State machine operating in hypopnea controller

Abstract

To provide an automated method which provides hypopnea detection for determining a hypopnea event and severity of the hypopnea event.SOLUTION: A calculated short-term variance of a measured respiratory flow signal is compared to first and second proportions of a calculated long-term variance of the measured flow signal. A detection of the hypopnea may be indicated when the first measure falls below and does not exceed a range of the first and second proportions during a first time period. Hypopnea severity measure is determined by automated measuring of an area bounded by first and second crossings of a short-term measure of ventilation and a proportion of a long-term measure. The detection methodology may be implemented for data analysis by a specific purpose computer, a detection device that measures a respiratory airflow or a respiratory treatment apparatus that provides a hypopneas treatment regime based on the detected hypopneas.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] [CROSS REFERENCE TO RELATED APPLICATIONS] This application is a joint venture of U.S. Provisional Patent Application No. 61 / 184,592, filed June 5, 2009. The disclosure of this application is incorporated herein by reference in its entirety. is incorporated into the book.

[0002] [Field of the Invention] The present technology relates to methods and apparatus for detecting hypopnea. [Background technology]

[0003] Patients with obstructive sleep apnea (OSA) experience recurrent periods of apnea or hypopnea during sleep. These episodes are terminated only by the patient awakening. It can be considered a partial reduction in breathing, lasting at least 10 seconds at a time. The 1999 American Academy of Sleep Medicine (AASM) guidelines state that hypopnea symptoms A flow drop of 50% or more continues for 10 seconds, or a flow drop of less than 50% A decrease in saturation is followed by an arousal response or a desaturation of at least 3%. Subsequent AASM guidelines define a 30% reduction in ventilation as A hypopneic episode is defined as a desaturation of at least 4%. These repetitive events cause sleep fragmentation and stimulation of the sympathetic nervous system. This may result in daytime sleepiness (with the potential for resulting motor vehicle accidents) for the patient. may have dangerous consequences, including reduced intellectual activity, memory impairment, depression, and hypertension. OSA patients also snore loudly, disrupting the sleep of their partners. This can also happen.

[0004] The best form of treatment for OSA patients is a blower (conductive air) through a connecting hose and mask. The CPAP system is a continuous positive airway pressure (CPAP) system that is delivered by a ventilator. Prevents narrowing of the patient's airway during breathing, thereby preventing recurrent apnea or hypopnea, and Such a respiratory treatment device is adapted to reduce the amount of airway obstruction during the subject's breathing cycle and to prevent its sequelae. Clean breathable gas (usually air, preferably with additional oxygen) should be provided at the appropriate time. A supply of fluid (which may or may not contain oxygen) to a patient at or under therapeutic pressure. The present invention can function to provide a

[0005] Respiratory therapy devices typically consist of a flow generator, an air filter, and a mask or cannula. a flow generator connected to the mask; an air delivery conduit; various sensors; and The flow generator is servo-controlled. The flow generator may further include a motor and an impeller. As an alternative to controlling the speed of the pump, a means of varying the pressure delivered to the patient is provided. It is also possible to provide a valve through which air can be vented. Using lancets, flow sensors, etc., it is possible to measure, among other things, the speed of the motor, the volumetric flow rate of the gas, , and the outlet pressure. The device may optionally include a humidifier in the path of the air delivery circuit. The controller may include a detector and / or a heating element. Data storage that may or may not have search / transfer and display capabilities It is possible to provide an amount.

[0006] To treat hypopnea, an automated device uses data from a flow sensor to This has been implemented by algorithms to detect hypopnea symptoms using conventional respiratory distress testing. An example of a hypopnea detection device is U.S. Pat. No. 5,295,333 to Dodakian. No. 490, U.S. Patent No. 5,605,151 to Lynn, Karakasoglu No. 5,797,852 to Raviv et al. No. 5,961,447 to Allen et al., and U.S. Pat. No. 6,313,316 to Allen et al. ,142,950, U.S. Pat. No. 6,165, to Rapoport et al. No. 133, U.S. Patent No. 6,368,287 to Hadas, and U.S. Patent No. 6,368,287 to Haberland For example, see U.S. Patent No. 7,118,536 to et al. For example, in one such device, a 10 second period in the flow (L / sec) signal or the root mean square (RMS) for 12 seconds is 1.2 times the long-term average minute ventilation (L / sec). Low-pass filter the absolute value of the flow signal divided in half (e.g., ) is considered to be below the normal R This corresponds roughly to a 50% decrease in MS ventilation. This corresponds roughly to a 50% decrease in RMS ventilation. For this, we use a 10-second window to calculate the variance in the flow signal over a 10-second period (0. 5) 2 and the product and ratio of the variance over a 60 second period in the flow signal calculated using a 60 second window. Such devices can also be used to detect the presence or absence of a signal. To avoid recording multiple hypopnea events in the same patient, For example, the device may be configured to have a refractory period after the release of a certain or RMS ventilation is greater than or equal to at least 4 minutes of long-term RMS ventilation over 15 consecutive seconds. It is possible to maintain refractory status until the patient returns to level 3. Summary of the Invention [Problem to be solved by the invention]

[0007] However, the question of the presence of hypopnea symptoms per se is open to interpretation. In these cases, clinician autonomy is not an issue when recording the presence of hypopnea. Therefore, automated devices rely on a variety of methods to detect symptoms. While it is possible that different implementations have been implemented, differences in the detection criteria used may result in As a result, a variety of hypopnea records may be generated for a common respiratory event. be.

[0008] Another method for detecting hypopnea includes an apparatus and method for detecting upper respiratory tract symptoms. To develop methods that can be implemented in devices for treating conditions of the upper respiratory tract and However, this is considered desirable. [Means for solving the problem]

[0009] A first aspect of some embodiments of the present technology is the detection of hypopnea and / or the severity of hypopnea. The present invention provides a method and device for detecting the severity of a disease.

[0010] Another aspect of some embodiments of the present technology is an apparatus for measuring a patient's respiratory flow signal. The objective of the study was to detect respiratory depression or the severity of respiratory depression in patients with pulmonary embolism.

[0011] Yet another aspect of the present technology is the association of detected hypopnea or the severity of hypopnea. Respiratory therapy devices, such as continuous positive airway pressure devices, based on or as a function of this number. The goal of the study is to implement detection of hypopnea or the severity of hypopnea at the device.

[0012] Some embodiments of the present technology detect hypopnea from a measured flow of breathable gas. The present invention includes an apparatus or controller having a method for controlling a processor to output a The controller or processor method includes: determining a first measure from short-term variance in the data based on the flow. This can further be achieved by determining the flow of breathable gas based on the measured flow of breathable gas. The method may include determining a second measure from a long-term variance in the data. This first measurement can be compared to the first and second ratios in the second measurement. By using this method, the device or controller can determine that the first measurement is 1 ratio and in the first period thereafter, the first and second ratios Based on the above comparison, hypopnea detection can be indicated if the range of It is.

[0013] In some embodiments, the first rate can be less than the second rate. The method further comprises determining whether the first measurement exceeds a first percentage during the first time period. If not, indicating detection of hypopnea. during the first period, the first measurement exceeds a first percentage while the second percentage indicates detection of hypopnea if the hypopnea threshold is not exceeded. In some embodiments, the comparison of the first measurement value to the first ratio occurs within about 10 to 20 seconds. The RMS value calculated from the respiratory flow data for a period of time (but preferably 12 seconds) is approximately 5 R calculated from respiratory flow data from 0 to 70 seconds (but preferably 60 seconds) a determination of whether the MS value is below a threshold of about 50 percent of the MS value, The time between the second measurement is about 3 to 8 seconds (but preferably 4 seconds). The comparison of the second ratio with the first ratio is performed for about 10 to 15 seconds (but preferably 12 seconds). The RMS value calculated from the respiratory flow data is maintained for approximately 50 to 70 seconds (but preferably A threshold consisting of approximately 75 percent of the RMS value calculated from respiratory flow data (60 seconds for It is possible to indicate whether the value is below the threshold.

