Collecting sleep quality information via a medical device

• US 9,623,248 B2
• Filed: 12/07/2015
• Issued: 04/18/2017
• Est. Priority Date: 03/16/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Heruth, Kenneth T., Miesel, Keith A.
• Primary Examiner(s): BERHANU, ETSUB D
• Application Number:
  US14/961,344
• Publication Number:
  US 20160158552A1
• Time in Patent Office: 498 Days
• Field of Search: None
• CPC Class Codes: A61B 3/113 for determining or recording eye movement
• 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 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36078 Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• 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
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37247 : User interfaces, e.g. input or presentation means

Abstract

At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient'"'"'s sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient'"'"'s sleep.

Claims

1. A method comprising:

delivering, by a medical device system, electrical stimulation therapy to a patient according to a plurality of different therapy parameter sets;

monitoring, by the medical device system, at least one physiological parameter of the patient;

determining when the patient is asleep, and detecting occurrences of at least one of arousals and apneas when the patient is asleep based on the at least one physiological parameter;

associating each detected occurrence of an arousal or an apnea with a corresponding one of the plurality of different therapy parameter sets according to which the medical device delivered the therapy when the occurrence of the arousal or the apnea was detected;

for each of the plurality of different therapy parameter sets;

determining a plurality of values of a sleep quality metric based on the occurrences of the at least one of arousals and apneas associated with the corresponding therapy parameter set, each value of the plurality of values of the sleep quality metric indicating a number of the arousals or apneas over a period of time; and

determining a representative value of the sleep quality metric for the therapy parameter set based on the plurality of values of the sleep quality metric associated with the therapy parameter set;

storing the representative values of the sleep quality metric and an indication of the association of the therapy parameter sets with the respective representative values of the sleep quality metric; and

automatically adjusting the delivery of the electrical stimulation therapy to the patient based on the determined representative values.

2. The method of claim 1, wherein monitoring at least one physiological parameter comprises monitoring at least one of activity level, posture, respiration rate, respiratory volume, blood oxygen saturation, partial pressure of oxygen within blood, muscular activity, or arterial blood flow.

3. The method of claim 1, wherein monitoring at least one physiological parameter comprises monitoring at least one of heart rate or blood pressure.

4. The method of claim 1, further comprising presenting sleep quality information to a user based on the plurality of values of the sleep quality metric.

5. The method of claim 4, wherein presenting sleep quality information to the user comprises presenting a graphical representation of the sleep quality metric values.

6. The method of claim 5, wherein presenting the graphical representation comprises presenting at least one of a trend diagram, a histogram and a pie chart based on the plurality of values of the sleep quality metric.

7. The method of claim 4, wherein presenting sleep quality information to the user comprises presenting a message related to sleep quality to the patient via a patient programmer.

8. The method of claim 1, wherein detecting the occurrences of at least one of arousals and apneas when the patient is asleep based on the at least one physiological parameter comprises detecting the occurrences of at least one of arousals and apneas based on sudden changes in at least one of heart rate, respiration rate, or blood pressure.

9. The method of claim 1, wherein detecting the occurrences of at least one of arousals and apneas when the patient is asleep based on the at least one physiological parameter comprises detecting the occurrences of at least one of arousals and apneas based on sudden changes in a variability of the at least physiological parameter.

10. The method of claim 1, wherein delivering therapy to the patient comprises delivering neurostimulation therapy to the patient.

11. The method of claim 1, wherein delivering therapy to the patient comprises delivering cardiac pacing therapy to the patient.

12. The method of claim 1, further comprising:

presenting a list of the therapy parameter sets and associated representative values to a user; and

ordering the list of therapy parameter sets according to the associated representative values.

