WO1996034586A1

WO1996034586A1 - Relief of obstructive sleep apnoea

Info

Publication number: WO1996034586A1
Application number: PCT/GB1996/001069
Authority: WO
Inventors: Simon Hayek
Original assignee: Dranez Anstalt
Priority date: 1995-05-05
Filing date: 1996-05-03
Publication date: 1996-11-07
Also published as: GB9509206D0; AU5509496A

Abstract

Apparatus for use in relieving obstructive sleep apnoea comprises means acting on the front surface of the throat of a patient for elevating the front surface of the throat so as to lift the tongue of the patient away from the soft palate of the patient, such as a magnetically attractable adhesive patch (22) for attachment to the surface of the throat of the patient and one or more magnets (20) for attracting and elevating the patch (22).

Description

RELIEF OF OBSTRUCTIVE SLEEP APNOEA

The present invention relates to the relief of obstructive sleep apnoea and provides apparatus for this purpose.

Obstructive sleep apnoea, sometimes referred to as "snoring sickness" is a condition which can vary in severity from causing merely snoring to causing life threatening cessation of breathing during sleep. It is a sleeping disorder in which the sufferer, often completely unawares, repeatedly chokes on his or her soft pallet and tongue during sleep. The result may be severely fragmented sleep with consequent daytime fatigue and assorted respiratory problems. It may even be a cause of sudden unexpected death. Severe sufferers have in the past been treated by continuous positive airway pressure lung ventilation. According to such a technique, a face mask is worn to which is supplied continuous positive air pressure to force opening of the airway. In order to achieve a sufficient air pressure, it is necessary for the face mask used to seal quite tightly against the patient's face. This necessitates the use of substantial pressure holding the mask on. This technique gives rise to a number of quite severe problems. First, air leakage from the mask causes drying of the skin. Draughts of air from the mask impinging on the eyes of the patient can cause severe discomfort and in an extreme case have been known to cause blindness. The exclusion of blood flow from the skin due to compression by the mask can cause skin irritation and blistering and more severe damage particularly around the bridge of the nose.

The constant downward pressure on the diaphragm produced by the inflation of the lungs caused by the airway pressure causes discomfort and difficulties of digestion. Lastly, the mask is uncomfortable which in itself interferes with sleep. Attempts to alleviate these difficulties such as providing a sensor to detect cessation of breathing and to supply positive airway pressure only in response to the sensor rather than constantly as in US-A-5301689 or by placing an object in the mouth to maintain the tongue in the correct position as in US-A-5052409 or by triggering an alarm when a sensor detects movement of the tongue into an apnoea causing position as in US-A-4593686 have not produced a satisfactory solution to the problems of obstructive sleep apnoea. The present invention provides apparatus for use in relieving obstructive sleep apnoea comprising means acting on the front surface of the throat of a patient for elevating the front surface of the throat as to lift the tongue of the patient away from the soft pallet of the patient. Apparatus according to specific examples of the invention described hereafter with reference to the drawings provides a simple, low cost and effective relief for obstructive sleep apnoea whilst permitting reasonable comfort for the patient.

According to a first aspect of the invention, the means for acting on the front surface of the throat of the patient to elevate the front surface of the throat may comprise a first means for attachment to the surface of the throat of the patient and a second means for elevating the first means. Typically, the first means will be an adhesive patch to be applied directly to the front surface of the throat of the patient, preferably in a band extending over approximately one-third to one-half of the circumference of the patient's neck.

The first means may be made magnetically attractable and the second means may then comprise one or more magnets for attracting and elevating the first means. Thus, an adhesive patch as described above may include a layer of magnetically attractable material such as iron or mild steel, preferably as a thin and flexible sheet. A support may be provided holding one or more magnets at a level above the said first means. Preferably, the height at which the magnets are supported is adjustable. However, the magnets may be held in contact with the first means and the means supporting the magnets may be such as to provide a desired amount of upward thrust. For this purpose, the 'magnets may be supported on resiliently upwardly biassed support members such as sprung arms or the equivalent. The degree of upward thrust is preferably adjustable. Alternatively, the second means may be physically connected to the first means other than by magnets. As in the case where magnets are used directly attached to the first means, the second means may force elevation of the first means to a predetermined level or may be resiliently biassed upwards at a desired level of strength to resiliently urge the first means upwardly.

The second means which is used for upwardly elevating the first means can take a wide variety of forms. It could for instance take the form of a weight acting over a member such as a pulley and attached by a line to said first means. The weight and line could instead be replaced by one or more tension springs acting between a fixed support and said first means. Many other alternatives will occur to those skilled in the art. According to a second aspect of the invention, the means for elevating the front surface of the patient's throat may take the form of a partially evacuatable chamber having some similarity with the form of chamber used in a cuirass-type ventilator. Thus, said means may comprise a chamber shaped to be locatable in a sealing manner over the throat of a patient to form therewith a substantially closed air-space, and means for partially evacuating said air-space. The chamber may comprise a top wall and depending side walls and front and rear walls each of the front and rear walls having an arch-shaped recess therein for receiving a patient's throat, with means for sealing the edges of the walls to the patient against air-flow into the chamber air-space. Suitable forms of seal are well known in the cuirass ventilator art. A preferred form of seal would be that disclosed in EPO 506467 in which sealing flaps of closed cell foam are provided around all of the edges of the chamber. Preferably, the sealing flaps are directed to extend outwardly of the chamber over the surface of the patient's skin so that when the external pressure is greater than the internal pressure, it tends to press the sealing flaps into closer contact with the patient producing a better seal.