[0014] Optionally, during a second period of time, further breathing is continued until the first measurement exceeds a second rate. It is also possible to block the detection of the decrease in absorption. This step of blocking further detection is The method may include a step of comparing the first measurement to a second ratio, the comparing step comprising: Calculated from approximately 10 to 15 seconds (but preferably 12 seconds) of respiratory flow data. The RMS values ​​obtained are taken from approximately 50 to 70 seconds (but preferably 60 seconds) of respiratory flow data. The threshold value of approximately 75 percent of the RMS value calculated from the data is then exceeded. and further comprising: the second period of time being about 10 to 20 seconds (but preferably 15 to 20 seconds). In some cases, the time over which long-term measurements of ventilation are calculated is divided into short-term The time may be at least about 3-5 times the time over which the measurements are calculated.

[0015] Some embodiments of the present technology detect hypopnea from a measured flow of breathable gas. The present invention includes an apparatus or controller having a method for controlling a processor to output a These processor or controller methods include long term changes in ventilation rate. It may include determining short term measures of ventilation and ventilation. These processor or controller methods further include long term measurements of ventilation. determining a threshold value as a ratio of a short-term measure of ventilation to the threshold value; and measuring an area bounded by the first and second intersections. This measured area can then be used to detect hypopnea. The step of determining whether or not the short-term measurement of the ventilation volume falls below the threshold is performed. Integrate the difference between the threshold and the short-term measurement over the period until the threshold is exceeded. In some embodiments, the measuring step may include measuring a short-term During the period from when the measured value falls below the threshold to when the short-term measured value exceeds the threshold. The method includes accumulating a plurality of sample differences, each of which is the difference between the sample of the threshold and the sample of the short-term measure of ventilation. It is possible.

[0016] Optionally, the method of the device or controller may be performed by a method starting at the second intersection. The device may be configured to block further hypopnea detection during the refractory period. Furthermore, the method compares short-term measurements of ventilation with the threshold by an inequality. By detecting the first crossing, a step of measuring the area is initiated. Further, the detection of hypopnea may further include detecting the presence of a hypopnea at the first crossover. It is also possible to set a condition that the time from the first crossing to the second crossing exceeds approximately 10 seconds. In some embodiments, the short term measure of ventilation is a measure of the flow of breathable gas. The half-value of the absolute value at the constant value is low-pass filtered with the first time constant. Similarly, long-term measurements of ventilation can be used to measure the breathability of a patient. The half-value of the absolute value of the measured flow of the active gas is measured with a second time constant that is greater than the first time constant. It is also possible to use a low-pass filter to obtain the output value. Arbitrarily, the percentage may be set to about 70 percent. The device or apparatus may use measurements in the above areas to indicate the severity of the hypopnea. Optionally, the device or apparatus may divide the measured area into at least four It can also be compared to a threshold value selected to give an approximate indication of % blood oxygen saturation. be.

[0017] Some embodiments of the present technology detect hypopnea from a measured flow of breathable gas. The present invention includes an apparatus or controller having a method for controlling a processor to output a The method further comprises: the controller or processor determining a long-term change in ventilation rate. determining a measure of ventilation and a short term measure of ventilation; and Thresholds are determined as a percentage of the long-term measurements of ventilation. The controller or processor may then determine the short-term measurements of ventilation as a function of the threshold. , calculate the extent of hypopnea. The device then uses the measured extent to determine whether hypopnea is present. The display may include outputting a measured range of values. This calculated range is the first and second deviation between the short-term measurement of ventilation and the threshold. It is also possible to have a calculated region bounded by the intersection of the two. And This calculated area may optionally be approximated to a blood oxygen saturation of at least 4 percent. It is also possible to compare the eigenvalue with a threshold value selected as shown in FIG.

[0018] In some embodiments, the apparatus or controller method further comprises measuring A measure of flow limitation can be detected from the flow of breathable gas, as described above. The indication of hypopnea detection may be further based on a measurement of flow limitation indicative of obstruction. It is.

[0019] Yet another embodiment of the present technology is a method for detecting hypopnea from a measured flow of breathable gas. The method may include controlling the processor to classify the The method of the present invention includes the steps of detecting a hypopnea event from a measured flow of breathable gas. The method can further include detecting a measured hypopnea event that occurs in conjunction with the hypopnea event. The step of determining a measurement indicative of obstruction in the flow may include: The method further comprises: determining a measurement indicative of obstruction based on the step of determining a measurement indicative of obstruction. Classifying the depressor event as obstructive or central. In some embodiments, the determining step includes detecting a partial occlusion; The classification step includes recording an obstructive hypopnea event. In some such embodiments, the method further includes detecting a lack of breathing. It is also possible that the classification step above may be based on this lack of breathing and may be a central It may also include the step of recording hypopnea events. The method includes the steps of detecting an absence of breathing occurring with a detected hypopnea event; Based on the absence of breathing, the detected hypopnea events were classified as central hypopnea or obstructive hypopnea. and avoiding recording the hypopnea as a hypopnea. In such a case, the event may be determined to be an apnea.

[0020] In some embodiments, the technology may be implemented as a hypopnea detection device. Such devices include a controller that controls the amount of the measured breathable gas. At least one processor for accessing data representing the flow. The controller derives a respiratory rate from data representing the measured flow of breathable gas. The controller may also be configured to control detection of hyposucker events. Additionally, in the data representing measured flow, obstructions occurring with hypopnea events The method may also be configured to control the step of determining a measurement indicative of the suitability of the device. The controller further comprises: determining a measurement indicative of obstruction based on the step of determining a measurement indicative of obstruction. The device can also be configured to control classification of detected hypopnea events as obstructive or central. In some such embodiments, the classification detects partial occlusions, and the classification In one such embodiment, the method includes recording an obstructive hypopnea event. In one embodiment, the controller may be configured to control detection of absence of breath. Alternatively, the classification may include recording a central hypopnea event. In an alternative embodiment, the controller further comprises: and determining whether the absence of breathing is occurring based on the detected absence of breathing, and It is also possible to avoid recording the condition as central or obstructive hypopnea. In such a case, it is possible to judge the above event as apnea. Such devices further generate breathable gas for a patient at a pressure greater than atmospheric pressure. The present invention may also include a flow generator configured to generate a flow sensor. The controller measures the flow of breathable gas using a flow sensor. and based on the detected hypopnea, configure the device to administer a pressure therapy regimen according to the pressure therapy regimen. The flow generator may also be configured to control the flow generator to generate breathable gas by be.

[0021] Further features of the present breathing technology are described in the detailed discussion, drawings and claims below. This should become clear by examining the area.

[0022] The present technology is illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings in which: In these figures, like elements are designated by like reference numbers. [Brief description of the drawings]

