Coordinated use of respiratory and cardiac therapies for sleep disordered breathing

• US 8,104,470 B2
• Filed: 08/21/2009
• Issued: 01/31/2012
• Est. Priority Date: 09/18/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lee, Kent, Hartley, Jesse W., Stahmann, Jeffrey E., Ni, Quan
• Primary Examiner(s): DOUGLAS, STEVEN O
• Application Number:
  US12/545,670
• Publication Number:
  US 20090308395A1
• Time in Patent Office: 893 Days
• Field of Search: 128/204.18, 128/204.23, 128/204.21, 128/204.22, 128/200.24, 128/204.28, 128/912, 607/3, 607/9, 607/42, 600/529, 600/26, 600/27
• US Class Current: 128/204.18
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0009 with sub-atmospheric pressure, e.g. during expiration
• 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 2205/3523 using telemetric means
• CPC Class Codes: A61M 2230/00 Measuring parameters of the user
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585

Abstract

Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.

Claims

1. An automated method for treating disordered breathing, comprising:

delivering an external therapy to a patient to treat a respiratory condition;

delivering an internal therapy to the patient using an implantable device to treat the respiratory condition;

sensing one or more parameters; and

coordinating delivery of the external therapy and the internal therapy by shifting therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the one or more sensed parameters.

2. The method of claim 1, wherein the respiratory condition comprises sleep disordered breathing.

3. The method of claim 1, wherein the one or more parameters comprises prediction of disordered breathing.

4. The method of claim 1, wherein the one or more parameters comprises therapy interaction between the external therapy and the internal therapy.

5. The method of claim 1, wherein the one or more parameters comprises patient usage of an external therapy device that delivers the external therapy.

6. The method of claim 1, wherein the external therapy comprises a positive airway pressure therapy.

7. The method of claim 1, wherein the internal therapy comprises electrical energy delivered internally to the patient.

8. The method of claim 1, wherein:

sensing the one or more parameters comprises sensing one or more side effect conditions affecting the patient and associated with an impact of one or more of the external therapy and the internal therapy on the patient; and

coordinating delivery comprises shifting therapy burden from the external therapy or the internal therapy associated with the side effect condition to the other of the external therapy or the internal therapy.

9. The method of claim 1, wherein:

sensing the one or more parameters comprises sensing an impact of one or more of the external therapy and the internal therapy on the patient; and

coordinating delivery comprises shifting therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the sensed impact.

10. The method of claim 1, wherein:

sensing the one or more parameters comprises sensing excessive battery life consumption by the implantable device in delivering the internal therapy; and

coordinating delivery comprises shifting therapy burden from the internal therapy to the external therapy.

11. The method of claim 1, wherein:

sensing the one or more parameters comprises sensing an indication of patient discomfort associated with delivery of one or more of the external therapy and the internal therapy on the patient; and

coordinating delivery comprises shifting therapy burden from the external therapy or the internal therapy associated with the indication of patient discomfort to the other of the external therapy or the internal therapy.

12. A medical system for controlling therapy to treat a respiratory condition comprising:

a patient external therapy device configured to deliver an external therapy to a patient to treat a respiratory condition;

an implantable device configured to implantably deliver an internal therapy to the patient to treat the respiratory condition;

a sensor system for sensing one or more parameters; and

circuitry in communication with the external therapy device, the implantable device, and the sensor system, the circuitry configured to coordinate delivery of the external therapy and the internal therapy by shifting therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the one or more sensed parameters.

13. The medical system of claim 12, wherein the respiratory condition comprises sleep disordered breathing.

14. The medical system of claim 12, wherein the circuitry is further configured to predict sleep disordered breathing based on the one or more parameters and shift therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the sleep disordered breathing prediction.

15. The medical system of claim 12, wherein the one or more parameters comprises usage of the patient external therapy device.

16. The medical system of claim 12, wherein:

the sensor system is configured to sense at least one or more side effect conditions associated with an impact of one or both of the external therapy and the internal therapy on the patient as the one or more parameters; and

the circuitry is configured to shift therapy burden from the external therapy or the internal therapy associated with the side effect condition to the other of the external therapy or the internal therapy.

17. The medical system of claim 12, wherein:

the sensor system is configured to sense impact of one or both of the external therapy and the internal therapy on the patient as the one or more parameters; and

the circuitry is configured to shift therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the sensed impact.

18. The medical system of claim 12, wherein:

the sensor system is configured to sense excessive battery life consumption by the implantable device in delivery of the internal therapy as the one or more parameters; and

the circuitry is configured to shift therapy burden from the internal therapy to the external therapy based on the sensed excessive battery life consumption.

19. The medical system of claim 12, wherein:

the sensor system is configured to sense patient discomfort associated with one of the external therapy and the internal therapy on the patient as the one or more parameters; and

the circuitry is configured to shift therapy burden from the external therapy or the internal therapy associated with the patient discomfort to the other of the external therapy or the internal therapy.

20. A medical system for treating a respiratory condition, comprising:

means for delivering an external therapy to a patient to treat a respiratory condition;

means for delivering an internal therapy to the patient to treat the respiratory condition;

means for sensing one or more parameters; and

means for coordinating delivery of the external therapy and the internal therapy to address the respiratory condition by shifting therapy burden from the external therapy or the internal therapy to the other of the external therapy or the internal therapy based on the one or more sensed parameters.