System and method for diagnosis and treatment of a breathing pattern of a patient

• US 9,867,955 B2
• Filed: 02/27/2015
• Issued: 01/16/2018
• Est. Priority Date: 08/14/2003
• Status: Expired due to Term

• Current Assignee: New York University
• Original Assignee: New York University
• Inventors: Rapoport, David M., Norman, Robert G.
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US14/633,535
• Publication Number:
  US 20150165147A1
• Time in Patent Office: 1,054 Days
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/0826 Detecting or evaluating apnoea events A61B5/4818 takes precedence
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4809 Sleep detection, i.e. determining whether a subject is asleep or not
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7267 involving training the classification device
• 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: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• 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 16/026 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 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/003 : with a flowmeter
• CPC Class Codes: A61M 2016/0033 : electrical
• CPC Class Codes: A61M 2016/0039 : in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 : in the expiratory circuit
• CPC Class Codes: A61M 2205/3334 : Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 : Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 : Electroencephalographic signals
• CPC Class Codes: A61M 2230/18 : Rapid eye-movements [REM]
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/42 : Rate
• CPC Class Codes: G16H 50/70 : for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: Y10S 128/925 : Neural network

Abstract

Described is a system including a sensor and a processing arrangement. The sensor measures data corresponding to a patient'"'"'s breathing patterns. The processing arrangement analyzes the breathing patterns to determine whether the breathing patterns are indicative of a REM sleep state. In another embodiment, the processing arrangement analyzes the breathing patterns to determine whether the breathing patterns are indicative of one of the following states: (i) a wake state and (ii) a sleep state. In another embodiment, a neural network analyzes the data to determine whether the breathing patterns are indicative of one of the following states: (i) a REM sleep state, (ii) a wake state and (iii) a sleep state. In another embodiment, the processing arrangement analyzes the data to determine whether the breathing pattern is indicative of an arousal.

Claims

1. A positive airway pressure system for delivery of a flow of breathable gas at a positive treatment pressure with respect to ambient air pressure delivered to an entrance of a patient'"'"'s airways in order to assist in treating a sleeping disorder in a patient, the positive airway pressure system comprising:

a flow generator which supplies a positive treatment pressure flow of breathable gases to the entrance of a tube, the tube directing the flow of breathable gases to the airway of a patient to provide the patient with the positive treatment pressure flow of breathable gases;

a flow sensor located in a flow path of the positive treatment pressure flow of breathable gases, the flow sensor measuring data corresponding to the flow of breathable gases directed to the patient and indicative of the patient'"'"'s breathing patterns; and

a processing arrangement which receives the measured data corresponding to the flow of breathable gases from the flow sensor and analyzes the data to determine the patient'"'"'s breathing patterns, the processing arrangement also determines whether to alter the pressure supplied to the airway of the patient based, at least in part, on the determined breathing patterns of the patient, wherein the processing arrangement applies a greater positive treatment pressure in an asleep state and a lesser positive treatment pressure in an awake state, wherein when the processor determines that the patient has transitioned between at least an awake state and an asleep state, the processing arrangement automatically controls the flow generator to increase a positive treatment pressure supplied to the entrance of the tube using a ramp system.

2. The system of claim 1, wherein the processing arrangement determines during an asleep state that the patient is experiencing an elevated upper airway resistance based on the determined patient'"'"'s breathing patterns and increases the positive treatment pressure supplied to the entrance of the tube.

3. The system of claim 1, wherein the processing arrangement determines during an asleep state that the patient is experiencing a hypopnea event based on the determined patient'"'"'s breathing patterns and increases the positive treatment pressure.

4. The system of claim 1, wherein the processing arrangement determines during an asleep state that the patient is experiencing an apnea event based on the determined patient'"'"'s breathing patterns and increases the positive treatment pressure.

5. The system of claim 1, wherein the processing arrangement determines that the patient has transitioned to an awake state from an asleep state based on the determined patient'"'"'s breathing patterns and lowers the positive treatment pressure.

6. The system of claim 5, wherein the awake state is a troubled wakefulness state.

7. The system of claim 1, wherein the processing arrangement determines the patient'"'"'s state as a function of at least one of a patient'"'"'s blood pressure, a heart rate and EEG data.

8. The system of claim 1, further comprising a mask connected to a patient end of the tube and placed on a face of the patient and covering at least one of the mouth and the nose of the patient.