[0023] [Figure 1] 14A-14C show an exemplary hypopnea detection device of the present technology having an optional flow sensor and flow generator. [Diagram 2]FIG. 1 is a flow diagram of an exemplary embodiment of a method for controlling an apparatus for detecting hypopnea. [Diagram 3] 1 is a state diagram of another example device capable of implementing a method for detecting hypopnea. [Figure 4] 11 is a graph illustrating detection correlation of an exemplary embodiment of the method of the present technique. [Diagram 5] FIG. 11 is another flow diagram of another exemplary embodiment of a method for controlling an apparatus for detecting hypopnea and / or the severity of hypopnea. [Figure 6] FIG. 13 shows graphs of measurements relating to detecting hypopnea and / or measuring the severity of hypopnea. [Figure 7] FIG. 1 is a block diagram of a controller in a hypopnea detection device including exemplary components thereof suitable for implementing the detection method of the present technology. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0024] As shown in FIG. 1, an embodiment of the present technology includes a respiratory hypodermic device having a controller 104. The controller 104 may include a detection device or apparatus. The present invention is also directed to a multi-processor system, which may be used to implement the multi-processor system described in this specification. Implements a specific hypopnea detection method, such as the algorithm described in detail in Thus, the device or apparatus may include integrated chips, memories, and / or other For example, the above-mentioned control instructions, data or information storage medium may be provided. A program instruction including such a detection method is stored in the memory of the device or the apparatus. By coding the integrated chip in the Additionally or alternatively, a suitable data storage medium may be used. and loading such instructions as software or firmware. By using such a controller or processor, This device can be used to process data from a flow signal. Thus, the processor may be adapted to the embodiments discussed in more detail herein. As explained in the article, the measured and recorded breath patterns from previous sleep sessions Ability to control the occurrence or severity of hypopnea based on inspiratory flow data Alternatively, this detection can be performed during a sleep session simultaneously with the measurement of the respiratory flow signal. Thus, in some embodiments, the device or apparatus itself may Optionally, for use with the implemented method, a device for measuring a respiratory flow signal. It is also possible to implement the flow sensor 106 in the form of a pneumotachograph, , a pressure differential transducer or similar device, e.g., for deriving a flow signal. By using a bundle of tubes or ducts for the purpose of The flow to or through the filter 108 or mask can be measured. Optionally, the flow signal can be estimated from other sensors, such as a motor current sensor. This motor current sensor is also disclosed in PCT / AU filed on November 2, 2005. 2005 / 001688, and its national phase U.S. patent application Ser. No. 12 / 294,9 No. 57, the entire disclosures of which are incorporated herein by cross-reference. , which is incorporated herein by reference.

[0025] In another example, the hypopnea detection device may be used as a respiratory treatment device to treat the detected hypopnea. For example, the control method shown in FIG. As mentioned above, the detection device is optionally equipped with a sensor suitable for the above control (e.g. It is possible to implement a flow generator such as a servo-controlled blower with a pressure sensor. Respiratory or pressure therapy regimens, such as CPAP therapy, The pressure level can be conveyed by the device's controller. Therapeutic pressure levels may be adjusted to detect hypopnea symptoms as described herein. It is also possible to automatically adjust accordingly. For example, when hypopnea is detected, It is possible to increase the pressure level by a certain amount. Optionally, this level can be detected It is also possible to increase proportionally as a function of the severity of the hypopnea caused. For example, Respiratory depression with higher severity measures was significantly higher than respiratory depression with lower severity measures. It is possible to implement other pressure regulation schemes, resulting in higher pressure regulation values. It is also possible to do so.

[0026] In some embodiments, the hypopnea detector detects hypopnea according to AASM guidelines. It is possible to implement a detection of the drop in the signal level. For example, this detector can be set to detect the drop in the signal level over a period of about 10 seconds or more. Detects a decrease in ventilation of approximately 30% or more and a decrease in blood oxygen of approximately 4% or more It can be configured to record hypopnea events when saturation is detected. In such embodiments, for example, a decrease in ventilation may be measured using a measure of ventilation, e.g., a single ventilation rate. The degree of respiratory flow is determined by air volume or other similar measurements based on the measured respiratory flow signal. Optionally, these ventilation measurements may be taken at the maximum ventilation rate for a determined breath. Derived by processing the maximum inspiratory flow and / or the maximum expiratory flow in a breath Similarly, a drop in blood oxygen can be detected by the optional oxygen concentration sensor (Figure 1). The data should be based on data from the oxygen concentration signal obtained from the However, as discussed in more detail in this specification, Other embodiments of the technology can be implemented without analyzing oxygen concentration data from an oxygen concentration sensor. ,It is also possible to implement it in a way that emulates the AASM guidelines mentioned above.

[0027] (1) Exemplary detection functions As shown in the flow chart of FIG. 2, in an embodiment of the present technology, the detection device The automatic detection of hypopnea symptoms due to the use of data representing measurements of the flow of breathable gas (i.e. The method may be based on determining or calculating the variance from the respiratory flow signal. For example, in step 220, a first measurement is determined from a short-term variance calculation. One such measurement is the respiratory flow signal from a flow sensor. Or, based on that, the square of the average value of the sample values ​​obtained from the recorded data is , can be calculated by determining the difference between the mean sum of squares and the mean squared sum. It is also possible to implement other methods for calculating the variance. The short-term variance is expressed in seconds ( For example, for about 10 to 15 seconds) It is possible to perform a 10 second dispersion using a sample of 100 μm. Similarly, a long-term dispersion can be performed using The measurement can be determined in step 222. For this long-term variance, , for example, flow, which lasts for about one minute, i.e., about 50 to 70 seconds. It can be 60 seconds long, using approximately 60 seconds of sampled values ​​from the signal. In some cases, the time period over which long-term measurements of ventilation are calculated is the same as the time period over which short-term measurements are calculated. It is possible to set the time to at least approximately 3-5 times the time the value is calculated. If long term measurements of volume are selected to be calculated from 60 seconds, Short-term measurements can be calculated as one-fifth of that (e.g., 60 / 5). This gives a period of 12 seconds.

[0028] In step 224, the short-term variance measure is multiplied by the first and second long-term variance measures. For example, it is possible to compare the percentage of In some cases, it may be desirable to detect hypopnea based on a decrease not exceeding 10%. In such a case, the long-term variance is (0.45) 2 and (0.7) 2 Multiply by a factor of Optionally, these factors can be multiplied by the square root of the long-term variance. If it is possible to use it without the squaring operation, the result is The resulting percentage is then compared to the square root of the short-term measure of variance. Such a comparison represents a measure of the reduction in airflow based on RMS ventilation. Then, in step 226, the short-term variance measure is below a first percentage, but If the range of the first and second ratios is not exceeded for a certain period of time after the The hypospasm event can be recorded or indicated. Such a system can During the period of time during which the decrease in the By tolerating short-term deviations that exceed a certain percentage but do not exceed a certain second percentage. This makes it possible to automatically detect and record hypopnea more accurately. do.

[0029] A state diagram for implementing such a detector embodiment in the present technology is shown in FIG. The detector detects hypopnea during a sleep session and identifies when a patient is experiencing this event. During the session, it may be useful to have a device that simultaneously records hypopnea. This device behavior can also be implemented for post-boot analysis. 0. In step 332, the device detects a threshold of approximately 50% RMS ventilation. For example, the device can determine whether the 2 seconds or 12 seconds data window (i.e., V 10 Or V 12 ) is measured by The short-term variance in the respiratory flow signal was measured over a 60-second data window. Percentage of variance (for example, V 60 (0.5) 2 This threshold can be compared with If the value is met, i.e., violated, then in step 334, the timing A period can be initiated or started and the device will enter a sub-50 state. (S1). For example, a countdown timer (specified as a "Sub 50 timer" ") may be set for a period of about 3 to 8 seconds, but preferably for a maximum period of 4 seconds. Other values ​​for this time setting may be desirable outcomes for the hypopnea criterion. In step 332, the above If the threshold is not met, the device returns to the start state (S0).

[0030] Thereafter, in step 336, the device monitors whether RMS ventilation remains below approximately 50%. Such a test is performed in step 332. If it does not remain below The device then transitions to the Excursion Range State (S2). From this state, the device At 338, test whether the RMS ventilation is again below about 50%. If it is, the device goes back to the sub-50 state (S1). The chair determines in step 340 whether the RMS ventilation exceeds a threshold of about 75%. For example, the device tests a 10 second or 12 second data window (i.e., Wow, V 10 Or V 12 ) is the short-term variance in the respiratory flow signal measured by , other proportions of long-term variance measured by a 60-second data window (e.g., V6 0(0.75) 2 This threshold is met, i.e., If the threshold is breached, the device will not record a hypopnea event and will not start. In step 340, if the threshold is met, the state may transition to state (S0). If not, the device returns to the Excursion Range State (S2).

