31 results about "Cheyne–Stokes respiration" patented technology

The present invention provides a method and apparatus for detecting and treating sleep respiratory events that includes a plurality of sensors gathering physiological data related to sleep respiratory events. A processor extracts an average cycle length and a frequency of at least one of Cheyne-Stokes respiration and periodic breathing based upon the physiological data, and determines whether therapy is required based on the average cycle length and the frequency.

A method and apparatus for treating a breathing disorder and, more particularly, a method and apparatus for providing a pressurized air flow to an airway of a patient to treat congestive heart failure in combination with Cheyne-Stokes respiration and / or sleep apnea or other breathing disorders. A positive airway pressure ventilator is utilized in combination with an algorithm that adjusts IPAP and EPAP in order to counter a Cheyne-Stokes breathing pattern. Cheyne-Stokes respiration is detected by monitoring a peak flow of the patient.

The present invention provides a method and apparatus for detecting and treating sleep respiratory events that includes a plurality of sensors gathering physiological data related to sleep respiratory events. A processor extracts an average cycle length and a frequency of at least one of Cheyne-Stokes respiration and periodic breathing based upon the physiological data, and determines whether therapy is required based on the average cycle length and the frequency.

A system and method for delivering a flow of breathing gas to an airway of a patient. The system monitors a characteristic that varies based on variations of the flow of the breathing gas and determines a Target Flow for the gas to be delivered to the patient based on the monitored characteristic. The Target Flow is set to a level sufficient to treat Cheyne-Stokes respiration or a sleep disordered breathing event. The system also alters the Target Flow based on a determination that the patient is experiencing a sleep disordered breathing event. In a further embodiment, the system determines an apnea detection time (Tapnea) as Tinsp plus a constant, and delivers a machine triggered breath if an amount since the start of inspiration reaches Tapnea. Yet another embodiment, monitors the characteristic during an inspiratory phase of a respiratory cycle, and controls the flow of gas during the inspiratory phase of the respiratory cycle based on a result of this comparison.

The present invention provides a diagnostic tool for detection of Cheyne-Stokes Respiration (CSR). This invention also provides a method for development of the diagnostic tool. The method comprises the steps of performing overnight oximetry recordings in patients suspected of sleep disordered breathing. Spectral analysis is performed on the oximetry recordings to obtain a set of parameters which can be used in the construction of a classification tree and a trained neural network. The diagnostic tools of the present invention can be used for classification of a patient as having CSR or obstructive sleep apnea.

Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.

A therapy system adapted to treat a patient's ventilatory instability using a ventilatory therapy, a gas modulation therapy, or both. The algorithm implemented by the therapy system monitors the ventilatory instability, such as Cheyne Stokes Respiration (CSR), mixed apneas, CPAP emergent apneas, and complex sleep disordered breathing (CSDB) and treats the ventilatory instability. The algorithm also determine a reference point with respect to the ventilatory instability. The therapy delivery system initiate the treatment based on the reference point.

A method and apparatus for treating a breathing disorder and, more particularly, a method and apparatus for providing a pressurized air flow to an airway of a patient to treat congestive heart failure in combination with Cheyne-Stokes respiration and / or sleep apnea or other breathing disorders. A positive airway pressure ventilator is utilized in combination with an algorithm that adjusts IPAP and EPAP in order to counter a Cheyne-Stokes breathing pattern. Cheyne-Stokes respiration is detected by monitoring a peak flow of the patient.

The present invention relates to a device and method for monitoring for sleep disordered breathing or other types of disordered breathing such as Cheyne-Stokes breathing. More specifically, a device and method for detecting disordered breathing is provided that monitors a physiological parameter, which becomes cyclical due to apnea-hyperpnea (or arousal) alternation and provides the basis for the determination of a number of breathing disorder metrics.

Method and apparatus for the treatment of cardiac failure, Cheyne Stokes breathing or central sleep apnea are disclosed. A subject is provided with ventilatory support, for example positive pressure ventilatory support using a blower and mask. Respiratory airflow is determined. From the respiratory airflow are derived a measure of instantaneous ventilation (for example half the absolute value of the respiratory airflow) and a measure of longterm average ventilation (for example the instantaneous ventilation low pass filtered with a 100 second time constant). A target ventilation is taken as 95% of the longterm average ventilation. The instantaneous ventilation is fed as the input signal to a clipped integral controller, with the target ventilation as the reference signal. The output of the controller determines the degree of ventilatory support. Clipping is typically to between half and double the degree of support that would do all the respirator work. A third measure of ventilation, for example instantaneous ventilation low pass filtered with a time constant of 5 seconds, is calculated. Ventilatory support is in phase with the subject's respiratory airflow to the fuzzy extent that this ventilation is above target, and at a preset rate conversely.

