WO2010006218A2 - Dispositif contre l'apnée du sommeil et procédé - Google Patents

Dispositif contre l'apnée du sommeil et procédé Download PDF

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Publication number
WO2010006218A2
WO2010006218A2 PCT/US2009/050177 US2009050177W WO2010006218A2 WO 2010006218 A2 WO2010006218 A2 WO 2010006218A2 US 2009050177 W US2009050177 W US 2009050177W WO 2010006218 A2 WO2010006218 A2 WO 2010006218A2
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WO
WIPO (PCT)
Prior art keywords
patient
stimulation
medical device
implanted
electrode assembly
Prior art date
Application number
PCT/US2009/050177
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English (en)
Other versions
WO2010006218A3 (fr
Inventor
Don Headley
Original Assignee
Don Headley
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Don Headley filed Critical Don Headley
Publication of WO2010006218A2 publication Critical patent/WO2010006218A2/fr
Publication of WO2010006218A3 publication Critical patent/WO2010006218A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3601—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
    • 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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/56—Devices for preventing snoring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/378—Electrical supply
    • A61N1/3787—Electrical supply from an external energy source

Definitions

  • This present invention is generally directed toward the implantation of a medical device for treating patients with a specific physiologic dysfunction and in particular, treating patients with obstructive sleep apnea.
  • Obstructive sleep apnea is a disorder that affects more than 12 million people in the United States alone. (American Lung Association. "Obstructive sleep apnea (OSA) or sleep disordered breathing (SDB): in-depth.)(http://www.lungusa.org).
  • Obstructive sleep apnea is a condition where the airway of an individual is temporarily obstructed during sleep. This most commonly occurs at the level of the soft palate and/or the base of the tongue and pharynx. Its causes are complex and multifactorial but appear to be due to the relaxation of muscles of the soft palate, tongue and pharynx that occur when one falls asleep.
  • OSA causes the cessation of breathing which eventually awakens the patient at which point muscle tone is temporarily restored allowing breathing to resume.
  • This sleep disturbance can occur more than 100 times per night in severe cases.
  • the physiologic consequences of a lack of a sound night sleep and the stress on the body during these apneic spells are becoming more apparent.
  • OSA is usually diagnosed by a sleep study. Patients found to have OSA are offered treatments ranging from weight loss and increase in exercise, dental appliances, continuous positive airway pressure (CPAP) to ablative surgical techniques. Weight loss and increased exercise have not been found to be a sustainable solution in most OSA patients. Noncompliance with CPAP has been reported in 46-83% of patients (Proc.
  • a method for treating obstructive sleep apnea in a patient comprising the steps of: applying direct intramuscular electrical stimulation to a specific set of muscle fibers in a muscle of the patient's airway, wherein the electrical stimulation is provided by an implanted electrode assembly, wherein the electrode assembly comprises one or more electrodes connected to an implanted receiver, and wherein the implanted electrode assembly is in operative association with an external electromagnetic frequency transmitting antenna located on or near a patient's body, such that said electrical stimulation is provided when the antenna transmits an electromagnetic frequency to the implanted electrode assembly, wherein upon receiving the frequency the implanted electrode assembly generates an electrical current in the one or more electrodes, and wherein the electrical current is delivered directly by wire to specific set of muscle fibers.
  • the method further comprises alternatively the step of implanting the electrode(s) using a 20 gauge needle, and/or implanting the receiver unit in the submental area in a patient who is somewhat obese as this would not be cosmetically apparent, and/or the step of implanting the receiver subcutaneously in the pectoral region which would remove any appearance of the receiver from view in a normally clothed individual, and/or the step of having the device implanted in the patient in the operating room in which case implantation over the pectoralis muscle would become far more comfortable under general anesthetic and this can be done while the patient may be undergoing some other operative procedure such as a septoplasty, turbinate reduction, or uvulectomy.
  • the method further comprises the step of having the power source on a timer to allow the stimulation to begin at some time period after the patient has gone to sleep, and/or the step of allowing the patient to adjust the length of stimulation based upon the quality of sleep and/or any sensation they may experience when the stimulator is turned on, and/or the step of allowing the patient to adjust the strength of the stimulation as the patient's physical condition or body habitus may change with time, and/or the step of utilizing sound activated stimulation, thereby allowing the power unit to turn on when the sound of snoring is received from the patient thus allowing the device to be utilized only during times when the patient may actually experience the apneic episodes, and/or the step of having the device turn on when the patient's oxygen concentration as measured by a transcutaneous receiver placed on the antenna over the patient's skin would detect an oxygen concentration of less than 96%, and/or the step of activating the receiver directly with Witricity which would be applied to the patient from a power source on a