9. The system of claim 8, further comprising a venting arrangement preventing the patient from rebreathing exhaled airflow.

10. The system of claim 1, wherein the flow sensor is internal to the flow generator.

11. The system of claim 1, wherein the flow sensor is external to the flow generator.

12. The system of claim 1, wherein the processing arrangement determines that the patient is in an asleep state when the breathing pattern is a period of regular breathing indicative of a sleep state.

13. The system of claim 1, wherein the processing arrangement determines that the patient is in an asleep state when the breathing pattern indicates a pattern of hypopnea event.

14. The system of claim 1, wherein the processing arrangement determines that the patient is in an asleep state when the breathing pattern indicates a pattern of obstructive apnea events.

15. The system of claim 14, wherein the pattern of obstructive apnea events is at least three apnea events.

16. The system of claim 1, wherein when the processing arrangement determines that the patient has transitioned between at least an awake state and an asleep state and is experiencing a hypopnea event, the processing arrangement automatically increases the pressure to a treatment pressure.

17. The system of claim 1, wherein when the processor determines that the patient has transitioned between at least an awake state and an asleep state and is experiencing an apnea event, the processing arrangement automatically increases the pressure to a treatment pressure.

18. The system of claim 1, wherein when the processor determines that the patient has transitioned between at least an awake state and an asleep state and is experiencing elevated upper airway resistance, the processing arrangement automatically increases the pressure to at least a first treatment pressure.

19. A method for treatment of a sleeping disorder in a patient using a positive airway pressure delivery system that delivers a flow of breathable gases at a positive treatment pressure with respect to ambient air pressure, the flow of breathable gases being delivered to an airway of a patient, the method comprising:

supplying, using a flow generator which generates a flow of gases to produce a positive pressure at or above a pressure at ambient air pressure, a flow of breathable gases to an airway of a patient;

measuring, using a sensor, data indicative of the patient'"'"'s breathing patterns;

determining, using a processing arrangement, an indication of the patient'"'"'s breathing patterns based on the data indicative of the patient'"'"'s breathing patterns;

analyzing, using the processing arrangement, the indication of the patient'"'"'s breathing patterns to determine the sleep state of a patient;

increasing a pressure of the flow of breathable gases, using the flow generator, to an airway of a patient when the patient is in an asleep state and an elevated upper airway resistance is detected;

applying a lower pressure, using the flow generator, when the processing arrangement determines the patient is in an awake state based on the indication of the patient'"'"'s breathing patterns; and

ramping an applied pressure to an elevated pressure when the processing arrangement determines that the patient transitions from the awake state to the asleep state based on the indication of the patient'"'"'s breathing patterns.

20. The method of claim 19, further comprising increasing a previously provided pressure supplied to a patient when the patient is in an asleep state and a hypopnea is detected.

21. The method of claim 19, further comprising increasing a previously provided pressure supplied to a patient when the patient is in an asleep state and an apnea event is detected.

22. The method of claim 19, further comprising increasing a previously provided pressure supplied to a patient when the patient is in an asleep state and an elevated upper airway resistance is detected.

23. The method of claim 19, wherein applying a lower pressure when the patient is in an awake state comprises applying a lower pressure when the patient is in a troubled wakefulness state.

24. The method of claim 19, wherein ramping the applied pressure comprises automatically ramping the applied pressure without requiring a manual initiation from a user.

25. The method of claim 19, wherein ramping the applied pressure comprises a delay in the onset of the applied pressure.

26. The method of claim 19, wherein an asleep state is determined when regular breathing indicative of a sleep state is detected.

27. The method of claim 19, wherein an asleep state is determined when a series of hypopnea events are detected.

28. The method of claim 19, wherein an asleep state is determined when a series of obstructive apnea events are detected.

29. The method of claim 28, wherein the series of obstructive apnea events is at least three obstructive apnea events.

30. The method of claim 19, wherein when the processor determines that the patient has transitioned between at least an awake state and an asleep state and is experiencing an apnea event, the processing arrangement automatically increases the pressure to a treatment pressure.

31. The method of claim 19, wherein when the processor determines that the patient has transitioned between at least an awake state and an asleep state and is experiencing elevated upper airway resistance, the processing arrangement automatically increases the pressure to at least a first treatment pressure.