A signal representative of a patient's respiration is split into equal length epochs. A primary feature is extracted from each epoch that acts as a compressed representation of the signal events. Statistics are applied to the primary feature to produce one or more secondary features that represent the entire epoch. Each secondary feature is grouped with one or more other features that are extracted from the entire epoch rather than selected epoch events. This grouping is the epoch pattern. The pattern is manipulated with suitable classifier algorithm to produce a probability for each class within the algorithm, that the signal may be representative of a disease state (Cheyne-Stokes, OSA etc). The epoch is assigned to the class with the highest probability. Also defined are methods of detecting Cheyne-Stokes breathing by analysing a signal to detect one or regions of hyperpnoea and if the length of a hyperpnoea exceeds a parameter, Cheyne-Stokes is present.

Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.

Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.

Methods and apparatus perform periodic breathing detection, such as Cheyne-Stokes respiration detection. The detection may be performed by one or more processors, such as by analysis of data from one or more sensors. In some cases, the detection may be based on an electrocardiogram (ECG) signal, such as from ECG electrodes and / or an accelerometer signal, such as from an accelerometer. An occurrence of periodic breathing may be detected based on features derived from the signal(s). For example, detection may be based on deriving a respiration signal from the sensed signal(s) and / or analysis of RR interval times or relative QRS amplitude values, which may be evaluated on a segment-by-segment basis. The detection may provide monitoring and reporting of the occurrence of periodic breathing by a monitoring device and / or provide a basis for controlling changes to a provided respiratory treatment or therapy, such as by a respiratory pressure therapy device.

Devices and systems provide methods of detecting a heart failure condition of a patient that may be based on one or more respiratory parameters of a patient. In an example embodiment, a monitoring device determines one or more heart failure condition indicators based on a measure of the patient respiratory airflow and / or a measure of treatment pressure. Respiratory parameters such as respiration rate, hypopneas, apneas, Cheyne-Stokes breathing patterns or apnea-hypopnea counts may be compared to thresholds that are selected to represent a change in the condition of a heart failure patient such as an onset of a decompensation event. Results of the comparisons may trigger a pressure treatment change and / or one or more warnings or messages to notify a patient or physician of a pending change to the patient's heart failure condition so that the patient may more immediately seek medical attention to treat the heart failure condition.

Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.

Devices and systems provide methods of detecting a heart failure condition of a patient that may be based on one or more respiratory parameters of a patient. In an example embodiment, a monitoring device determines one or more heart failure condition indicators based on a measure of the patient respiratory airflow and / or a measure of treatment pressure. Respiratory parameters such as respiration rate, hypopneas, apneas, Cheyne-Stokes breathing patterns or apnea-hypopnea counts may be compared to thresholds that are selected to represent a change in the condition of a heart failure patient such as an onset of a decompensation event. Results of the comparisons may trigger a pressure treatment change and / or one or more warnings or messages to notify a patient or physician of a pending change to the patient's heart failure condition so that the patient may more immediately seek medical attention to treat the heart failure condition.

A therapy system adapted to treat a patient's ventilatory instability using a ventilatory therapy, a gas modulation therapy, or both. The algorithm implemented by the therapy system monitors the ventilatory instability, such as Cheyne Stokes Respiration (CSR), mixed apneas, CPAP emergent apneas, and complex sleep disordered breathing (CSDB) and treats the ventilatory instability. The algorithm also determine a reference point with respect to the ventilatory instability. The therapy delivery system initiate the treatment based on the reference point.

Techniques are provided for improving cardiac output and also suppressing certain forms of apnea / hypopnea within a patient using an implantable medical device, such as a pacemaker or ICD. In one example, a selected pacing parameter—usually the pacing rate—is temporarily altered by an amount sufficient to elevate cardiac output, the elevation in cardiac output being eventually reduced by intrinsic compensatory mechanisms within the patient. The pacing parameter is then temporarily reset for a duration sufficient to allow the compensatory mechanisms to return toward a previous state so as to permit a subsequent alteration in the pacing parameter to again elevate cardiac output. The pacing parameter is repeatedly altered and reset so as to achieve an overall increase in cardiac output despite the intrinsic compensatory mechanisms. The increase in cardiac output is often sufficient to suppress certain forms of apnea / hypopnea, particularly apnea / hypopnea arising from Cheyne-Stokes Respiration (CSR).

