining a positive pressure within said mask in the range of about 5-15 centimeters water at all times when said mask is fitted over the nose of a patient for respiration;

at least one continuously open vent hole located on the nose mask for continuously venting patient expiratory flow while said positive pressure is applied to said mask via said supply means, said vent hole being small enough not to vent off all of the positive pressure supplied by the supply means while at the same time being large enough to vent the patient'"'"'s expired air over the period of expiration..Iaddend..Iadd.14. An assembly for treatment of obstructive sleep apnea as claimed in claim 13, wherein said vent hole is located on the mask such that the incoming pressurized air carries the patient'"'"'s expired air through the vent hole..Iaddend..Iadd.15. A method for the treatment of a patient suffering from obstructive sleep apnea, comprising;

(a) supplying air at a continuous positive pressure within a pressure range of about 5-15 centimeters water via a long flexible tube to means fitted to the nose of the patient for sealing off the nose to maintain the nasopharyngeal airway of the patient open,

(b) controlling the positive pressure in the means fitted to the nose by a pressure controller connected to the flexible tube at a position remote from the mask,

(c) continuously venting air, including patient expiratory air, directly from said means fitted to the nose via at least one hole associated with said means fitted to the nose while said air at a continuous positive pressure is being supplied to the means fitted to the nose of the patient,

(d) said at least one hole associated with said means fitted to the nose of the patient being sized such that it does not vent all of the positive pressure supplied via the flexible tube while at the same time venting the patient'"'"'s expired air over the period of expiration, the air at the positive pressure carrying the patient'"'"'s expired air through the at least one hole associated with said means fitted to the nose of the patient.