[0031] In step 336, the test determines whether the RMS ventilation remains below about 50%. If so, then in process block 342 the sub-50 timer value is If is not finished (for example, if it is greater than 0), decrement it. Then, in step 344, the sub-5 The 0 timer determines whether the timing period has ended or expired for the exhalation episode. If it is not finished, the device goes to the sub-50 state (S1). If it is finished, the device will enter the recording state when the respiratory rate is low. In this way, the detection device records the sub-50 state (S1) and the deviation Based on the analysis of the range state (S2), symptoms of hypopnea are indicated.

[0032] Once in the Recording State (S3), other functions of the device will record common hypopnea events. This is an implementation of a refusal period to prevent multiple recordings. Therefore, in step 346, the RMS ventilation is tested and determined to be above a threshold of approximately 75%. This test is equivalent to the comparison in step 340. If, in step 346, it does not exceed this threshold, the device , remain in the recording state (S3). If it exceeds this threshold in step 346 If so, then in step 348, another clock period, i.e., a refractory clock period, is started or The device will be able to start and enter the Super 75 state (S4). For example, a countdown timer (specified as a "Super 75 Timer") can be set to approximately Can be set for 10 to 20 seconds, but preferably with a maximum duration of 15 seconds The refractory period to ensure that the documented episodes of hypopnea have ceased. Other values ​​for this time setting may be pre-determined depending on the desired length of time. It is Noh.

[0033] From this Super 75 state (S4), similar to the comparison in step 346, step 35 0, to ensure that RMS ventilation remains above a threshold of approximately 75%. The S ventilation is checked. If it remains above, step 352 Then, the Super 75 timer is decremented and continues to run, i.e., At step 354, the Super 75 timer expires. That is, if the desired period has elapsed, the device returns to the start state (S0). If not, the device remains in this Super 75 state (S4).

[0034] In summary, this detector detects when short-term ventilation measurements are below a 50% threshold. The detector also checks whether the object remains there for about four seconds. A deviation exceeding a threshold of 50% is tolerated over a 7 second period. No deviations above the 5% threshold are tolerated. However, if the deviations exceed the 5% threshold before the end of the time period, If the 75% threshold is exceeded, the detector will not trigger a hypopnea indication and will not start. Once the transition is complete, hypopnea is displayed. The detector then detects the refractory period, e.g., consecutive For 15 seconds, the short-term threshold measurement must exceed the 75% threshold. In such an implementation, the detector will not record short hypopneas and will not record cluttered episodes. Record periods of reduced flow occurring during the day as one hypopnea rather than two or more. This means that the system has a tendency to make it possible to

[0035] In some embodiments, entering a storage state (S3) or otherwise reducing respiratory rate is In regard to displaying or recording flow limitation, obstructive apnea and / or Another condition may be the detection of central apnea. a processor for detecting hypopnea, or another processor in electronic communication with the processor for detecting hypopnea. The detection can be performed by a general processor, such as the processor of This device is described in U.S. Patents 6,138,675 and 6,029,665. Obstructive apnea, partial obstruction and / or central obstruction were diagnosed by any of the methods described in It is possible to configure the device to detect apnea of ​​the pulmonary circulation as well. All disclosures may be cross-referenced to other processors or detectors. Similarly, PCT / AU filed on May 9, 2008, 008 / 000647 (as International Patent Application Publication No. (WO / 2008 / 138040) No. 60 / 965, filed Aug. 17, 2007. As described in ,172, the device measures flow restriction, e.g. It may also be configured to detect unclear flow limit measurements, and these disclosures The contents of which are incorporated herein by reference. In such an embodiment, , central apnea, airway patency, absence of partial obstruction, obstructive apnea, or Any one or more of the following: low or insufficient measurements of flow restriction The determination of reduced ventilation (e.g., classification related to sub-50 status) should be based on symptoms of hypopnea. In such cases, the reduction in ventilation may be considered a contraindication to apnea. For example, partial blockage or flow restriction may be the result of Measurements indicate that there is no significant or no obstruction during the sub-50 time period. If the hypopnea detector detects hypopnea, the detector will return to the start state (S0) or It is possible to return to another waiting state (not shown) which is initiated when the measured ventilation Wait for the threshold to return above the 75% threshold discussed in step 346. Similarly, as another example, central apnea Central respiratory failure was not observed during any time period in which measurements of inhalation or airway patency were less than 50%. If the detector indicates that breathing is occurring, it will start without recording hypopnea. It is possible to return to state (S0) or to another waiting state. This waiting state is The measurement returns above a threshold, e.g., the 75% threshold discussed in step 346. In yet another example, obstructive apnea may be provided. If the inhalation measurements indicate obstructive apnea for a time period of less than 50 minutes, In this case, the detector will return to the start state (S0) or another standby state without recording hypopnea. This standby state occurs when the measured ventilation rate falls below a threshold, e.g. A similar failure to wait for the recovery above the 75% threshold discussed in step 346. Provide a time period for response.

[0036] One embodiment of the detector described above based on the state diagram of FIG. 3 detects the respiratory flow of a patient being recorded. The library of data representing the oxygen saturation and flow signals has been tested. The hypopnea detector separates the flow data. The hypopnea events are recorded. The hypopnea events detected are classified as saturation events. The correlation is plotted in Figure 4. The graph shows that the method of detecting hypopnea works well with ODIs of at least 4% saturation. It shows that they are related.

[0037] In another example of the recording method shown in FIG. 3, apneic events (e.g., central Avoid recording hypopnea when apnea or obstructive apnea is detected It is possible to implement the states of this state machine such that, for example, the detector When entering the recording state (S3), the hypopnea is simply "preregistered" (i.e. (For example, by setting a "pre-registration" variable to true). This can be considered as a potential hypopnea detection by the detector. At this point, an apnea detector (e.g., obstructive apnea and / or or central apnea detectors) (e.g., continuously in this state). By this, it is determined whether the apnea detector detects apnea. Depending on the condition, if apnea detection is confirmed, the value of the "pre-registered" variable is changed (for example, For example, set it to false) and the hypopnea detector status is set to Super 7 The game proceeds to state 5 (S4) and the Super 75 timer is set at 348. In this way, it is possible to avoid recording hypopnea. 75 Proceeding to state (S4), a potential hypopnea event is determined to be hypopnea based on pre-registered variables. The event will be registered or recorded as a pre-registration event (e.g., the "pre-registration" variable is true). If the "pre-registration" variable is false, the event is registered as a hypopnea. In some cases, the event is not registered or recorded as a hypopnea.)

[0038] In this embodiment, the detector state machine starts by entering the Super 75 state (S4). Therefore, the Super 75 state is If apnea is confirmed at any time during the period from when the patient enters the respiratory tract (S4) to when the patient enters the respiratory tract (S5), breathing In addition, no hypopnea is recorded during any of the time periods. If apnea is identified before the hypopnea detector is activated, the hypopnea detector will enter a refractory state. No recording is possible until the end of the period. This embodiment therefore Prevents recording a false positive hypopnea when the hypopnea event is an apnea event This embodiment can be useful in investigating the above-mentioned Individual detectors (e.g., individual devices or common Coordinated apnea control by a separate software / hardware module in the device and hypopnea detection. However, in some embodiments, known methods By modifying the state of the state machine described above with an additional threshold for detecting apnea by In such cases, a common software / hardware module is used. The output of the integrated state machine, which consists of a set of Depending on the assessment of the respiratory rate, the device detects either hypopnea or apnea. It becomes possible.

[0039] (2) Additional detection configuration In some embodiments, the recording of hypopnea further comprises a severity level of the recorded hypopnea. An example of such a method is illustrated in FIG. In this example, short-term and long-term measures of ventilation are measured in stages. In each of steps 540 and 542, a respiratory flow signal is determined. For example, this measurement can be performed using a short The determination is made by a short-term (e.g., about 12 seconds) time window and a long-term (e.g., about 60 seconds) time window. It can be a calculated value of RMS ventilation or variance, which is calculated using the These ventilation measurements were then converted to low-pass filtered mean ventilation ( For example, from the flow signal, obtained by using short-term and long-term constants In yet another embodiment, the absolute value of the data sample may be half the absolute value of the data sample. Measures of ventilation include the long-term average tidal volume over multiple breaths and the average tidal volume over a single breath. It is also possible to use the most recent tidal volume or the average of several breaths. In step 544, a threshold is determined as a function of the long-term measurements. The threshold can also be a fraction or percentage of the measurement (e.g., 50%, 75%, etc.). This threshold can also be determined experimentally based on the patient's symptoms of hypopnea. Then, in step 546, the threshold and the short-term measurement are used to For example, the first and second intersections of this threshold with short-term measurements of ventilation By measuring the area that is separated, the detection device detects hypopnea or hypopnea. Detect lower severity.