  • a medical device for treating a patient for obstructive sleep apnea comprising an implanted electrode assembly, wherein the electrode assembly comprises one or more electrodes connected to an implanted receiver, and wherein the implanted electrode assembly is in operative association with an external electromagnetic frequency transmitting antenna located on or near a patient's body, such that electrical stimulation is directly provided by wire to a specific set of muscle fibers in a muscle of the patient's airway when the antenna transmits an electromagnetic frequency to the implanted electrode assembly, wherein upon receiving the frequency the implanted electrode assembly generates an electrical current in the one or more electrodes, and wherein the electrical current is delivered directly by wire to the specific set of muscle fibers.
  • the device further comprises wherein the electrode(s) of the electrode assembly are made from wire having a dimension of 0.007 inches, and/or further comprises wherein the electrode(s) (wire) is sized to fit within a 20- gauge needle (about 0.0230 inches internal diameter), and/or wherein the medical device further comprises a needle for implantation means where the needle may range from 27 ga to 10 ga, with 20 gauge being optimal.
  • the needle may range from 27 ga to 10 ga, with 20 gauge being optimal.
  • the device further comprises alternatively timer- means for having the power source on a timer to allow the stimulation to begin at some time period after the patient has gone to sleep, and/or length-adjustment-means for allowing the patient to adjust the length of stimulation based upon the quality of sleep and/or any sensation they may experience when the stimulator is turned on, and/or strength-adjustment-means for allowing the patient to adjust the strength of the stimulation as the patient's physical condition or body habitus may change with time.
  • the medical device further comprises alternatively sound-activation-means for allowing the power unit to turn on when the sound of snoring is received from the patient thus allowing the device to be utilized only during times when the patient may actually experience the apneic episodes, and/or oxygen-sensing means and auto-start means for having the device turn on when the patient's oxygen concentration as measured by a transcutaneous receiver placed on the antenna over the patient's skin would detect an oxygen concentration of less than 96%.
  • the medical device further comprises wireless electricity means for activating the receiver directly with "Witricity" which would be applied to the patient from a power source on a bedside table and through the wireless activation of the stimulator.
  • the medical device further comprises one or more electrodes implanted in the constrictor muscles of the pharynx to aid in opening the airway.
  • the medical device further comprises any of the above claims further comprising microprocessor electronics to process the devices activities.
  • Another preferred embodiment provided herein comprises a specific surgically implantable electrode having an atraumatic removal feature, comprising an electrically conductive wire connected to a stainless steel deformable barb, wherein the deformable barb comprises two operative positions, the first position comprising a pointed hook shape for attachment to tissue, and a second position comprising a straightened shape, wherein upon removal of the deformable barb from the tissue, the deformable barb changes from the first to the second position.
  • Figure 1 Shows a lateral sagittal view of the oropharynx showing the location of the tongue in proximity to the posterior pharyngeal wall. The location of the hyoid bone and the chin portion of the mandibular bone and the approximate areas at which the electrodes would be introduced into that muscle.
  • Figure 2 Shows a frontal view of a patient whose head is tilted up revealing the site of the incision in the submental region and also the site of the incision just anterior to the sternoclydomastoid muscle in the neck.
  • Figure 3 Shows the proposed power source which would be able to be clipped to patient's night clothes and be powered by AA replaceable or rechargeable batteries.
  • Figure 4 Shows the antenna which delivers the radiofrequency to the receiver and is to be placed over the receiver on the skin and held in place with a small adhesive dressing.
  • Figure 5 Shows the receiver with the 2 electrodes present.
  • FIG. 6A Shows the point of the muscle stimulator which is at the end of Teflon coated stainless steel wire.
  • Fig. 6B shows detail indicating the wire is sufficiently flexible to allow deformation of the tip if the stimulator needs to be removed.
