WO2019172603A1 - 수면 무호흡 치료 장치 및 방법 - Google Patents
수면 무호흡 치료 장치 및 방법 Download PDFInfo
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- WO2019172603A1 WO2019172603A1 PCT/KR2019/002509 KR2019002509W WO2019172603A1 WO 2019172603 A1 WO2019172603 A1 WO 2019172603A1 KR 2019002509 W KR2019002509 W KR 2019002509W WO 2019172603 A1 WO2019172603 A1 WO 2019172603A1
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- electrical
- sleep apnea
- closed area
- electrode
- respiratory tract
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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
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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
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
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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—Detecting, measuring or recording devices for evaluating the respiratory organs
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
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- 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
Definitions
- the present invention relates to a technical concept of treating sleep apnea by applying electrical stimulation to the upper airway, and more particularly, to estimate the degree of occlusion of the upper airway, and to electrically stimulate the airway muscle or nerve of the subject according to the estimated degree of upper airway obstruction. It relates to a technique for treating sleep apnea.
- Sleep apnea is a serious health problem that causes heart disease, obesity, fatigue and drowsiness accidents, and the number of subjects is increasing due to the increase in the average life span and the increase in the obese population.
- Sleep apnea (PSG, polysomnography) is mainly used to diagnose sleep apnea, and a medical institution that performs sleep polyposis is equipped with a number of biosignal measuring instruments and image monitoring devices, including brain waves, etc. It is operated through sleeping articles.
- Types of sleep apnea include obstructive apnea, central apnea, and combined apnea.
- Obstructive sleep apnea refers to sleep respiratory distress, which is frequently manifested by frequent disturbances in airflow through the upper airway during sleep, and a decrease in blood oxygen saturation levels. Compared with a reduction of more than 90% compared to five times an hour on average, it is defined as a sustained or increased effort for breathing.
- central sleep apnea is an apnea that occurs due to various causes of the brain or nervous system, and is defined as a case where there is no aspiration for at least 10 seconds and there is no effort to breathe at the same time.
- a method of treating sleep apnea by electric stimulation is controlling the electric stimulation time by detecting an exhalation or inspiration time from the output of a breathing effort signal detection sensor implanted into the chest.
- the conventional method causes unnecessary power consumption by applying unnecessary electric stimulation even during normal breathing, and prevents normal breathing.
- An object of the present invention is to measure the opening and closing of the upper respiratory tract on the basis of the change in electrical impedance measured through the electrode in contact with the upper respiratory tract, and thereby to selectively apply electrical stimulation to the upper respiratory tract to treat sleep apnea.
- An object of the present invention is to measure the opening and closing of the upper airway according to the upper airway image by applying an electrical impedance tomography (EIT) method according to the electrode in contact with the upper airway, and accordingly, to selectively apply electrical stimulation to the upper airway to treat sleep apnea. It is done.
- EIT electrical impedance tomography
- the present invention aims to prevent unnecessary power consumption and normal breathing disturbance by applying electrical stimulation for sleep apnea treatment according to the opening and closing of the upper airway.
- the sleep apnea treatment device includes an upper respiratory tract electrode part including a measuring electrode and an electrical applying electrode contacted with different sides of the upper respiratory tract, and the electrical contact between the different sides through the contacted measuring electrode.
- the electrical impedance measuring unit may determine a time point of decreasing the measured electrical impedance based on the measured electric impedance, and estimate the closed area of the upper island based on the determined time point of reduction.
- the electrical impedance measuring unit may generate an electrical impedance tomography (EIT) image of the upper respiratory tract based on the measured electrical impedance, and based on the area change of the upper respiratory tract in the generated electrical impedance tomography (EIT) image.
- EIT electrical impedance tomography
- the electrical stimulation control unit may control the contacted electrical applying electrode to apply the electrical stimulation when the estimated size of the closed area is larger than a reference size.
- the electrical stimulation controller may control the contacted electrical applying electrode to prevent the closing of the upper respiratory tract muscles by relaxing or contracting the muscles of the upper respiratory tract based on the applied electrical stimulation.
- the electrical stimulation control unit may control the contacted electrical application electrode to change the intensity of the applied electrical stimulation according to the estimated change of the closed area.