[0040] It should be understood that embodiments of the present technology are illustrated in the graph of FIG. This graph shows the long-term ventilation measurements 650 and the short-term ventilation measurements 651. For these measurements, the respiratory flow signal being measured is plotted at 652. This graph also shows the effect of ventilation on the long-term ventilation rate as a function of the ventilation measurements. Also shown is the threshold of 650P, which was determined by the pulmonary circulation test. The extent of the boundary region A that can be provided is detected using the data from these measurements. It is possible to determine this by the device. For example, the boundary area A can be determined by the following example: It is also possible to make the determination using a mathematical formula.

number

[0041] In one exemplary embodiment, the integral of the ventilation measurements is used to measure the ventilation rate at a common time for these signals. The threshold and short-term measurements are taken from time (a) to time (b). The sample difference between the sample and a constant (i.e., f(x)-g(x), where x is the sample This can be implemented by continuously integrating the time (the ring time) shown in Figure 6. As shown in FIG. 1, the integration operation compares the short-term measurement to a threshold value to Determine whether a value is smaller than a threshold (for example, when x=a, G(x)<=F(x)). It can be initiated (at "trigger a") by This integration operation again compares the short-term ventilation to the threshold and indicates when the short-term measurement exceeds the threshold. and (for example, when x=b, G(x)>=F(x)) The resulting total value is then used to determine the severity of the disease. In some embodiments, sampling is performed. The time period (e.g., sample counts) that is taken is indicative of hypopnea, e.g., a selected time period. If the severity measurement does not exceed 10 seconds, it may be ignored (e.g. , (ba) for <10 seconds).

[0042] The area determination method shown in FIG. 5 may be optionally implemented using the area determination method shown in FIG. By implementing this together with the recording method, each event recorded based on both methods will It may also provide a measure of severity of the respiratory distress syndrome and / or provide a joint respiratory distress syndrome. For example, either method, or alternatively, both methods, may be effective in treating hypopnea. Hypopneas can also be counted by the detector if an occurrence is detected. And a measure of severity can be provided in terms of counted hypopneas. However, the area method is implemented as an independent detector and is independent of the former method. It is possible.

[0043] Thus, rather than just recording hypopnea, area measurements serve as a measure of its severity. For example, a measure of severity can be provided by the It is also possible to compare a threshold value indicative of reduced absorption. For example, a predetermined threshold value can be compared to a saturation level, e.g. It can also be experimentally determined to indicate, for example, about 4% saturation events. Hypopnea events are recorded by comparing the severity measure with thresholds as described above. Optionally, the severity can be determined, for example, by determining whether it exceeds a threshold value, or It may be further analyzed or quantified by determining its value as a ratio to a threshold value. Additionally, the value of the area itself can also serve as a measure of severity. be.

[0044] In some embodiments, the length of hypopnea, e.g., its time or duration, may also be a measure of severity. It can serve as a measure of degree. As with the area measure, it can be used to By comparing the hypopnea event to a threshold, it is possible to access the hypopnea event. In some embodiments, the region measurements, length or duration, and counts are The respiratory depression can be recorded and / or its severity can be assessed by analyzing each of the For example, the above-described embodiment may be used to record the Hypopnea events can be characterized by their length and area to indicate severity. It is also possible.

[0045] In yet another embodiment of the hypopnea detection technique, the type may be determined by, for example: By determining that the hypopnea event is an obstructive hypopnea or The hypopnea event is characterized by determining that the hypopnea event is centrally mediated. In this way, the detector can distinguish between different types of calls. For example, (1) any of the following items described in this specification can be used to distinguish between the following: By any method, for example, hypopnea events may be detected in the absence of confirmation of detected apnea. (2)(a) a measurement of the flow limit (e.g., the flow limit (b) by analyzing the indices of breathing or respiratory suppression during hypopnea; Detection of a cycle (e.g., when a patient transitions from an exhalation state to an inhalation state based on a triggering threshold) (c) a measurement of partial obstruction; collectively to record the simultaneous occurrence of one or more of the following: This can be considered a detection of obstructive rather than central hypopnea. Similarly, (1) any of the methods described herein can be used to detect, for example, A hypopnea event was detected in the absence of confirmed apnea, and (a) signs of airway patency; (b) failure to detect respiration or respiratory cycles (e.g., based on a trigger threshold, the patient may transition from an exhalation state to an inhalation state for a period of time. (c) not initiating a transition; and / or (d) not being flow-limited or partially occluded. to record the simultaneous occurrence of one or more of the following: Collectively, these findings are considered to be detection of central hypopnea rather than obstructive hypopnea. It is therefore possible to count the number of recorded hypopnea events as obstructive hypopnea and It is possible to show the total of both central and central respiratory depression, and Some embodiments may be decoupled from the number of central hypopneas determined by the detector. Implement measures to record or report the analysis of the number of obstructive hypopneas observed. is possible.

[0046] As another example, one of the detector embodiments described above detects central events During the time that no hypopnea events are recorded, an obstructive hypopnea event may be recorded. In this embodiment, the nucleotide sequence detected by any of the methods described herein is and calls occurring with a flow limit index that meets a desired threshold. Hypopnea events can be recorded as hypopneas or obstructive hypopneas. However, a detected hypopnea event may occur without the detection of a breath or respiratory cycle. If the patient is still breathing, it may be possible not to record hypopnea. No inhalation or exhalation cycles have been detected (e.g., based on a trigger threshold) The patient has not initiated the transition from the expiratory to the inspiratory state for a long period of time. It may also be considered an indicator of apnea (e.g., central apnea).

[0047] Exemplary Structures An exemplary system structure of the controller is shown in the block diagram of FIG. The hypopnea detection device 701 or a general purpose computer may include one or more The device may further include a processor 708 for displaying the image. 7, including an interface 710 for use in detecting hypopnea, as described herein. Reporting of symptoms (e.g., hypopnea counts and / or severity measurements), results, and or a graph (e.g., an area curve as illustrated in Figure 6) on a monitor or Or it can be output to an LCD panel. User Control / Input Interface 712 is for example a keyboard, touch panel, control button, mouse, etc. and may be adapted to operate the methods described herein. The device further includes programming instructions, oximetry data, flow data, A sensor or data interface is used to receive and transmit data, such as hypopnea detection data. The device may also include an interface 714, such as a bus. The present invention further includes a memory / device including control instructions for the above-mentioned method (e.g., FIG. 2 to FIG. 6). These may also include data storage components. These are described in more detail herein. As described above, in step 722, the flow signal or oximetry signal is processed. Including processor control instructions (e.g., pre-processing methods, filtering) These may also be used in conjunction with the determination of the measured ventilation volume in step 724 (e.g., It may include processor control instructions for (e.g., variance, RMS calculation, etc.) These may further include, in step 726, detecting hypopnea or measuring the severity ( For example, to determine thresholds, make comparisons, measure areas, trigger, timing methods, record, etc. Finally, these may include instructions for controlling a processor to implement the above method (e.g. For example, measures of detected hypopnea events and / or severity of hypopnea, threshold rates, timescales, etc. 728 Recorded data on timing thresholds, reports, and graphs, etc. It is possible to include

[0048] In some embodiments, a processor control instructions and data for controlling the above-described method is provided. The data is provided as software for use by a general-purpose computer. It is also possible to store the software on a recording medium that can be read by the computer. By loading the software onto a general-purpose computer, for a particular purpose according to any of the methods discussed in this specification. This allows the system to function as a computer.

