Method and apparatus for non-invasive detection of physiological and patho-physiological sleep conditions

Abstract

Method and apparatus for the non-invasive detection of certain breathing conditions, certain sleep disordered breathing conditions, or assessment of the person's myocardial contractility and its dynamic changes, comprising steps of: determining the sleep or wake status of a person, monitoring circulatory pulse waveforms and amplitude normalized pulse wave systolic upstrokes recorded from a person's body and determining at least one index of the upstroke to characterize the strength of the contraction of the heart during the systolic upstroke during a series of heart beats relating to a breathing cycle or an absent anticipated breathing cycle of the patient, and determining that a certain change in a breathing condition, a sleep disordered breathing condition, or assessment of the person's myocardial contractility and its dynamic changes, has occurred when a specific change in the sleep disordered breathing analysis, and the at least one index of the upstroke has been detected.

Description

RELATED APPLICATION[0001]This application is a continuation application of PCT Application No. PCT / IB2017 / 053154, filed May 29, 2017, which relates to and claims priority to U.S. Provisional Application Ser. No. 62 / 347111, filed Jun. 8, 2016, the entirely of which is herein incorporated by reference.FIELD OF INVENTION[0002]The present invention and the present patent application relates to a method and apparatus for analyzing externally recorded physiological data of a patient for detecting and monitoring various breathing conditions of the patient.[0003]In particular, this patent application relates to the analysis of circulatory pulse waveforms recorded from the body's surface of a patient, for determining changes in the performance of the heart during its contraction phase, due to the intra-thoracic pressure changes caused by the breathing cycle of the patient, and inferring there from the presence of certain breathing conditions and sleep disordered breathing conditions of the p...

AI Technical Summary

Benefits of technology

[0049]The pressure applied to the exposed heart may directly affect its pumping action in relation to the magnitude of the imposed pressure level; for example, increased negative intra-thoracic pressure would tend to oppose ventricular contraction, thereby reducing the effective rate blood ejection from the ventricle. The effective influence of thoracic pressure fluctuations due to breathing on the pumping action of the heart may be conveniently determined non-invasively by measuring arterial pulsewave signals, and analyzing such signals to measure the effect on the contraction dynamics of the left ventricle to determine relative changes of the systolic upstroke (relative to the entire systolic upstroke).

[0081]Thus, a major advantage of the currently described inventive method is that it facilitates quantification of the pulse signal changes due to the action of the heart as affected by the thoracic pressure, irrespective of vascular tone due to the contractile state musculature of the blood vessels themselves. This is a critical improvement over the prior art since, as mentioned, the above-mentioned vasomotor influences may be confounding, and thus obscure the true nature of the specific breathing related changes of interest.

Problems solved by technology

While the above mentioned accelerometric based and PTT methods may be influenced by changes in intrathoracic pressure related to sleep related respiratory acts, there are some important limitations associated with these methods.

For example, accelerometric measurement is extremely sensitive to the degree of coupling to the body surface as well as to movement and posture changes of the patient which can adversely the accuracy of the assessments, and PTT measurement involves the use of multiple measurement modalities and requires a high degree of precision and complicated analysis for accurate assessments, as well as requiring careful instrumentation of the subject.

Thus, it can be seen that the various prior art methods described above, suffer from a variety of limitations of accuracy and ease of application and use.

As is well known, obstructive sleep apnea, the more common form, is caused when upper airway partial or complete obstruction results in insufficient or absent ventilation, whereas central sleep apnea is caused by abnormal or periodically absent respiratory drive due to faulty central nervous system control of breathing.

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