Respiratory Support Device for REM-Aware PAP Pressure Control
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Solution Overview
Problem
Existing positive airway pressure (PAP) therapy for sleep-disordered breathing conditions, particularly REM-dominant obstructive sleep apnea, causes discomfort due to high pressure settings during REM sleep, leading to sleep fragmentation and REM sleep deprivation, which can result in daytime sleepiness and health issues.
Innovation Solution
A method to determine sleep characteristics by analyzing sleep stage and respiratory event information, using neurological and surrogate measures, to adjust PAP therapy settings dynamically, balancing the reduction of respiratory events during REM sleep with maintaining sufficient REM sleep duration.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If high pressure setting is used during REM sleep to reduce respiratory events, then the number of SDB events is reduced, but subject comfort deteriorates and sleep fragmentation occurs
Solution Approach 1:
The PAP therapy system dynamically adjusts pressure settings based on detected sleep stages. During REM sleep, the system monitors respiratory events and selectively increases pressure only when SDB events are detected, rather than maintaining continuously high pressure. This dynamic adjustment maintains airway patency when needed while minimizing discomfort and sleep fragmentation during stable REM periods.
Solution Approach 2:
The system applies different pressure levels to different sleep stages and respiratory event states. High pressure is applied locally only during detected SDB events in REM sleep, while normal or reduced pressure is maintained during stable sleep periods. This localized application of high pressure achieves therapeutic effect while minimizing overall discomfort and sleep disruption.
2Reliability
If high pressure is maintained during REM sleep to keep airways open, then airway patency is improved, but REM sleep duration is reduced due to arousals
Solution Approach 1:
The system employs periodic monitoring of respiratory signals during REM sleep and applies pressure support in periodic bursts corresponding to detected respiratory events rather than continuous high pressure. This periodic action maintains airway patency during critical moments while allowing uninterrupted REM sleep during stable periods, preserving overall REM sleep duration.
Solution Approach 2:
The pressure support system transitions from static high-pressure maintenance to dynamic, event-responsive pressure adjustment. The system continuously monitors respiratory signals and adjusts pressure in real-time, applying high pressure only during detected SDB events and reducing pressure during stable respiratory periods, thereby maintaining airway patency while minimizing sleep disruptions.
3Ease of operation
If pressure is reduced to improve comfort and REM sleep duration, then subject comfort is improved, but the effectiveness in reducing SDB events during REM sleep deteriorates
Solution Approach 1:
The system implements closed-loop feedback control by continuously monitoring respiratory signals during sleep and adjusting pressure settings based on detected SDB events. During REM sleep, the system detects apneic or hypopneic episodes and automatically increases pressure in response to these events, ensuring therapeutic effectiveness is maintained while allowing lower baseline pressure for improved comfort.
Solution Approach 2:
The system dynamically adapts pressure settings based on real-time respiratory monitoring. During stable REM sleep periods, lower pressure is maintained for comfort, but upon detection of SDB events, pressure is immediately increased to restore airway patency. This dynamic response ensures both comfort during stable periods and therapeutic effectiveness during respiratory events.
Data Source
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AI summary
There is provided a there is a computer program product, comprising instructions which, when executed by a processing system, cause the processing system to carry out a method for determining a sleep characteristic of a subject during a sleep session. The method comprises receiving sleep stage information and respiratory event information. The method comprises determining a REM value and a NREM value based on the sleep stage information and the respiratory event information. The method comprises determining a first ratio between the REM value and the NREM value; determining whether the first ratio exceeds a first threshold; determining a REM occurrence value representative of an amount of REM sleep during the sleep session; and determining whether the REM occurrence value exceeds a second threshold.