[0049] In the above description and accompanying drawings, certain terminology, equations, and drawing symbols are used according to the principles of the art. In some cases, these specialists may be The terms and symbols do not imply any particular specific details that are required to practice the present technology. For example, the specification may refer to "first" and "second" Although certain terms are used, unless otherwise specified, these terms do not necessarily imply any particular The following description is not intended to impose a specific order on the present invention, but merely to illustrate different elements of the present invention. Furthermore, the processing steps in the detection method are performed in a certain order. Although the figures are illustrated with an ordering, such ordering is not required. It is possible to modify such ordering and / or to change the manner in which it is done. It should be recognized that parallel implementation is possible.

[0050] Furthermore, although the present technology has been described in this specification based on specific embodiments, It is to be understood that these embodiments are merely illustrative of the principles and applications of the present technology. It should be understood that numerous modifications to the exemplary embodiments are possible. and that it is possible to make the same without departing from the spirit and scope of the present technology. It should be understood that other configurations may be devised. For example, the recording method described above may be The method and severity measurement method were performed without using measured blood oxygen data. However, in some embodiments, the detector may further include an oxygen detector. This includes accessing saturation data from a concentration sensor, thereby determining the actual SpO 2 data and ventilation or airflow data, e.g., AASM Guide It is also possible to classify hypopneas according to the methods shown in the lines. In one embodiment, the detector is a detector as described in the embodiments described above (e.g., FIGS. 2, 3 and 5). The authors propose a method to detect hypopnea using SpO2 data without using conventional data. Therefore, this device can be implemented using either method. Record hypopnea by detection, or alternatively, by detection using both methods. Such an embodiment can be further illustrated by comparing the results obtained from both methods. To evaluate one method over the other by comparison, or or if hypopnea is detected by both methods, It can also be used to execute a process.

[0051] By considering the following explanatory paragraphs, the present technology disclosed in this specification To this end, it is also possible to realize further exemplary embodiments in The present technology may also include the following configurations.

[0052] Controlling a processor to detect hypopnea from the measured flow of breathable gas. In a method for detecting a short-term change in data based on a measured flow of breathable gas, determining a first measurement from the variance of the measured flow of breathable gas; determining a second measurement from the long-term variance in the data; comparing the value of the first measurement to the first and second ratios in the second measurement; The fixed value is below the first ratio and, during a first period thereafter, and indicating detection of hypopnea based on the comparison if the second ratio range is not exceeded. A method comprising the steps of:

[0053] The method of any of the preceding paragraphs, wherein the first ratio is smaller than the second ratio. and the first measured value does not exceed the first ratio during the first period. indicating detection of hypopnea.

[0054] The method of any of the preceding paragraphs, wherein the first ratio is smaller than the second ratio. and during the first period, the first measured value exceeds the first percentage; and indicating detection of hypopnea if the second rate is not exceeded. How to do it.

[0055] In any of the methods of the preceding paragraphs, a flow rate of a breathable gas is calculated from the measured flow rate of the breathable gas. detecting a measure of hypopnea, wherein said step is further based on said measurement of said flow limitation being indicative of obstruction. .

[0056] The method of any of the preceding paragraphs, wherein the comparison of the first measurement value and the first ratio The RMS value calculated from the respiratory flow data for about 10 to 15 seconds was about 50 seconds to 7 seconds. The threshold value is approximately 50 percent of the RMS value calculated from the 0-second respiratory flow data. wherein the first period represents a determination of whether or not the vehicle is rotating, and the first period is about 3 to 8 seconds.

[0057] The method of any of the preceding paragraphs, wherein said comparing said second measurement value to said second ratio comprises: The RMS value calculated from the respiratory flow data for about 10 to 15 seconds was about 50 seconds to 7 seconds. The threshold value is approximately 75 percent of the RMS value calculated from the 0-second respiratory flow data. A method showing a determination of whether or not something is rotating.

[0058] The method of any of the preceding paragraphs, wherein the comparison of the first measurement value and the first ratio The RMS value calculated from the respiratory flow data for about 10 to 15 seconds was about 50 seconds to 7 seconds. The threshold value is approximately 50 percent of the RMS value calculated from the 0-second respiratory flow data. wherein the first period represents a determination of whether or not the vehicle is rotating, and the first period is about 3 to 8 seconds.

[0059] The method of any of the preceding paragraphs, wherein during a second period of time, the first measurement is and blocking further detection of hypopnea until the ratio exceeds 2. ,method.

[0060] The method of any of the preceding paragraphs, wherein the step of blocking further detection comprises: 1 to the second ratio, the comparing step being about 1 The RMS value calculated from the respiratory flow data from 0 to 15 seconds is The threshold value of approximately 75 percent of the RMS value calculated from the respiratory flow data is exceeded. and the second period of time is about 10 to 20 seconds. method.

[0061] The method of any of the preceding paragraphs, further comprising: measuring the flow of breathable gas using a flow sensor; The method further comprises the step of measuring

[0062] Accessing data representative of a measured flow of breathable gas in a hypopnea detection device The present invention relates to a controller having at least one processor for performing a program for a computer-implemented program. The roller further determines a first measure from a short-term variance in the data. determining a second measurement value from the long-term variance in the first measurement value; and and comparing the first measurement to a first and second ratio, and determining if the first measurement is below the first ratio. and in the first period thereafter, the range of the first and second ratios is exceeded. if not, indicating the detection of hypopnea based on the comparison. Degradation detection device.

[0063] The apparatus of any of the preceding paragraphs, wherein the first ratio is less than the second ratio. and the controller further determines whether the first measurement value is greater than the first measurement value during the first period. . The apparatus is configured to indicate detection of hypopnea if a percentage of the hypopnea is not exceeded.

[0064] The apparatus of any of the preceding paragraphs, wherein the first ratio is less than the second ratio. and the controller further comprises: during the first period, the first measurement value being the and detecting hypopnea when the first rate is exceeded but the second rate is not exceeded. 16. An apparatus configured as shown.

[0065] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: and detecting a measurement of low restriction; and providing an indication of said detection of said hypopnea. but further based on a measurement of said flow limitation being indicative of obstruction.

[0066] In the apparatus of any of the preceding paragraphs, the first measurement value and the first ratio are correlated. The comparison is based on the RMS value calculated from the respiratory flow data for about 10 to 15 seconds, and the RMS value calculated from the respiratory flow data for about 50 seconds. A threshold consisting of approximately 50 percent of the RMS value calculated from the first 70 seconds of respiratory flow data. and the first period represents a determination of whether the first period is below a value of about 3 to 8 seconds. A device that is in between.

[0067] In any of the apparatus of the preceding paragraphs, said comparing said second measurement value to said second ratio The RMS value calculated from the respiratory flow data for about 10 to 15 seconds was about 50 seconds to 7 seconds. The threshold value is approximately 75 percent of the RMS value calculated from the 0-second respiratory flow data. A device that represents the determination of whether or not something is rotating.

[0068] In any of the apparatus of the preceding paragraphs, the comparison of the first measurement value and the first ratio The RMS value calculated from the respiratory flow data for about 10 to 15 seconds was about 50 seconds to 7 seconds. The threshold value is approximately 50 percent of the RMS value calculated from the 0-second respiratory flow data. and the first period represents a period of about 3 to 8 seconds. A device.

[0069] The apparatus of any of the preceding paragraphs, wherein the controller, during a second period, and configured to block further detection of hypopnea until the first measurement exceeds the second rate. A device that is configured to

[0070] The apparatus of any of the preceding paragraphs, wherein the blocking of the further detection comprises: and comparing said second rate to said respiratory flow rate for about 10 to 15 seconds. The RMS value calculated from the respiratory flow data is calculated from approximately 50 to 70 seconds of respiratory flow data. This represents a judgment as to whether or not the threshold value of approximately 75 percent of the RMS value is exceeded. Preferably, the second period of time is about 10 to 20 seconds.