The invention relates to a method and a device for treating Cheyne-Stokes respiration, periodic respiration and central or mixed apnea. If the respiration waxes and wanes periodically, there is pressure support in phases of periodic respiration, taking into account the natural patient respiration.

Methods and apparatus perform periodic breathing detection, such as Cheyne-Stokes respiration detection. The detection may be performed by one or more processors, such as by analysis of data from one or more sensors. In some cases, the detection may be based on an electrocardiogram (ECG) signal, such as from ECG electrodes and / or an accelerometer signal, such as from an accelerometer. An occurrence of periodic breathing may be detected based on features derived from the signal(s). For example, detection may be based on deriving a respiration signal from the sensed signal(s) and / or analysis of RR interval times or relative QRS amplitude values, which may be evaluated on a segment-by-segment basis. The detection may provide monitoring and reporting of the occurrence of periodic breathing by a monitoring device and / or provide a basis for controlling changes to a provided respiratory treatment or therapy, such as by a respiratory pressure therapy device.

The invention relates to a method and a device for treating Cheyne-Stokes respiration, periodic respiration and central or mixed apnea. If the respiration waxes and wanes periodically, there is pressure support in phases of periodic respiration, taking into account the natural patient respiration.

The present invention relates to use 1,3-thiazol-2-yl substituted benzamide compounds of general formula (I) as described and defined herein, to pharmaceutical compositions and combinations comprising said compounds for the treatment or prophylaxis of diseases which are associated with nerve fiber sensitization, and / or other pathological conditions associated with autonomic imbalance caused by increased chemoreceptor sensitivity, in particular for the treatment of breathing disorders, Cheyne Stokes respiration, central and obstructive sleep apnea, cardiovascular disease, hypertension, resistant hypertension, and heart failure, which are related to increased activity of P2X3 receptors.

A system and method for providing ventilatory support to a patient suffering from sleep disordered breathing (SDB), in particular, non-obstructive SDB, such as Cheyne Stokes respiration and hypoventilation, including obesity hypoventilation syndrome. The system and method monitor obtain data corresponding to a breathing pattern of a patient and determine when the patient experiences oscillating breathing or low spontaneous ventilation. In particular, the system and method determine when the patient's real-time breathing patterns fall below a predetermined baseline threshold, and subsequently initiate a short series of mechanical breaths to be delivered to the patient.

The present invention relates to a method and a respiration device having a respiration unit for generating an airflow for the respiration and having a monitoring unit. The monitoring unit is used to detect a respiration parameter and to classify events in the respiration on the basis of monitoring of the respiration parameter. In this case, the monitoring unit is able and designed to carry out an event analysis to recognize an occurrence, which is characteristic for Cheyne-Stokes respiration, of chronologically successive events and for this purpose to ascertain the period length thereof and to compare them to one another and to register the presence of Cheyne-Stokes respiration when the compared period lengths each deviate by less than 40% from one another.

Methods and systems to treat Cheyne-Stokes respiration (CSR) and / or central sleep apnea (CSA) include monitoring retrograde breathing and detecting respiratory events. Based on the occurrences of certain respiratory events, a target volume of rebreathing is adjusted to reduce arousals as well as CSR / CSA.

Methods and apparatus for treating a respiratory disorder, in one aspect, include an apparatus that delivers backup breaths at a sustained timed backup rate that is a function of the patient's spontaneous respiratory rate. Other aspects include apparatus that delivers backup breaths at a rate that gradually increases from a spontaneous backup rate to a sustained timed backup rate or, alternatively, apparatus that oscillates a treatment pressure in antiphase with the patient's spontaneous respiratory efforts when a measure indicative of ventilation is greater than a threshold. Other aspects include apparatus configured to treat Cheyne-Stokes respiration by computing the treatment pressure so as to bring a measure indicative of ventilation of the patient towards a target ventilation that is dependent on the measure indicative of ventilation or, alternatively, by periodically elevating the treatment pressure to a high level for a short time, the high level being high enough and the short time being long enough to induce a central apnea in a patient. Depending on functionality, the foregoing apparatus may comprise an adaptive servo-ventilator or CPAP therapy device.

The present invention relates to a method and a respiration device having a respiration unit for generating an airflow for the respiration and having a monitoring unit. The monitoring unit is used to detect a respiration parameter and to classify events in the respiration on the basis of monitoring of the respiration parameter. In this case, the monitoring unit is able and designed to carry out an event analysis to recognize an occurrence, which is characteristic for Cheyne-Stokes respiration, of chronologically successive events and for this purpose to ascertain the period length thereof and to compare them to one another and to register the presence of Cheyne-Stokes respiration when the compared period lengths each deviate by less than 40% from one another.