- the electrical impedance measuring unit estimates the closed area of the upper respiratory tract by measuring electrical impedance between the different sides through a measuring electrode contacted to different sides of the upper respiratory tract. And controlling, at the electrical stimulation control unit, an electrical applying electrode contacted to the different sides to apply the electrical stimulation to at least one of the different sides based on the estimated closed area.
- the estimating the closed area of the upper island may include determining a time of reduction of the measured electrical impedance based on the measured electrical impedance and estimating the closed area of the upper island based on the determined decrease time. can do.
- the estimating the closed area of the upper airway may include generating an electrical impedance tomography (EIT) image of the upper airway based on the measured electrical impedance and the area of the upper airway in the generated electrical impedance tomography (EIT) image. Estimating the closed area of the upper airway based on the change.
- EIT electrical impedance tomography
- the controlling of the contacted electric applying electrode may include controlling the contacted electric applying electrode to prevent the closing of the upper respiratory muscles by relaxing or contracting the muscles of the upper respiratory tract, and applying the applied electric power according to the estimated change of the closed area. Controlling the contacted electrical applying electrode to alter the intensity of the electrical stimulus.
- the present invention can measure the opening and closing of the upper respiratory tract on the basis of the change in electrical impedance measured through the electrode in contact with the upper respiratory tract, and accordingly selectively apply electrical stimulation to the upper respiratory tract to treat sleep apnea.
- the present invention may apply the electrical impedance tomography (EIT) method according to the electrode in contact with the upper airway to measure the opening and closing of the upper respiratory tract according to the upper respiratory tract image, and thereby selectively apply electrical stimulation to the upper respiratory tract to treat sleep apnea.
- EIT electrical impedance tomography
- the present invention can prevent unnecessary power consumption and normal breathing disturbance by applying electrical stimulation for sleep apnea treatment according to the opening and closing of the upper airway.
- FIG. 1 is a view for explaining a sleep apnea treatment apparatus according to an embodiment of the present invention.
- FIG. 2 is a view for explaining the upper electrode portion according to an embodiment of the present invention.
- FIG. 3 is a view for explaining a sleep apnea treatment method according to an embodiment of the present invention.
- Embodiments according to the inventive concept may be variously modified and have various forms, so embodiments are illustrated in the drawings and described in detail herein. However, this is not intended to limit the embodiments in accordance with the concept of the present invention to specific embodiments, and includes modifications, equivalents, or substitutes included in the spirit and scope of the present invention.
- first or second may be used to describe various components, but the components should not be limited by the terms. The terms are only for the purpose of distinguishing one component from another component, for example, without departing from the scope of the rights according to the inventive concept, the first component may be called a second component, Similarly, the second component may also be referred to as the first component.
- FIG. 1 is a view for explaining a sleep apnea treatment apparatus according to an embodiment of the present invention.
- Figure 1 illustrates the components of the sleep apnea treatment device according to an embodiment of the present invention.
- the sleep apnea treatment apparatus 100 includes an upper airway electrode unit 110 and a control unit 120.
- the control unit 120 includes an electrical impedance measuring unit 121 and an electrical stimulation control unit 122.
- the upper airway electrode part 110 includes a measuring electrode and an electrical application electrode contacted to different sides of the upper airway.
- the upper airway electrode unit 110 may include a measurement electrode and an electrical application electrode that are in contact with the left and right sides of the neck part of the subject.
- the measuring electrode and the electrically applied electrode may be attached in the form of a patch to the neck of the subject or implanted into the subject's skin.
- the measuring electrode may measure an electrical impedance according to the change in the closed area of the upper airway.
- the electrically applying electrode can apply an electrical stimulus to the neck of the subject.
- the controller 120 may control the electrical impedance measuring unit 121 and the electrical stimulation control unit 122.
- the electrical impedance measuring unit 121 may estimate the closed area of the upper airway by measuring the electrical impedance between the different sides through the measuring electrodes contacting different sides of the upper airway.
- the electrical impedance measuring unit 121 continuously measures the electrical impedance of the subject's upper airway through measurement electrodes attached or implanted to the left and right sides of the upper airway of the subject, and a time point of decreasing the electrical impedance based on the measured impedance. Can be determined.
- the electrical impedance measuring unit 121 determines a time for decreasing the electrical impedance based on the measured electrical impedance between the left and the right corresponding to the different side of the upper figure, and based on the determined reduction time
- the closed area of the upper respiratory tract can be estimated.