[0071] The device of any of the preceding paragraphs further comprising a flow sensor. The flow sensor further determines a measured flow of breathable gas. 4. An apparatus configured to:

[0072] In any of the devices of the preceding paragraphs, a pressure greater than atmospheric pressure is provided for the patient. The control system further comprises a flow generator configured to generate a breathable gas. and determining whether or not the pressure therapy regimen is to be initiated based on the detected hypopnea. and controlling the flow generator to generate the breathable gas. Place.

[0073] Controlling a processor to detect hypopnea from the measured flow of breathable gas. The method includes determining a long-term measure of ventilation and determining a short-term measure of ventilation that is in agreement with the threshold as a percentage of the long-term measure of ventilation; determining a first and second value of the short-term measure of ventilation and the threshold value; measuring an area bounded by the crossovers; and using the measured area to and detecting said hypopnea.

[0074] The method of any of the preceding paragraphs, wherein the measuring step determines the short-term change in ventilation. During the period from when the measurement value falls below the threshold to when the short-term measurement value exceeds the threshold integrating the difference between the threshold and the short-term measurement.

[0075] The method of any of the preceding paragraphs, wherein the measuring step determines whether the short-term measurement is greater than or equal to the threshold. A plurality of short-term measurements during a period from when the short-term measurement value falls below the threshold to when the short-term measurement value exceeds the threshold. The step of accumulating sample differences, each sample difference being a difference between the threshold sample and the The difference between the samples of short-term measurements in ventilation.

[0076] The method of any of the preceding paragraphs, wherein during a refractory period beginning at the second crossover portion, The method of claim 1, further comprising the step of blocking further detection of hypopnea.

[0077] The method of any of the preceding paragraphs, further comprising: When the first intersection is detected by comparing with an inequality, the measurement of the area is The method further comprising the step of initiating the determining step.

[0078] The method of any of the preceding paragraphs, wherein the detection of the hypopnea comprises detecting a hypopnea from the first crossover portion. the time from the first crossing to the second crossing exceeds about 10 seconds.

[0079] The method of any of the preceding paragraphs, wherein the short-term measure of ventilation is The half-value of the absolute value of the gas flow measurement is calculated using a low-pass filter with the first time constant. and filtering the output values.

[0080] The method of any of the preceding paragraphs, wherein the long-term measure of ventilation is The half-value of the gas flow measurement is calculated using a low-pass filter with a second time constant. and the second time constant is greater than the first time constant. It's getting bigger, way.

[0081] The method of any of the preceding paragraphs, wherein the percentage is about 70 percent.

[0082] In any of the methods of the preceding paragraphs, measurements of the area are used to assess the severity of the hypopnea. The method further comprising the step of:

[0083] The method of any of the preceding paragraphs, wherein the detecting step comprises: Compared to a threshold value selected to approximately indicate a blood oxygen saturation of at least 4 percent. The method includes the step of comparing.

[0084] The method of any of the preceding paragraphs, further comprising: measuring the flow of breathable gas using a flow sensor; The method further comprises the step of measuring

[0085] The method of any of the preceding paragraphs, further comprising: determining a flow limitation from the measured flow signal; detecting a constant value of the hypopnea, the detection of the hypopnea further determining whether the obstruction is present. The method is also based on the flow limitation measurement indicating.

[0086] 1. An apparatus for detecting hypopnea from a measured flow of breathable gas, comprising: at least one process for accessing data representative of the flow of breathable gas received by the a controller having a controller for detecting the measured flow rate, the controller further comprising: determining a long-term measurement of ventilation from the flow and determining a long-term measurement of ventilation from the measured flow; A short-term measurement is determined, and a threshold is determined as a percentage of the long-term measurement in ventilation. bounded by first and second intersections of the short-term measure of air volume and the threshold. and detecting said hypopnea using said measured area. A device that is configured to

[0087] In any of the devices of the preceding paragraphs, the controller controls the short-term change in ventilation rate. During the period from when the measurement value falls below the threshold to when the short-term measurement value exceeds the threshold The area is measured by integrating the difference between the threshold and the short-term measurement. 4. An apparatus configured to:

[0088] The apparatus of any of the preceding paragraphs, wherein the controller detects whether the short-term measurement exceeds the threshold. A plurality of short-term measurements during a period from when the short-term measurement value falls below the threshold to when the short-term measurement value exceeds the threshold. The area is measured by integrating sample differences, and each sample Pull delta is the difference between the threshold sample and the short-term measurement sample of ventilation. That is, the device.

[0089] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: During the refractory period initiated by the detection of a minute of hypopnea, the device is designed to block further detection of hypopnea. The device is configured to.

[0090] In any of the devices of the preceding paragraphs, the controller further comprises: The first intersection is determined by comparing the short-term measurement value with the threshold value by an inequality. and configured, upon detection, to initiate said measurement of said area.

[0091] In any of the apparatus of the preceding paragraphs, the detection of the hypopnea comprises detecting a hypopnea from the first crossover portion. providing that the time from the first crossing to the second crossing exceeds about 10 seconds.

[0092] In any of the devices of the preceding paragraphs, the short-term measurement of ventilation is The half-value of the absolute value of the gas flow measurement is calculated using a low-pass filter with the first time constant. The apparatus has an output value obtained by filtering the signal.

[0093] In any of the devices of the preceding paragraphs, the long-term measurement of ventilation is The half-value of the gas flow measurement is calculated using a low-pass filter with a second time constant. and the second time constant is greater than the first time constant. The device is getting bigger.

[0094] The apparatus of any of the preceding paragraphs, wherein the percentage is about 70 percent.

[0095] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: a severity of said hypopnea using a signal from said device;

[0096] The apparatus of any of the preceding paragraphs, wherein the detecting comprises: A threshold is selected to approximately represent 4 percent blood oxygen saturation. An apparatus including a step.

[0097] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: a measurement of low restriction, the detection of the hypopnea further comprising: The device also bases the measurement of flow limitation on an indication of obstruction.

[0098] The device of any of the preceding paragraphs further comprising a flow sensor. The roller further determines the measured flow of breathable gas using the flow sensor. 4. An apparatus configured to:

[0099] In any of the devices of the preceding paragraphs, a pressure greater than atmospheric pressure is provided for the patient. The control system further comprises a flow generator configured to generate a breathable gas. and determining whether or not the pressure therapy regimen is to be initiated based on the detected hypopnea. and controlling the flow generator to generate the breathable gas. Place.

[0100] Controlling a processor to detect hypopnea from the measured flow of breathable gas. The method includes determining a long-term measure of ventilation and determining a short-term measure of ventilation that is in agreement with the threshold as a percentage of the long-term measure of ventilation; determining a value of the short-term measure of ventilation and a respiratory rate as a function of the threshold value; calculating an extent of hypopnea; and using the measured extent to assess the severity of the hypopnea. A method comprising the steps of:

[0101] The method of any of the preceding paragraphs, wherein the indicating step indicates the measured range of values. The method includes the step of outputting.

[0102] In any of the methods of the preceding paragraphs, the calculated range is the short-term change in ventilation rate. a calculated region bounded by first and second intersections of the measurement of That is, the method.

[0103] In any of the methods of the preceding paragraphs, the calculated area is reduced by at least 4 percent. and comparing the blood oxygen saturation of the subject to a threshold value selected to approximately represent the subject's blood oxygen saturation. The method includes the steps of:

[0104] The method of any of the preceding paragraphs, further comprising: measuring the flow of breathable gas using a flow sensor; The method further comprises the step of measuring

[0105] deriving a measure of flow restriction from the measured flows, and wherein the indication of the detection of hypopnea comprises: The method further comprises based on the measurement of said flow limitation being indicative of obstruction.

