NZ784397B2 - Methods and apparatus for treating respiratory disorders - Google Patents

Methods and apparatus for treating respiratory disorders Download PDF

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Publication number
NZ784397B2
NZ784397B2 NZ784397A NZ78439717A NZ784397B2 NZ 784397 B2 NZ784397 B2 NZ 784397B2 NZ 784397 A NZ784397 A NZ 784397A NZ 78439717 A NZ78439717 A NZ 78439717A NZ 784397 B2 NZ784397 B2 NZ 784397B2
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New Zealand
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events
sleep
patient
event
generate
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NZ784397A
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NZ784397A (en
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Dinesh Ramanan
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ResMed Pty Ltd
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Publication of NZ784397A publication Critical patent/NZ784397A/en
Publication of NZ784397B2 publication Critical patent/NZ784397B2/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/087—Measuring breath flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/087—Measuring breath flow
    • A61B5/0871—Peak expiratory flowmeters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/091—Measuring volume of inspired or expired gases, e.g. to determine lung capacity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/097—Devices for facilitating collection of breath or for directing breath into or through measuring devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A61B5/4809—Sleep detection, i.e. determining whether a subject is asleep or not
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A61B5/4812—Detecting sleep stages or cycles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A61B5/4818—Sleep apnoea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A61B5/7282—Event detection, e.g. detecting unique waveforms indicative of a medical condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0605—Means for improving the adaptation of the mask to the patient
    • A61M16/0633—Means for improving the adaptation of the mask to the patient with forehead support
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0683—Holding devices therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/105—Filters
    • A61M16/1055—Filters bacterial
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
    • A61M16/16—Devices to humidify the respiration air
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/0007—Special media to be introduced, removed or treated introduced into the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/02—Gases
    • A61M2202/0208—Oxygen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/07—General characteristics of the apparatus having air pumping means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/18—General characteristics of the apparatus with alarm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/42—Reducing noise
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics

Abstract

Methods and apparatus infer or indicate sleep stage(s) of a patient from a respiratory flow rate signal of the patient. The method may include applying a plurality of detection pathways to a signal representing a respiratory flow rate of the patient, wherein each detection pathway is configured to generate start events and end events indicating start times and end times of episodes respectively of a corresponding sleep stage, wherein each start event and each end event has a priority; and combining the start events and end events based on their priorities to produce an indication of the sleep stage of the patient. The apparatus may include a sensor configured to generate a signal representing a property of a flow of air within a patient interface; and a processor configured to implement a method of inferring a sleep stage of the patient from the signal.

Claims (33)