  • Figure 7. Shows the stimulator and the stimulator insertion device which is a 20 or 22 gauge 1 1 A inch needle. The larger of the barbs of the stimulator tip would be placed in the barrel of the needle as shown. This coupled device would then be introduced into the genioglossus muscle and the needle removed leaving the stimulator device in place.
  • Figure 8. Shows the transformation of the needle tip as it is with drawn from the tissue of the patient if necessary and illustrates the atraumatic way in which the stimulator can be removed.
  • FIG. 1 shows a cross section of the upper airway in particular the tongue (genioglossus muscle) 20.
  • FIG. 1 also shows the locations, Ll and L2, of the specific placements for the electrodes 110.
  • the device itself consists of 4 parts.
  • First is a power source 120 (Fig. 3).
  • Second is an antenna 118 (Fig. 4).
  • Third is a receiver 116 and fourth is the stimulating electrode 110 (Fig. 5).
  • the power source provides the power for the device and is of small size so that it can be clipped to the upper nightwear of the patient being treated. This is connected to the antennae which deliver the radio frequency to the receiver which has been implanted in the neck of the patient with the stimulating electrodes emanating from the receiver and entering into specific muscle sites in the tongue of the patient.
  • the antennae is held in place via an adhesive and this is applied over the receiver on the patient's neck at the time the patient would be going to sleep. It is then removed in the morning.
  • the receiver includes an electrical pulse source, or pulse generator.
  • the electrodes impart electrical pulses, generated by the pulse generator, directly by wire to the genioglossus muscle to stimulate the specific muscle fibers to a point where the patient's tongue is moved anteriorly to maintain upper airway patency.
  • the pulse generator has an output that provides electrical pulses having selectable properties of mode, polarity, amplitude, current, pulse width, and frequency.
  • the pulse mode may be direct current; and, the polarity may be negative or positive.
  • the polarity of the electrical pulses may be periodically reversed according to predetermined criteria for balanced electrical current flows through the genioglossus muscle.
  • pulse generators provide pulses having many of the previously mentioned variables and may include microprocessor and electronics for signal processing and cooperation with apnea detection devices.
  • the stimulator may be variably set to provide direct current pulses having an amplitude, a frequency, and a duration to provide a non-awakening stimulation directly by wire to the specific muscle fibers.
  • the preferred method of implantation of the device would be performed in a physician's office under local anesthesia and is expected to take approximately 15-20 minutes.
  • the area under the patient's chin in the midline is infiltrated with local anesthetic as is the area just anterior to the sternoclidomastoid muscle in the mid portion of the neck.
  • a line connecting these two points is also infiltrated with the same local anesthetic.
  • the area is cleansed with beta dyne.
  • a 1 centimeter horizontal incision 210 (Fig. 2) is then made in the anesthetized area just anterior to the sterniclidomastoid muscle.
  • a small pocket is created subcutaneously and the receiver is placed in this pocket.
  • the second incision 220 measuring approximately 1 centimeter is made in the mid portion of the submental region approximately halfway between the hyoid bone and the chin.
  • a common surgical tunneling device is then used to connect these two pockets.
  • the electrodes are then attached to the tunneling device and pushed or pulled through the subcutaneous tunnel emanating in the submental incision.
  • the electrodes are then attached as in Fig. 7 to the electrode positioning device 140 (a 20 gauge needle).
  • the electrode(s) of the electrode assembly are made from biocompatible wire having a dimension ranging from about 0.005 to about 0.010 inches, with preferred thickness being about 0.007 inches.
  • the tip (barb) 112 is made of medical grade stainless steel. Alternatively it may be made of other functionally equivalent materials.
  • the wire has a biocompatible coating 160, which may include silastic, Teflon ® and the like.
  • the electrode(s) (wire) is sized to fit within a 20-gauge needle (about 0.0230 inches internal diameter), but the implantation or insertion needle may range from 27 ga to 10 ga, with 20 gauge being optimal.
  • the wire is 0.007 inch platinum and has a 4-way folded barb shown in Fig. 7 at its terminus for attaching to tissue.
  • the barb may be housed within (internal to) the needle, either entirely or partially as shown in Fig. 7. Alternately the barb may be external to the implantation needle where only the wire is disposed within the needle. For a barb housed entirely within the needle, upon insertion, the wire may be threaded down the needle such that the barb expands into the space of the needle being withdrawn from the tissue.
  • a barb-like four- way fold of the wire can be seen in cross- section to have a central wire with three adjacent wires in an approximate triangular formation around the central wire, and thus requiring an implantation needle that has at least about 0.021 inches in diameter for a 0.007 inch wire.
  • the internal diameter of the needle need only be large enough to accommodate the width of the electrode wire.