- the electrical impedance measuring unit 121 may be configured based on a change in the air region generated by closing or narrowing the upper airway as the upper airway filled with air, which is an insulator, based on the time point of decreasing the electrical impedance.
- the closed area can be estimated.
- the electrical impedance measuring unit 121 may determine the change of the upper airway based on the change of the air region in the upper air according to the time of decreasing the electrical impedance, and estimate the closed area of the upper air based on the determined change.
- the present invention may measure the opening and closing of the upper respiratory tract based on the change of the electrical impedance measured through the electrode contacted to the upper respiratory tract, and accordingly selectively applying electrical stimulation to the upper respiratory tract to treat sleep apnea.
- the electrical impedance measuring unit 121 generates an electrical impedance tomography (EIT) image of the upper airway based on the electrical impedance measured through the measuring electrode, and the upper airway in the electrical impedance tomography (EIT) image.
- EIT electrical impedance tomography
- the closed area of the upper respiratory tract can be estimated based on the area change of.
- the electrical impedance measuring unit 121 generates a first EIT image of the upper airway based on the electrical impedance measured through the measuring electrode, and after a predetermined time, the electrical impedance measuring unit 121 generates the first EIT image.
- a second EIT image may be additionally generated.
- the first EIT image may be a reference image for determining the degree of occlusion of the upper airway, and may correspond to image data pre-stored in the sleep apnea treatment apparatus 100, and the second EIT image is measured through a current measurement electrode. It may correspond to the image data generated based on the electrical impedance.
- the electrical impedance measuring unit 121 may compare the first EIT image and the second EIT image to determine a change in the portion corresponding to the closed area in the upper island, and estimate the closed area of the upper island based on the determined change.
- the present invention measures the opening and closing of the upper respiratory tract according to the upper respiratory tract image by applying an electrical impedance tomography (EIT) method according to the electrode in contact with the upper respiratory tract, and accordingly selectively applies an electrical stimulation to the upper respiratory tract to treat sleep apnea. have.
- EIT electrical impedance tomography
- the electrical stimulation control unit 122 is contacted to apply the electrical stimulation to at least one of the different sides of the above figure based on the closed area estimated by the electrical impedance measurement unit 121. Can be controlled.
- the electrical stimulation controller 122 may compare the size of the closed area estimated by the electrical impedance measuring unit 121 with the size of the reference area for applying the electrical stimulation.
- the electrical stimulation control unit 122 may control the electrical application stimulation in contact with the upper airway to apply the electrical stimulation when the size of the closed area estimated by the electrical impedance measuring unit 121 is larger than the reference size.
- the electrical stimulation control unit 122 may control the electrical application electrode to prevent the closing of the upper airway by the muscles of the upper airway to relax or contract based on the electrical stimulation.
- the electrical stimulation control unit 122 may control the electric applying electrode to change the intensity of the electrical stimulation according to the change in the closed area estimated by the electrical impedance measuring unit 121.
- the electrical stimulation control unit 122 generates feedback information according to the change of the closed area estimated by the electrical impedance measuring unit 121, and flexibly changes the intensity of the electrical stimulation based on the generated feedback information. You can adjust the intensity.
- control unit 120 may control a plurality of hardware or software components connected to the control unit 120 by running an operating system or an application program, and may perform various data processing and operations. .
- the controller 120 may be implemented as a system on chip (SOC).
- SOC system on chip
- the controller 120 may load and process a command or data received from at least one of other components (eg, nonvolatile memory) into the volatile memory, and store the result data in the nonvolatile memory.
- other components eg, nonvolatile memory
- the controller 120 may control the sleep apnea treatment apparatus 100 to perform the procedure shown in FIG. 3.
- FIG. 2 is a view for explaining the upper electrode portion according to an embodiment of the present invention.
- Figure 2 illustrates the upper airway electrode portion in contact with the neck portion of the subject in accordance with one embodiment of the present invention.
- the upper airway electrode part 200 is in contact with a neck part of a test subject, and the measuring electrode and the electric applying electrode included in the upper airway electrode part 200 are located at the neck part. Can be in contact with different sides.
- the measurement electrode included in the upper electrode part 200 may be in contact with the left or right side of the subject's neck to measure an electrical impedance output from the upper island.