1. A method of indicating a sleep stage of a patient, the method comprising: applying, in one or more processors, a plurality of detection pathways to a signal representing a respiratory flow rate of the patient, wherein each detection pathway is configured to generate start events and end events indicating start times and end times respectively of episodes of a corresponding sleep stage, wherein each start event and each end event has a priority; and combining, in the one or more processors, the start events and end events based on their priorities to produce an indication of a sleep stage of the patient, wherein the indication of sleep stage is a selected output from one of a plurality of different detectors that are each configured to evaluate variance, trend, and difference features to determine a different indication of sleep stage.
2. The method of claim 1 wherein the one or more processors is configured to resolve detection collisions between sleep stages detected by different detection pathways.
3. The method of any one of claims 1 to 2 wherein the combining comprises disregarding a detected stage of a lower priority in favor of a detected sleep stage of higher priority.
4. The method of any one of claims 1 to 3 wherein the one or more processors is configured to indicate the sleep stage from a set of stages including any two or more of: deep sleep; Long-term awake type 2; respiratory event sleep (RES); Long-term awake type 1; Short-term awake; and
5. A method according to any one of claims 1 to 4, further comprising: generating a supply of air at positive pressure to an airway of the patient; and altering a treatment pressure of the supply of air based on the indication of the sleep stage of the patient. 506185NZDIV2 / P1275NZ3 RESMED 3.4 -158 NZ DIV II (2428)
6. A method according to any of claims 1 to 5, further comprising storing the indication of the sleep stage of the patient in a hypnogram.
7. A method according to any of claims 1 to 5, wherein combining the start events and end events comprises: storing the start events and end events in time order; and consolidating the start events and end events into a hypnogram based on their priorities.
8. A method according to any of claims 1 to 7, wherein one detection pathway is a respiratory event pathway configured to generate start events and end events indicating start times and end times respectively of episodes of respiratory event sleep.
9. A method according to claim 8, wherein the respiratory event pathway is configured to generate a respiratory event sleep start event on detecting a series of respiratory events in close succession.
10. A method according to claim 9, wherein the respiratory events are one or more of apneas, hypopneas, and respiratory event-related arousals (RERAs).
11. A method according to claim 10, wherein each hypopnea is an obstructive hypopnea.
12. A method according to any of claims 9 to 11, wherein the respiratory event pathway is configured to generate a respiratory event sleep end event upon not detecting a respiratory event for a timeout threshold.
13. A method according to any of claims 1 to 12, wherein one detection pathway is a breathing stability pathway configured to generate start events and end events indicating start times and end times respectively of episodes of one or more of: non-respiratory-event sleep, and wakefulness. 506185NZDIV2 / P1275NZ3 RESMED 3.4 -158 NZ DIV II (2428)
14. A method according to claim 13, wherein non-respiratory event sleep comprises one or more of: REM sleep, and deep sleep.
15. A method according to claim 1, wherein at least one of the detection pathways comprises a REM sleep detector configured to generate a REM start event on detecting short- term and medium-term variation in breath features, and long-term stability of the breath features.
16. A method according to claim 1, wherein at least one of the detection pathways comprises a sleep onset detector configured to generate a deep sleep start event on detecting a transition of breath features from highly variable to semi-stable.
17. A method according to claim 1, wherein at least one of the detection pathways comprises a wakefulness detector configured to generate start events and end events indicating start times and end times respectively of episodes of one or more of: short-term awake; and long-term awake.
18. A method according to claim 17, wherein the wakefulness detector is configured to generate a short-term awake start event on detecting large short-term variation in breath features.
19. A method according to claim 18, wherein the wakefulness detector is configured to generate a long-term awake start event on detecting large long-term variation in breath features.
20. A method according to claim 19, wherein the wakefulness detector is configured to generate start events and end events indicating start times and end times respectively of episodes of two types of long-term awake.
21. A method according to claim 20, wherein the wakefulness detector is configured to generate a long-term awake start event of a second type on detecting medium-term variability of a breath feature.
22. A method according to any of claims 1 to 7, wherein: 506185NZDIV2 / P1275NZ3 RESMED 3.4 -158 NZ DIV II (2428) one detection pathway is a respiratory event pathway configured to generate start events and end events indicating start times and end times respectively of episodes of respiratory event sleep; and one detection pathway is a breathing stability pathway configured to generate start events and end events indicating start times and end times respectively of episodes of deep sleep, and deep sleep events have a higher priority than respiratory event sleep events.
23. A computer processor-readable memory storage apparatus having processor- executable instructions encoded thereon which, when executed by a processor, cause the processor to perform a method of indicating a sleep stage of a patient, the method comprising any one of the methods of claims 1 to 22.
24. Apparatus comprising: a sensor configured to generate a signal representing a property of a flow of air within a patient interface, the patient interface configured to engage with an entrance to an airway of a patient; and one or more processors coupled with the computer processor-readable memory storage apparatus of claim 23, wherein the one or more processors is configured to indicate a sleep stage of the patient from the signal according to the processor-executable instructions encoded on the computer processor-readable memory storage apparatus.
25. The apparatus of claim 24 further comprising: a pressure generator configured to generate a supply of air at positive pressure to an airway of the patient via the patient interface over an air circuit, wherein the one or more processors is/are configured to control the supply of air based on the sleep stage indicated.
26. Apparatus according to any one of claims 24 to 25, wherein the sensor is located within the patient interface and the property is pressure.
27. Apparatus according to any of claims 24 to 26, wherein the one or more processors is/are located within the patient interface. 506185NZDIV2 / P1275NZ3 RESMED 3.4 -158 NZ DIV II (2428)
28. Apparatus according to any of claims 24 to 27, wherein the one or more processors is/are located in a remote external computing device configured to communicate with the patient interface.
29. Apparatus according to any of claims 25 and 26 to 28, when dependent on claim 25, wherein the sensor is located within the pressure generator, and the property is flow rate.
30. Apparatus according to any of claims 24 to 29, wherein the sensor is located within the air circuit, and the property is flow rate.
31. The apparatus of any one of claims 24 to 30, further comprising the patient interface.
32. A system comprising: means for generating a signal representing a property of a flow of air within a means for engaging with an entrance to an airway of a patient; means for applying a plurality of detection pathways to the signal, wherein each detection pathway is configured to generate start events and end events indicating start times and end times respectively of episodes of a corresponding sleep stage, wherein each start event and each end event has a priority; and means for combining the start events and end events based on their priorities to produce an indication of a sleep stage of the patient, wherein the indication of sleep stage is a selected output from one of a plurality of different detectors that are each configured to evaluate variance, trend, and difference features to determine a different indication of sleep stage.
33. The system of claim 32, further comprising the means for engaging with an entrance to an airway of the patient.
NZ784397A 2017-02-01 Methods and apparatus for treating respiratory disorders NZ784397B2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2016900329A AU2016900329A0 (en) 2016-02-02 Methods and apparatus for treating respiratory disorders
NZ744519A NZ744519B2 (en) 2017-02-01 Methods and apparatus for treating respiratory disorders

Publications (2)

Publication Number Publication Date
NZ784397A NZ784397A (en) 2024-08-30
NZ784397B2 true NZ784397B2 (en) 2024-12-03

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