  • One electrode is placed through the stab incision in the submental area just anterior to the midline and is slowly advanced with the introducer until located just behind the front portion of the mandible in the genioglossus muscle.
  • the depth ranges from about 0.5 cm to about 2.0 cm, and more preferably from about 1.0 cm to about 1.75 cm, and more preferably from about 1.5 cm to about 1.75 cm.
  • the location L2 of the second electrode is initially determined by inserting a non-barbed probe to identify the optimal placement by depth and angle.
  • the depth varies from patient to patient, it is contemplated that an average depth of about 1.5 to about 1.75 cm within the genioglossus muscle 20.
  • the second electrode is placed, parallel to the non-barbed probe, to the same depth and angle, through the same stab incision site but placed anterior to the hyoid bone but posterior to the first electrode, the stimulator being used intermittently while the tongue is observed through a flexible laryngoscope or dental mirror for appropriate movement. After this has been placed in it's position and stimuli is applied, the location L2 is finally determined as it causes the base of the tongue to move forward.
  • the underlying tissues are closed over the electrodes and wires using ...sutures of 4-0 chromic or vicryl and the skin incisions are closed with interrupted sutures of 5-0 or 6-0 fast absorbing gut.
  • a small amount of bacitracin or antibiotic ointment is applied.
  • the patient is then given oral antibiotics for 3 days postoperatively. The wounds are kept clean during the healing period which would be approximately 14 days.
  • the patient then returns to the office where the antennae is placed over the receiver in the neck and the intensity of voltage is calibrated to achieve adequate tongue movement clearing the back of the throat and not causing the patient to experience any pain. After this is accomplished the patient is instructed on how to apply the antennae
  • a second modification of the implant includes implanting the receiver 116 in the submental area in a patient who is somewhat obese as this would not be cosmetically apparent.
  • a fourth application would be to have the device implanted in the patient in the operating room or on an outpatient basis.
  • implantation over the pectoralis muscle would become far more comfortable under general anesthetic and this can be done while the patient may be undergoing some other operative procedure such as a septoplasty, turbinate reduction, tonsilectomy, or uvulectomy.
  • some other operative procedure such as a septoplasty, turbinate reduction, tonsilectomy, or uvulectomy.
  • outpatient implantation complications are minimized. It is contemplated that implantation may also be performed using ultrasound imaging to assist with targeting the locations Ll and
  • a fifth application would be to have the power source 120 on a timer. This would allow the stimulation to begin at some time period after the patient has gone to sleep.
  • a sixth application would be to allow the patient to adjust the parameters of stimulation based upon the quality of sleep and/or any sensation they may experience when the stimulator is turned on.
  • Parameters contemplated herein include without limitation length of time of stimulation, strength of stimulation, and so forth.
  • a seventh application would be to allow the patient to adjust the parameters of the stimulation as the patient's physical condition or body habitus may change with time.
  • An eighth application would be sound activated stimulation. This would allow the power unit to turn on when the sound of snoring is received from the patient. This would allow the device to be utilized only during times when the patient may actually experience the apneic episodes.
  • a ninth application would be to have the device turned on when the patient's oxygen concentration as measured by a transcutaneous receiver placed on the antenna over the patient's skin would detect an oxygen concentration of less than 96%.
  • a tenth application would be activation of the receiver directly with Witricity which would be applied to the patient from a power source on a bedside table and ....through the wireless activation of the stimulator.
  • An eleventh application is to have the stimulators implanted in the constrictor muscles of the pharynx to aid in opening the airway.
  • the device as described herein and/or the method as described herein provides for alternating on/off "intermittent" treatment wherein the tissue is stimulated for a given period, and then the tissue is allowed to rest for a given period.
  • the device or method applies stimulation for 5 seconds, and then stimulation is turned off for 5 seconds.
  • the period of stimulation ranges from 1 to 20 seconds, with varying rest periods.
  • the period of stimulation is 20 seconds and the rest period is 5 seconds.
  • the period is 60 seconds on with 60 seconds off.
  • On periods may range, without limitations from 1 to 120 seconds, and off periods similarly.
  • On/off intermittent periods include from 5/5, 20/5, 10/10, 5/60, 60/5, 20/20, 30/30, 40/40, 50/50, 60/60, and so forth.
  • the period is 60 seconds on and 60 seconds off, with sub-intervals of 5 seconds on and 5 seconds off during the 60 seconds "on" stimulation period. Accordingly, alternating intermittent periods can be optionally used with sub-intervals in ranges of on/of periods from