As an alternative to attempting to form a seal between the mouth of the chamber at the area of the edges of the walls of the chamber and the patient, the chamber may be provided with a membrane closing the bottom of the chamber with means for adhering said membrane to the throat of a patient. Evacuation of the chamber will then cause movement of the membrane into the chamber and the patient's throat will be obliged to follow.

The required partial vacuum may be provided by an air pump connected to a port in a wall of the chamber.

Preferably, means are provided for supporting the top of the chamber at a fixed height. This may be accomplished simply by continuing the depending side walls of the chamber to a level at which they will rest on the surface upon which the patient is sleeping.

Preferably, according to all of the embodiments of the invention the apparatus may comprise a neck rest for the patient. By elevating the back of the neck of the patient between the patient's head and shoulders, the tendency of the tongue and soft pallet to collapse upon one another is to some extent relieved.

The invention will be further described with reference to the specific embodiment illustrated in the accompany drawings in which:- Figure 1 is a perspective view of a preferred form of apparatus according to the invention; -5-

Figure 2 is a side view of a variant of the apparatus of Figure 1 in use;

Figure 3 is a perspective view of a second embodiment according to the invention; and Figure 4 is a view of the apparatus of Figure 3 being applied to a patient.

As shown in Figure 1, an example of apparatus according to the invention comprises a neck rest 10 having a neck receiving trough 12 lined with a flexible foam material 14 for the patient's comfort and having on opposite sides of the trough 12 elevated plateaus 16 from each of which extends upwardly a flexible arm 18 which bears at its end a respective magnet 20 enclosed within a plastics housing. In the variant shown in Figure 2, there is only one arm 18 bearing one magnet 20. As shown in Figure 2, both forms of the apparatus further comprise means for attachment to the surface of the throat of the patient which is to be attracted by the magnets 20. This comprises an adhesive patch 22 having an underside of adhesive and on its upper surface a thin mild steel plate which is attractable by the magnet 20.

In use, the arms 18 are adjusted to a level at which the magnetic attraction between the magnets 20 and the steel plate 22 is sufficient to achieve a small elevation of the front of the throat of a patient. This will have the effect of lifting the tongue away from the soft pallet and preventing or reducing sleep apnoea.

As shown in Figures 3 and 4, a second embodiment according to the invention comprises a neck rest 30, similar to neck rest 10. A chamber 32 comprises a shell 34 of transparent plastics such as polycarbonate moulded to a curved shape having a top wall area with depending front, rear and opposed side wall areas defining an arched tunnel to fit over the neck of a patient. Snap connectors at the bottom of the shell connect with complementary formations on the plateaus or peaks at either side of the neck rest. Seals of closed cell foam strip 36 extend from all the edges of the shell 34 to complete the chamber 32.

A pert 38 for a vacuum hose 40 is positioned in the top wall of the shell 32.

Levers 42 on each side of the chamber 32 assist in detaching the chamber 32 from the base 30.

After assembly of the apparatus around the throat of the patient a partial vacuum is established in the chamber 32 via the port 38 using a vacuum pump which lifts the front of the throat, so reducing snoring and sleep apnoea. Many modifications and variations of the invention as illustrated in the accompanying drawings are possible within the scope of the invention.

In particular, the permanent magnets 20 used in the embodiments of Figures 1 and 2 may be replaced by electromagnets. The power supplied to the electromagnets may be regulated to adjust the degree of magnetic attraction. This may be done in conjunction with sensors measuring the height of the patient's throat so as to maintain a constant degree of elevation of the patient's throat or in response to sensors measuring the onset of sleep apnoea so as to increase the amount of magnetic force applied if symptoms appear.

Alternatively, instead of utilising magnets 20, one or more tension springs could be extended between the ends of the arms 18 and engagement locations on the patch 22. Such tension springs could take the form of resilient bands, e.g. of rubber, or elasticated fabric, or could take the form of springs such as coil springs. The flexible arms 18 could be replaced by one or more fixed arms or a fixed bridge to which any of the means acting on the patch 22 discussed above could be located.

The magnet or magnets 20 may be positioned on the patch 22 and passive means for attracting the magnets may replace the magnets 20 on the arms 18.

Claims

1. Apparatus for use in relieving obstructive sleep apnoea comprising means acting on the front surface of the throat of a patient for elevating the front surface of the throat so as to lift the tongue of the patient away from the soft palate of the patient.

2. Apparatus as claimed in Claim 1, wherein said means comprises a first means for attachment to the surface of the throat of the patient and a second means for elevating the first means.

3. Apparatus as claimed in Claim 2, wherein said first means is magnetically attractable and said second means comprises one or more magnets for attracting and elevating the first means.

4. Apparatus as claimed in Claim 3, wherein said magnet or magnets are mounted on a support of adjustable height.

5. Apparatus as claimed in Claim 2, wherein said second means comprises a support physically connected to the first means.

6. Apparatus as claimed in Claim 1, wherein said means comprises a chamber shaped to be locatable in a sealing manner over the throat of a patient to form therewith a substantially closed air space, and means for partially evacuating said air space.

7. Apparatus as claimed in Claim 6, wherein said chamber comprises a top wall and depending side walls and front and rear walls each of the front and rear walls having an arch shaped recess therein for receiving the patient's throat, with means for sealing edges of said walls to the patient against air flow into said chamber air space.

8. Apparatus as claimed in Claim 6, wherein said chamber comprises a top wall and depending side walls and front and rear walls each of the front and rear walls having an arch shaped recess therein for receiving the patient's throat, and a membrane closing the bottom of the chamber with means for adhering said membrane to the throat of a patient.

9. Apparatus as claimed in any preceding claim, further comprising a neck rest for the patient.