13. A medical system comprising:

a medical device configured to deliver an electrical stimulation therapy to a patient via a plurality of electrodes according to a plurality of different therapy parameter sets;

a monitor configured to monitor at least one physiological parameter of the patient;

a processor configured to determine when the patient is asleep, and detect occurrences of at least one of arousals or apneas when the patient is asleep based on the at least one physiological parameter,

wherein the processor is configured to associate each detected occurrence of an arousal or an apnea with a corresponding one of the plurality of therapy parameter sets according to which the medical device delivered the therapy when the occurrence of the arousal or the apnea was detected,

wherein, for each of the plurality of therapy parameter sets, the processor is configured to;

determine a plurality of values of a sleep quality metric based on the occurrences of the at least one of arousals or apneas associated with the corresponding therapy parameter set, each value of the plurality of values of the sleep quality metric indicating a number of the arousals or apneas over a period of time, and

determine a representative value of the sleep quality metric for the therapy parameter set based on the plurality of values of the sleep quality metric associated with the therapy parameter set; and

a memory that stores the representative values of the sleep quality metric and an indication of the association of the therapy parameter sets with the respective representative values of the sleep quality metric,

wherein the medical device is configured to automatically adjust the delivery of the electrical stimulation therapy to the patient based on the determined representative values.

14. The medical system of claim 13, wherein the at least one physiological parameter comprises at least one of activity level, posture, respiration rate, respiratory volume, blood oxygen saturation, partial pressure of oxygen within blood, muscular activity, or arterial blood flow.

15. The medical system of claim 13, wherein the at least one physiological parameter comprises at least one of heart rate or blood pressure.

16. The medical system of claim 13, further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor, wherein at least one of the one or more computing devices presents sleep quality information to a user based on the values of the sleep quality metric determined by the processor.

17. The medical system of claim 16, wherein the user comprises a clinician, and the computing device comprises a clinician programmer that presents at least one of a trend diagram, a histogram or a pie chart to the clinician based on the values of the sleep quality metric.

18. The medical system of claim 16, wherein the user comprises a patient, and the computing device comprises a patient programmer that presents a message related to sleep quality to the patient based on the values of the sleep quality metric.

19. The medical system of claim 13,

further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor,

wherein at least one of the one or more computing devices presents a list of the therapy parameter sets and the associated representative values to a user, and orders the list of therapy parameter sets according to the associated representative values.

20. The medical system of claim 13, wherein the medical device comprises the monitor.

21. The medical system of claim 13, wherein the medical device comprises the processor.

22. The medical system of claim 13, wherein the representative value for each therapy parameter set comprises one of a mean value or a median value of the numbers of arousals or apneas over the periods of time.

23. The medical system of claim 13, wherein, for each of the plurality of therapy parameter sets, the processor determines the value of the overall sleep quality metric by applying a function or look-up table to the determined values of each of the plurality of sleep quality metrics associated with that particular therapy parameter set.

24. The medical system of claim 13, wherein the processor is configured to detect the at least one of arousals and apneas based on sudden changes in occurrences of at least one of heart rate, respiration rate, or blood pressure.

25. The medical system of claim 13, wherein the processor is configured to detect the occurrences of at least one of arousals and apneas based on sudden changes in a variability of the at least physiological parameter.

26. The medical system of claim 13, wherein the medical device comprises an implantable medical device.

27. The medical system of claim 13, wherein the medical device is configured to deliver neurostimulation therapy to the patient.

28. The medical system of claim 13, wherein the medical device comprises a cardiac rhythm management device configured to deliver a cardiac pacing therapy to the patient.

29. A medical system comprising:

an implantable medical device comprising;

therapy delivery circuitry configured to deliver an electrical stimulation therapy to a patient via a plurality of electrodes according to a plurality of different therapy parameter sets;

sensing circuitry configured to sense at least one physiological parameter of the patient;

a processor configured to;

determine when the patient is asleep;

detect occurrences of at least one of arousals or apneas when the patient is asleep based on a variability of the at least one physiological parameter; and

associate each detected occurrence of an arousal or an apnea with a corresponding one of the plurality of therapy parameter sets according to which the medical device delivered the therapy when the occurrence of the arousal or the apnea was detected,

wherein, for each of the plurality of therapy parameter sets, the processor is configured to;

determine a plurality of values of a sleep quality metric based on the occurrences of the at least one of arousals or apneas associated with the therapy parameter set, each value of the plurality of values of the sleep quality metric indicating a number of the arousals or apneas over a period of time, and

determine a representative value of the sleep quality metric for the therapy parameter set based on the plurality of values of the sleep quality metric associated with the therapy parameter set; and

a memory that stores the representative values of the sleep quality metric and an indication of the association of the therapy parameter sets with the respective representative values of the sleep quality metric,

wherein the processor is configured to automatically adjust the delivery of the electrical stimulation therapy to the patient based on the determined representative values.