[0106] 1. An apparatus for detecting hypopnea from a measured flow of breathable gas, comprising: at least one process for accessing data representative of the flow of breathable gas received by the a controller having a processor, the controller further converting the data into determining a long-term measure of ventilation volume and determining from the data a short-term measure of ventilation volume; , determining a threshold as a percentage of the long-term measure of ventilation; Calculating a range of hypopnea as a function of the measurement and the threshold value, and further calculating the calculated range. a severity of said hypopnea using a signal from said device;

[0107] The apparatus of any of the preceding paragraphs, wherein the controller determines the calculated range value. The apparatus is configured to indicate the severity by outputting to an output device.

[0108] In any of the devices of the preceding paragraphs, the controller controls the short-term change in ventilation rate. calculating an area bounded by first and second intersections of the measurement with the threshold value; and calculating the range by:

[0109] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: The range is selected to approximately represent a blood oxygen saturation of at least 4 percent. The apparatus is configured to compare to a threshold value.

[0110] The device of any of the preceding paragraphs further comprising a flow sensor. The flow sensor further determines a measured flow of breathable gas. 4. An apparatus configured to:

[0111] In any of the devices of the preceding paragraphs, a pressure greater than atmospheric pressure is provided for the patient. The control system further comprises a flow generator configured to generate a breathable gas. and determining whether or not the pressure therapy regimen is to be initiated based on the detected hypopnea. and controlling the flow generator to generate the breathable gas. Place.

[0112] The apparatus of any of the preceding paragraphs, wherein the controller further comprises: a measurement of low restriction, the measurement indicating said detection of hypopnea. wherein said determining is further based on said flow limitation being indicative of obstruction.

[0113] Controlling a processor to classify hypopnea from the measured flow of breathable gas. The method includes steps for detecting a hypopnea event from a measured flow of breathable gas. and a measurement indicating an obstruction in the measured flow occurring with the hypopnea event. determining a fixed value based on the step of determining the measurement indicative of obstruction; and classifying the detected hypopnea event as obstructive or central. ,method.

[0114] The method of any of the preceding paragraphs, wherein the determining step detects a partial occlusion. and wherein the classifying step includes recording an obstructive hypopnea event. Includes, a method.

[0115] The method of any of the preceding paragraphs, further comprising detecting a lack of breathing. and wherein the classifying step includes recording a central hypopnea event. Law.

[0116] In any of the methods of the preceding paragraphs, a hypopnea event occurring together with another detected hypopnea event detecting an absence of breathing; and determining based on the detected absence of breathing, and avoiding recording another hypopnea event.

[0117] Accessing data representative of a measured flow of breathable gas in a hypopnea detection device a controller having at least one processor for executing the program; the controller further determines from the data representing the measured flow of breathable gas a hypopnea detecting an event; and detecting the hypopnea event in the data representing the measured flow. determining a measurement indicative of obstruction occurring with the image; Based on the determining step, the detected hypopnea event is characterized as obstructive or central. and a classifying step.

[0118] The apparatus of any of the preceding paragraphs, wherein the determining step detects a partial occlusion; An apparatus wherein the classifying step includes the step of recording an obstructive hypopnea event.

[0119] In any of the devices of the preceding paragraphs, the controller further detects absence of breathing. and wherein the step of classifying comprises controlling the step of issuing a central hypopnea. The apparatus includes the step of recording the event.

[0120] In any of the apparatuses of the preceding paragraphs, the controller further comprises: Detecting a lack of breathing that occurs with a hypopnea event, and detecting the detected lack of breathing. and configured to avoid recording another detected hypopnea event based on There is a device.

[0121] In any of the devices of the preceding paragraphs, a pressure greater than atmospheric pressure is provided for the patient. A flow generator configured to generate a breathable gas, and a flow sensor. and the controller further comprises: and based on the detected hypopnea, Controlling the flow generator to generate the breathable gas in accordance with a pressure therapy regimen. 4. An apparatus configured to:

Claims

1. at least one for accessing data representative of the measured flow of breathable gas; a controller having a processor for The controller further comprises: determining a first measure of short term variance in the data; determining a second measure from the long-term variance in the data; comparing the first measurement to a first and second ratio of the second measurement; The first measurement is below the first percentage and for a first period thereafter. and if the first and second ratio ranges are not exceeded, based on the comparison, and configured to indicate said detection of hypopnea. Hypopnea detection device.

2. the first rate being less than the second rate, and the controller further if the first measurement value does not exceed the first ratio during the first period, , the apparatus of claim 1 configured to indicate detection of hypopnea.

3. the first rate being less than the second rate, and the controller further In the first period, the first measurement value exceeds the first percentage, but configured to indicate detection of hypopnea when the second percentage does not exceed the second percentage.

13. The apparatus of claim 1 .

4. The controller is further configured to detect a measure of flow restriction from the data. and wherein said detection of said hypopnea is further indicative of obstruction. The apparatus of claim 1 , wherein the measurement is based on a flow limit that is determined by the flow rate.

5. 1. An apparatus for detecting hypopnea from a measured flow of breathable gas, comprising: at least one process for accessing data representative of the flow of breathable gas received; a controller having a The controller further comprises: determining a long term measure of ventilation from the measured flow; determining a short term measure of ventilation from the measured flow; determining a threshold value as a percentage of said long-term measure of ventilation; bounded by first and second intersections of said short-term measure of ventilation and said threshold value; Measure the area covered by the and detecting said hypopnea using said measured area. Device.

6. The controller continues to adjust the ventilation rate from the moment the short-term measurement falls below the threshold. A short-term measurement value and the threshold value during a period leading up to when the short-term measurement value exceeds the threshold value. and measuring the area by integrating the difference between Item 6. The device described in item 5.

7. The controller continues to monitor the short-term measurement from the time when the short-term measurement falls below the threshold. and accumulating the differences between a plurality of sample values ​​during the period until the fixed value exceeds the threshold value. and the difference between each sample value is determined to be equal to or less than the threshold value.

6. The difference between a sample of a value of the short-term measure of ventilation and a sample of the short-term measure of ventilation. The apparatus described in

8. The controller further comprises: comparing the short-term measure of ventilation and the threshold value by an inequality. and comparing the measurement of the region when the first crossover is detected. The device of claim 5 configured for starting.

9. The controller further uses the area measurement to indicate a severity of the hypopnea. The apparatus of claim 5 , configured to:

10. 1. An apparatus for detecting hypopnea from a measured flow of breathable gas, comprising: at least one process for accessing data representative of the flow of breathable gas received; a controller having a The controller further comprises: determining a long-term measure of ventilation from the data; determining a short-term measure of ventilation from the data; determining a threshold value as a percentage of said long-term measure of ventilation; Calculating the extent of hypopnea as a function of said short-term measure of ventilation and said threshold; and configuring said calculated range to indicate a severity of said hypopnea. Device.

11. at least one for accessing data representative of the measured flow of breathable gas; a controller having a processor for The controller further comprises: Detecting a hypopnea event from the data representative of the measured flow of breathable gas. And, In the data representing the measured flow, determining a measurement indicative of obstruction; the detected hypopnea event based on the determining the measurement indicative of obstruction. The present invention is configured to classify the above-mentioned into an obstructive or central type, and to control the above-mentioned. Hypopnea detection device.

12. The determining detects a partial obstruction and the classifying detects an obstructive hypopnea. The apparatus of claim 11 further comprising recording the event.

13. The controller is further configured to control detecting absence of breathing. and said classifying comprises recording a central hypopnea event.

12. The apparatus described in 11.

14. The controller further comprises detecting a lack of breathing occurring in conjunction with another detected hypopnea event. and based on the absence of the detected breath, determining whether the detected breath is another breath.

12. The apparatus of claim 11, configured to avoid recording a degradation event.

15. A blower configured to generate breathable gas at a pressure greater than atmospheric pressure for a patient. A raw generator; and a flow sensor, The controller further comprises: a flow sensor for detecting the flow of breathable gas; and determining a pressure therapy based on the detected hypopnea. and controlling the flow generator to generate the breathable gas in accordance with a therapeutic regimen. The apparatus according to any one of claims 1 to 14, configured to:

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