- the electrical application electrode included in the upper airway electrode unit 200 may be in contact with the left or right side of the subject's neck to apply electrical stimulation to the upper airway.
- the upper respiratory tract electrode 200 may be connected to the control unit via a wire, and the control unit may be located at the upper chest part of the test subject.
- FIG. 3 is a view for explaining a sleep apnea treatment method according to an embodiment of the present invention.
- FIG. 3 illustrates that the sleep apnea treatment method according to an embodiment of the present invention estimates the closed area of the upper respiratory tract based on the electrical impedance measured from the upper respiratory tract, and applies electrical stimulation to the upper respiratory tract based on the estimated closed area. Illustrate the procedure for treating sleep apnea.
- the sleep apnea treatment method measures electrical impedance between electrodes in contact with different sides of the upper airway.
- the sleep apnea treatment method may measure the electrical impedance between the left and right sides of the upper airway through the measurement electrodes contacting the left and right sides of the upper airway.
- the sleep apnea treatment method at step 302 estimates the upper airway obstruction area based on the electrical impedance measured at step 301.
- the sleep apnea treatment method may determine the time of decrease of the electrical impedance on the basis of the electrical impedance measured between the left and the right corresponding to the different sides of the upper airway, and may estimate the closed area of the upper airway on the basis of the determined decrease time. have.
- the sleep apnea treatment method in step 303 compares the reference size with the size of the closed area estimated in step 302.
- the sleep apnea treatment method proceeds to step 304 if the size of the occluded area is greater than the reference size and proceeds to step 301 again if the size of the occluded area is smaller than the reference size.
- step 304 the sleep apnea treatment method applies electrical stimulation.
- the sleep apnea treatment method may control the contacted electrical applying electrode to apply electrical stimulation to at least one of the different aspects of the upper airway based on the estimated closed area in step 302.
- the sleep apnea treatment method can control the electrically applied electrode to prevent muscle closure of the upper airway and prevent closure of the upper airway based on electrical stimulation.
- the present invention can prevent unnecessary power consumption and normal breathing disturbance by applying electrical stimulation for sleep apnea treatment according to the opening and closing of the upper airway.
- the apparatus described above may be implemented as a hardware component, a software component, and / or a combination of hardware components and software components.
- the devices and components described in the embodiments may be, for example, processors, controllers, arithmetic logic units (ALUs), digital signal processors, microcomputers, field programmable arrays (FPAs), It may be implemented using one or more general purpose or special purpose computers, such as a programmable logic unit (PLU), microprocessor, or any other device capable of executing and responding to instructions.
- the processing device may execute an operating system (OS) and one or more software applications running on the operating system.
- the processing device may also access, store, manipulate, process, and generate data in response to the execution of the software.
- OS operating system
- the processing device may also access, store, manipulate, process, and generate data in response to the execution of the software.
- processing device includes a plurality of processing elements and / or a plurality of types of processing elements. It can be seen that it may include.
- the processing device may include a plurality of processors or one processor and one controller.
- other processing configurations are possible, such as parallel processors.
- the method according to the embodiment may be embodied in the form of program instructions that can be executed by various computer means and recorded in a computer readable medium.
- the computer readable medium may include program instructions, data files, data structures, etc. alone or in combination.
- the program instructions recorded on the media may be those specially designed and constructed for the purposes of the embodiments, or they may be of the kind well-known and available to those having skill in the computer software arts.
- Examples of computer-readable recording media include magnetic media such as hard disks, floppy disks, and magnetic tape, optical media such as CD-ROMs, DVDs, and magnetic disks, such as floppy disks.
- Examples of program instructions include not only machine code generated by a compiler, but also high-level language code that can be executed by a computer using an interpreter or the like.
- the hardware device described above may be configured to operate as one or more software modules to perform the operations of the embodiments, and vice versa.
- the software may include a computer program, code, instructions, or a combination of one or more of the above, and configure the processing device to operate as desired, or process it independently or collectively. You can command the device.
- Software and / or data may be any type of machine, component, physical device, virtual equipment, computer storage medium or device in order to be interpreted by or to provide instructions or data to the processing device. Or may be permanently or temporarily embodied in a signal wave to be transmitted.
- the software may be distributed over networked computer systems so that they may be stored or executed in a distributed manner.
- Software and data may be stored on one or more computer readable recording media.