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  • Health & Medical Sciences (AREA)
  • Physiology (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L'invention concerne un dispositif et un procédé pour le traitement de l'apnée obstructive. Ce procédé implique l'implantation d'une électrode de stimulation de muscle directement dans le muscle génioglosse qui avance l'aspect postérieur de la langue antérieurement, en libérant ainsi l'obstruction de la langue lors de l'apnée du sommeil. Le dispositif est alimenté par un stimulateur implanté qui reçoit son énergie à son tour d'une radiofréquence transmise par un dispositif transcutané, qui est appliqué au patient lors du sommeil.
PCT/US2009/050177 2008-07-11 2009-07-09 Dispositif contre l'apnée du sommeil et procédé WO2010006218A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US7989108P 2008-07-11 2008-07-11
US61/079,891 2008-07-11

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WO2010006218A2 true WO2010006218A2 (fr) 2010-01-14
WO2010006218A3 WO2010006218A3 (fr) 2010-04-15

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014016700A2 (fr) * 2012-07-26 2014-01-30 Adi Mashiach Dispositif de traitement de l'apnée du sommeil du type implant comprenant une antenne
US20150142120A1 (en) * 2013-11-19 2015-05-21 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US11291842B2 (en) 2019-05-02 2022-04-05 Xii Medical, Inc. Systems and methods for improving sleep disordered breathing
US11420061B2 (en) 2019-10-15 2022-08-23 Xii Medical, Inc. Biased neuromodulation lead and method of using same
US11491324B2 (en) 2019-10-16 2022-11-08 Invicta Medical, Inc. Adjustable devices for treating sleep apnea, and associated systems and methods
WO2022246129A1 (fr) * 2021-05-20 2022-11-24 Invicta Medical, Inc. Techniques pour placer des électrodes implantables pour traiter l'apnée du sommeil et systèmes associés
US11617888B2 (en) 2020-11-04 2023-04-04 Invicta Medical, Inc. Implantable electrodes with remote power delivery for treating sleep apnea, and associated systems and methods
US11691010B2 (en) 2021-01-13 2023-07-04 Xii Medical, Inc. Systems and methods for improving sleep disordered breathing
US11964154B1 (en) 2022-12-22 2024-04-23 Invicta Medical, Inc. Signal delivery devices to treat sleep apnea, and associated methods and systems

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US6345202B2 (en) * 1998-08-14 2002-02-05 Advanced Bionics Corporation Method of treating obstructive sleep apnea using implantable electrodes
US20050085874A1 (en) * 2003-10-17 2005-04-21 Ross Davis Method and system for treating sleep apnea
US20050278000A1 (en) * 2004-06-10 2005-12-15 Strother Robert B Implantable pulse generator for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue
US20080103545A1 (en) * 2006-10-13 2008-05-01 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods

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US6345202B2 (en) * 1998-08-14 2002-02-05 Advanced Bionics Corporation Method of treating obstructive sleep apnea using implantable electrodes
US20050085874A1 (en) * 2003-10-17 2005-04-21 Ross Davis Method and system for treating sleep apnea
US20050278000A1 (en) * 2004-06-10 2005-12-15 Strother Robert B Implantable pulse generator for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue
US20080103545A1 (en) * 2006-10-13 2008-05-01 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods

Cited By (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014016700A2 (fr) * 2012-07-26 2014-01-30 Adi Mashiach Dispositif de traitement de l'apnée du sommeil du type implant comprenant une antenne
WO2014016700A3 (fr) * 2012-07-26 2014-05-30 Adi Mashiach Dispositif de traitement de l'apnée du sommeil du type implant comprenant une antenne
US8903515B2 (en) 2012-07-26 2014-12-02 Nyxoah SA Implant sleep apnea treatment device including an antenna
US9220908B2 (en) 2012-07-26 2015-12-29 Adi Mashiach Implant sleep apnea treatment device including an antenna
AU2013294705B2 (en) * 2012-07-26 2018-02-01 Nyxoah SA Implant sleep apnea treatment device including an antenna
US20150142120A1 (en) * 2013-11-19 2015-05-21 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US20170106190A1 (en) * 2013-11-19 2017-04-20 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US9757560B2 (en) * 2013-11-19 2017-09-12 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US20170296815A1 (en) * 2013-11-19 2017-10-19 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US10029098B2 (en) * 2013-11-19 2018-07-24 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US10065038B2 (en) * 2013-11-19 2018-09-04 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US11491333B2 (en) 2013-11-19 2022-11-08 The Cleveland Clinic Foundation System and method for treating obstructive sleep apnea
US11351380B2 (en) 2019-05-02 2022-06-07 Xii Medical, Inc. Implantable stimulation power receiver, systems and methods
US11420063B2 (en) 2019-05-02 2022-08-23 Xii Medical, Inc. Systems and methods to improve sleep disordered breathing using closed-loop feedback
US11291842B2 (en) 2019-05-02 2022-04-05 Xii Medical, Inc. Systems and methods for improving sleep disordered breathing
US11869211B2 (en) 2019-05-02 2024-01-09 Xii Medical, Inc. Systems and methods to improve sleep disordered breathing using closed-loop feedback
US11420061B2 (en) 2019-10-15 2022-08-23 Xii Medical, Inc. Biased neuromodulation lead and method of using same
US11883667B2 (en) 2019-10-15 2024-01-30 Xii Medical, Inc. Biased neuromodulation lead and method of using same
US11491324B2 (en) 2019-10-16 2022-11-08 Invicta Medical, Inc. Adjustable devices for treating sleep apnea, and associated systems and methods
US11617888B2 (en) 2020-11-04 2023-04-04 Invicta Medical, Inc. Implantable electrodes with remote power delivery for treating sleep apnea, and associated systems and methods
US11883668B2 (en) 2020-11-04 2024-01-30 Invicta Medical, Inc. Implantable electrodes with remote power delivery for treating sleep apnea, and associated systems and methods
US11986658B2 (en) 2020-11-04 2024-05-21 Invicta Medical, Inc. Implantable electrodes with remote power delivery for treating sleep apnea, and associated systems and methods
US11691010B2 (en) 2021-01-13 2023-07-04 Xii Medical, Inc. Systems and methods for improving sleep disordered breathing
WO2022246129A1 (fr) * 2021-05-20 2022-11-24 Invicta Medical, Inc. Techniques pour placer des électrodes implantables pour traiter l'apnée du sommeil et systèmes associés
US11964154B1 (en) 2022-12-22 2024-04-23 Invicta Medical, Inc. Signal delivery devices to treat sleep apnea, and associated methods and systems

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