Method and apparatus for optimizing the continuous positive airway pressure for treating obstructive sleep apnea
Inactive Publication Date: 2005-01-27
RAPOPORT DAVID M +1
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- Abstract
- Description
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- Application Information
AI Technical Summary
Benefits of technology
In accordance with the invention, an apparatus for the treatment of obstructive sleep apnea is provided, comprising a source of air, and means for directing an air flow from said source to a patient. This part of the system may be of the type disclosed, for example, in U.S. Pat. No. 5,065,756. In addition, means are provided for sensing the waveform of said airflow, to detect deviations therein that
Problems solved by technology
OSAS is one of the most common causes of excessive daytime somnolence.
The obstruction results in a spectrum of respiratory disturbances ranging from the total absence of airflow (apnea) to significant obstruction with or without reduced airflow (hypopnea and snoring), despite continued respiratory efforts.
However, it is now well recognized that obstruction of the upper airway during sleep is in part due to the collapsible behavior of the supraglottic segment during the negative intraluminal pressure generated by inspiratory effort.
The availability of this non-invasive form of therapy has resulted in extensive publicity for apnea and the appearance of large numbers of patients who previously may have avoided the medical establishment because of the fear of tracheostomy.
Despite its success, limitations to the use of nasal CPAP exist.
These mostly take the form of discomfort from the mask and the nasal pressure required to obliterate the apneas.
Furthermore, the therapeutic pressure may both rise or fall with time in patients with changing anatomy (nasal congestion / polyps), change in weight, changing medication or with alcohol use.
Retesting is often necessary if the patient complains of incomplete resolution of daytime sleepiness, and may reveal a change in the required pressure.
Method used
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Embodiment Construction
FIGS. 1-5 illustrate the waveforms of flow from a CPAP generator, obtained during the testing of a patient, in sleep studies. In these tests, the patient was wearing a CPAP mask connected to an air source, in the manner illustrated in U.S. Pat. No. 5,065,765. Each of these tests illustrate an epoch of 30 seconds, with the vertical lines depicting seconds during the tests. FIGS. 1-5 depict separate sweeps that were taken from 1 to 2 minutes apart, and with different pressures from the source of air.
FIG. 1 illustrates a “normal” waveform, in this instance with a CPAP pressure of 10 cm H2O. This pressure was identified as corresponding to apnea free respiration. It is noted that this waveform, at least in the inspiration periods, is substantially sinusoidal. The waveforms of FIGS. 2-5 illustrate that, as the controlled positive pressure is lowered, a predictable index of increasing collapsibility of the airway occurs, prior to the occurrence of frank apnea, periodic breathing or arousa...
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A breathing apparatus is provided for the treatment of obstructive sleep apnea that optimizes the positive pressure to the airway of a patient. The apparatus is configured to detect flow limitations in the patient airway from an analysis of inspiratory flow waveforms. The airway pressure setting is raised, lowered or maintained depending on whether a flow limitation has been detected and on the previous actions taken by the apparatus. The apparatus may include a blower, a flow sensor, a pressure sensor, a microprocessor, a pressure controller and a nasal fitting. The apparatus is configured to increase the airway pressure when a flow limitation is detected in the airway of the patient and to decrease the airway pressure when a flow limitation is not detected.
Description
BACKGROUND OF THE INVENTION This invention relates to a method and apparatus for adjusting the positive airway pressure of a patient to an optimum value in the treatment of obstructive sleep apnea, and more particularly to a breathing device which maintains constant positive airway pressure and method of use which analyzes an inspiratory flow waveform to titrate such a pressure value. Obstructive sleep apnea syndrome (OSAS) is a well recognized disorder which may affect as much as 1-5% of the adult population. OSAS is one of the most common causes of excessive daytime somnolence. OSAS is most frequent in obese males, and it is the single most frequent reason for referral to sleep disorder clinics. OSAS is associated with all conditions in which there is anatomic or functional narrowing of the patient's upper airway, and is characterized by an intermittent obstruction of the upper airway occurring during sleep. The obstruction results in a spectrum of respiratory disturbances rang...
Claims
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Login to View More IPC IPC(8): A61B5/08A61B5/00A61B5/085A61B5/087A61B5/097A61B5/145A61B5/1455A61M16/00A61M16/06A61M39/22G06F17/00
CPCA61B5/0002A61M16/0677A61B5/6803A61M16/0051A61M39/228A61M2016/0036A61M2016/0039A61M2230/04A61M2230/08A61M2230/205A61M2230/62A61B5/4818A61M16/0069A61B5/7239A61M2230/005A61M16/026G16H50/30G16H20/40G16H50/20G16H40/63
InventorRAPOPORT, DAVID M.NORMAN, ROBERT G.
OwnerRAPOPORT DAVID M