Abstract
Description
Claims (10)
- 상기도의 서로 다른 측면에 접촉된 측정 전극 및 전기 인가 전극을 포함하는 상기도 전극부;상기 접촉된 측정 전극을 통해 상기 서로 다른 측면의 사이에서 전기 임피던스를 측정하여 상기 상기도의 폐쇄 면적을 추정하는 전기 임피던스 측정부; 및상기 추정된 폐쇄 면적에 기초하여 상기 서로 다른 측면 중 적어도 하나에 전기 자극을 인가하도록 상기 접촉된 전기 인가 전극을 제어하는 전기 자극 제어부를 포함하는수면 무호흡 치료 장치.
- 제1항에 있어서,상기 전기 임피던스 측정부는, 상기 측정된 전기 임피던스에 기초하여 상기 측정된 전기 임피던스의 감소 시점을 결정하고, 상기 결정된 감소 시점에 기초하여 상기 상기도의 폐쇄 면적을 추정하는수면 무호흡 치료 장치.
- 제1항에 있어서,상기 전기 임피던스 측정부는, 상기 측정된 전기 임피던스에 기초하여 상기 상기도의 EIT(Electrical Impedance Tomography) 영상을 생성하고, 상기 생성된 EIT(Electrical Impedance Tomography) 영상에서의 상기 상기도의 면적 변화에 기초하여 상기 상기도의 폐쇄 면적을 추정하는수면 무호흡 치료 장치.
- 제1항에 있어서,상기 전기 자극 제어부는, 상기 추정된 폐쇄 면적의 크기(size)가 기준 크기(size)보다 클 경우, 상기 전기 자극을 인가하도록 상기 접촉된 전기 인가 전극을 제어하는수면 무호흡 치료 장치.
- 제1항에 있어서,상기 전기 자극 제어부는, 상기 인가된 전기 자극에 기초하여 상기 상기도의 근육이 이완 또는 수축되어 상기 상기도의 폐쇄를 방지하도록 상기 접촉된 전기 인가 전극을 제어하는수면 무호흡 치료 장치.
- 제1항에 있어서,상기 전기 자극 제어부는, 상기 추정된 폐쇄 면적의 변화에 따라 상기 인가된 전기 자극의 세기를 변경하도록 상기 접촉된 전기 인가 전극을 제어하는수면 무호흡 치료 장치.
- 전기 임피던스 측정부에서, 상기도의 서로 다른 측면에 접촉된 측정 전극을 통해 상기 서로 다른 측면의 사이에서 전기 임피던스를 측정하여 상기 상기도의 폐쇄 면적을 추정하는 단계; 및전기 자극 제어부에서, 상기 추정된 폐쇄 면적에 기초하여 상기 서로 다른 측면 중 적어도 하나에 전기 자극을 인가하도록 상기 서로 다른 측면에 접촉된 전기 인가 전극을 제어하는 단계를 포함하는수면 무호흡 치료 방법.
- 제7항에 있어서,상기 상기도의 폐쇄 면적을 추정하는 단계는,상기 측정된 전기 임피던스에 기초하여 상기 측정된 전기 임피던스의 감소 시점을 결정하는 단계; 및상기 결정된 감소 시점에 기초하여 상기 상기도의 폐쇄 면적을 추정하는 단계를 포함하는수면 무호흡 치료 방법.
- 제7항에 있어서,상기 상기도의 폐쇄 면적을 추정하는 단계는,상기 측정된 전기 임피던스에 기초하여 상기 상기도의 EIT(Electrical Impedance Tomography) 영상을 생성하는 단계; 및상기 생성된 EIT(Electrical Impedance Tomography) 영상에서의 상기 상기도의 면적 변화에 기초하여 상기 상기도의 폐쇄 면적을 추정하는 단계를 포함하는수면 무호흡 치료 방법.
- 제7항에 있어서,상기 접촉된 전기 인가 전극을 제어하는 단계는,상기 상기도의 근육이 이완 또는 수축되어 상기 상기도의 폐쇄를 방지하도록 상기 접촉된 전기 인가 전극을 제어하되, 상기 추정된 폐쇄 면적의 변화에 따라 상기 인가된 전기 자극의 세기를 변경하도록 상기 접촉된 전기 인가 전극을 제어하는 단계를 포함하는수면 무호흡 치료 방법.
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