Implantable medical device with sleep disordered breathing monitoring

• US 6,964,641 B2
• Filed: 12/24/2003
• Issued: 11/15/2005
• Est. Priority Date: 12/24/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sheldon, Todd J., Warman, Eduardo N., Cho, Yong Kyun
• Primary Examiner(s): Nasser, Robert L.
• Assistant Examiner(s): MALLARI, PATRICIA C
• Application Number:
  US10/746,814
• Publication Number:
  US 20050148897A1
• Time in Patent Office: 692 Days
• Field of Search: 600300-301, 600529-543, 600/508, 600/509, 600587-595, 607/6, 607/8, 607 17- 24, 607/47, 607/116, 607/119, 607/42
• US Class Current: 600/529
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/0833 Measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/0878 using temperature sensing means
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61N 1/3601 : of respiratory organs
• CPC Class Codes: A61N 1/36521 : the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36557 : controlled by chemical substances in blood

Abstract

An implantable medical device (IMD) includes a sensor for monitoring parameters indicative of sleep disordered breathing. The IMD also includes a position sensor that indicates the relative position and/or activity level of the patient. The position sensor data is used in one or more ways in conjunction with the SDB sensing. The position data is used to confirm that such sensed data is likely indicative of SDB or to select the appropriate criteria for comparison.

Claims

1. An implantable medical device (IMD) comprising:

means for sensing a physical parameter relevant to sleep disordered breathing (SDB);

means for sensing a patient posture;

means for selecting criteria for evaluating the physical parameter, wherein the means for selecting base the criteria selection on the sensed patient posture; and

means for determining if the physical parameter is indicative of SDB based on the sensed patient posture and according to the selected criteria.

2. The IMD of claim 1, further comprising means for sensing a patient activity level, wherein the means for determining determines if the physical parameter is indicative of SDB based on the sensed patient posture and the sensed patient activity level.

3. A method of using an implantable medical device (IMD) for the detection of sleep disordered breathing in a patient comprising:

sensing a parameter indicative of SDB;

determining an orientation of the IMD indicative of a posture of the patient;

selecting a set of criteria to evaluate the sensed parameter, wherein the set of criteria is selected based on the determined orientation; and

evaluating the sensed parameter according to the selected set of criteria based upon the determined orientation to determine if SDB is present.

4. The method of claim 3, wherein the set of criteria include impedance values.

5. The method of claim 3, further comprising:

sensing an activity level of the patient, wherein evaluating further includes evaluating the sensed parameter based upon the determined orientation and the activity level.

6. The method of claim 3, wherein sensing of the parameter occurs prior to determining the orientation.

7. The method of claim 3, wherein determining the orientation occurs prior to sensing the parameter.

8. The method of claim 7, wherein the determined orientation toggles the IMD to sense for SDB when the determined orientation indicates a posture conducive to sleep.

9. The method of claim 4 wherein a first set of impedance values are utilized if the orientation indicates the patient is prone or supine and a second set of impedance values are utilized if the orientation indicates the patient is laying on his or her side.

10. An implantable medical device comprising:

a microprocessor;

a position sensor coupled with the microprocessor and providing data indicative of a patient posture;

a sleep disordered breathing (SDB) sensor communicatively coupled with the microprocessor and configured to sense a physical parameter that is useful in monitoring SDB and provide data to the microprocessor indicative of the physical parameter, wherein the microprocessor evaluates the data from the SDB sensor in a first manner if the position sensor indicates a first position and evaluates the data in a second manner if the position sensor indicates a second position; and

a memory containing a plurality of SDB criteria sets, wherein the microprocessor selects a given set of SDB criteria from the memory based ucon a specific position identified by the position sensor.

11. The IMD of claim 10, wherein the SDB sensor is an impedance sensor for monitoring minute ventilation and the criteria sets are impedance values.

12. The IMD of claim 11, wherein a first set of impedance values are selected if the position sensor indicates a prone or a supine position and a second set of impedance values are selected if the position sensor indicates a lateral position.

13. The IMD of claim 10, wherein the first position includes positions indicative of a sleep state and the second position includes positions indicative of a waking state.

14. The IMD of claim 10, further comprising an activity sensor communicatively coupled with the microprocessor wherein the activity sensor provides additional data to the microprocessor for selecting the first manner or the second manner.