Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing

• US 8,517,014 B2
• Filed: 12/30/2010
• Issued: 08/27/2013
• Est. Priority Date: 03/31/2004
• Status: Active Grant

• Current Assignee: ResMed Pty Ltd. (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Farrell, Michael, Hebblewhite, Malcolm, Stewart, Deidre, Tisthammer, Ann, Vance, Maya, Randolph, Robin
• Primary Examiner(s): DOUGLAS, STEVEN O
• Application Number:
  US12/982,536
• Publication Number:
  US 20110139155A1
• Time in Patent Office: 971 Days
• Field of Search: 128/204.18, 128/200.24, 128/200.26, 128/204.21, 128/204.26
• US Class Current: 128/204.18
• 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 5/7282 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 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/085 Gas sampling
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A method for relating to each other cardiovascular and sleep disordered breathing conditions of a patient. The patient'"'"'s heart rate and/or detailed echocardiogram data is monitored and recorded continuously or periodically together with sleep disordered breathing information on similar time scales. Changes in the patient'"'"'s heart rate associated with changes in sleep disordered breathing can then be observed. More specifically, positive airway pressure at therapeutic levels for treatment of sleep disordered breathing is applied while events associated with the treatment of the patient'"'"'s sleep disordered breathing are detected and recorded. At the same time, information concerning the cardiovascular condition of the patient is stored and the stored information concerning the cardiovascular condition of the patient and the recorded events associated with the treatment of the patient'"'"'s sleep disordered breathing are related to each other.

Claims

1. An apparatus for adjusting delivery of treatment for sleep disordered breathing to a patient comprising:

a positive airway pressure delivery device for continuously delivering therapeutic levels of pressurized air,

a detector for detecting patient breathing and events associated with the patient'"'"'s sleep disordered breathing,

a monitor for monitoring at least one parameter regarding the cardiovascular condition of said patient,

a storage medium for storing data regarding the breathing and cardiovascular condition of the patient and the delivered pressurized air over time, and

a processor for adjusting delivery of positive airway pressure based on breathing-associated detected events as well as patient breathing and cardiovascular condition changes over time.

2. The apparatus of claim 1 wherein said monitor monitors the patient'"'"'s heart rate.

3. The apparatus of claim 2 wherein said monitor is a Holter monitor.

4. The apparatus of claim 1 wherein said monitor is an echocardiogram monitor.

5. The apparatus of claim 1 wherein said breathing-associated detected events include at least one of apneas, hypopneas, partial obstructions, snoring, pressure versus time, flow versus time, and leaks.

6. The apparatus of claim 1 wherein the stored data include at least one or more of blood pressure, heart rate, oximetry data, electrocardiogram data, Holter analysis results, body mass index, left ventricular ejection fraction (LVEF), cardiac output data, and VO₂ max data.

7. The apparatus of claim 1 wherein said monitor is an oximeter.

8. A pressurized air delivery apparatus for relating a patient'"'"'s cardiovascular and sleep disordered breathing conditions to each other, comprising:

a cardiovascular condition monitor for monitoring and recording the cardiovascular condition of a patient continuously or periodically,

a detector for detecting patient breathing and related events associated with the treatment of the patient'"'"'s sleep disordered breathing over time,

a respiratory therapy delivery device for providing a patient with respiratory therapy, and

a processor (1) for analyzing detected patient breathing and sleep disordered breathing treatment on similar time scales, (2) for correlating changes in the patient'"'"'s cardiovascular condition with changes in sleep disordered breathing and treatment, and (3) for adjusting the delivered therapy treatment.

9. The apparatus of claim 8 wherein said monitor monitors the patient'"'"'s heart rate.

10. The apparatus of claim 9 wherein said monitor is a Holter monitor.

11. The apparatus of claim 8 wherein said monitor is an echocardiogram monitor.

12. The apparatus of claim 9 wherein said sleep disordered breathing-associated events include at least one of apneas, hypopneas, partial obstructions, snoring, pressure versus time, flow versus time, and leaks.

13. The apparatus of claim 8 wherein said monitor records at least one or more of blood pressure, heart rate, oximetry data, electrocardiogram data, Holter analysis results, body mass index, LVEF, cardiac output data, and VO₂ max data.

14. The apparatus of claim 8 wherein said monitor is an oximeter.

15. An apparatus for delivering respiratory therapy to a patient suffering from sleep disordered breathing, comprising:

an adjustable pressure delivery device,

a detector for detecting patient breathing over time and events associated with the patient'"'"'s sleep disordered breathing,

a monitor for collecting a patient'"'"'s cardiovascular condition data over time, and

a processor for automatically adjusting the pressure delivered by said pressure delivery device based on analyzing responses to a questionnaire regarding the patient'"'"'s condition, said collected cardiovascular condition data, and said detected breathing events.

16. The apparatus of claim 15 wherein said monitor monitors the patient'"'"'s heart rate.

17. The apparatus of claim 16 wherein said monitor is a Holter monitor.

18. The apparatus of claim 15 wherein said monitor is an echocardiogram monitor.

19. The apparatus of claim 15 wherein said sleep disordered breathing events include at least one of apneas, partial obstructions, snoring, pressure versus time, flow versus time, and leaks.

20. The apparatus of claim 15 wherein the collected data include at least one of one or more of blood pressure, heart rate, oximetry data, electrocardiogram data, Holter analysis results, body mass index, LVEF, cardiac output data, and VO₂ max data.

21. The apparatus of claim 15 wherein said monitor is an oximeter.