Collecting sleep quality information via a medical device

Patent metadata

Field	Value
Publication number	US-2016263382-A1
Application number	US-201615160455-A
Country	US
Kind code	A1
Filing date	May 20, 2016
Priority date	Mar 16, 2004
Publication date	Sep 15, 2016
Grant date	—

Abstract

At least one of a medical device, such as an implantable medical device, a monitor, and a computing device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

First claim

What is claimed is:

1 . A medical system comprising:
a medical device comprising a plurality of electrodes and configured to deliver at least one of a cardiac pacing therapy or a neurostimulation therapy to a patient according to a plurality of different therapy parameter sets; a monitor configured to monitor one or more electrocardiogram morphological features based on an electrocardiogram sensed via the plurality of electrodes; a processor configured to determine when the patient is asleep, and detect at least one of arousals or apneas when the patient is asleep based on sudden changes in one or more electrocardiogram morphological features, wherein the processor is configured to associate each of the detected arousals or apneas with one of the plurality of therapy parameter sets according to which the medical device delivered the therapy when the arousal or apnea was detected, wherein, for each of the plurality of therapy parameter sets, the processor is configured to:
determine a plurality of values of a sleep quality metric based on the arousals or apneas associated with the therapy parameter set, each value of the plurality of values of the sleep quality metric indicating a number of the arousals or apneas over a period of time, and
determine a representative value of the sleep quality metric for the therapy parameter set based on the plurality of values of the sleep quality metric associated with the therapy parameter set; and
a memory that stores the representative values of the sleep quality metric and an indication of the association of the therapy parameter sets with the respective representative values of the sleep quality metric, wherein the medical device is configured to automatically adjust the delivery of the at least one of the cardiac pacing therapy or the neurostimulation therapy to the patient based on the determined representative values.

2 . The medical system of claim 1 , further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor, wherein at least one of the one or more computing devices presents sleep quality information to a user based on the values of the sleep quality metric determined by the processor.

3 . The medical system of claim 2 , wherein the user comprises a clinician, and the computing device comprises a clinician programmer that presents at least one of a trend diagram, a histogram or a pie chart to the clinician based on the values of the sleep quality metric.

4 . The medical system of claim 2 , wherein the user comprises a patient, and the computing device comprises a patient programmer that presents a message related to sleep quality to the patient based on the values of the sleep quality metric.

5 . The medical system of claim 1 ,
further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor, wherein at least one of the one or more computing devices presents a list of the therapy parameter sets and the associated representative values to a user, and orders the list of therapy parameter sets according to the associated representative values.

6 . The medical system of claim 1 , further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor, wherein the one or more computing devices comprise the monitor.

7 . The medical system of claim 1 , wherein the medical device comprises the monitor.

8 . The medical system of claim 1 , wherein the processor identifies when the patient is asleep based on at least one of electrocardiogram morphology, subcutaneous temperature, muscular tone, electrical activity within a brain of the patient or eye motion.

9 . The medical system of claim 1 , further comprising a server that includes the processor.

10 . The medical system of claim 1 ,
wherein the representative value for each therapy parameter set comprises one of a mean value or a median value of the numbers or arousals or apneas over the periods of time, the system further comprising a computing device that presents a list of the therapy parameter sets and the associated representative values to a user.

11 . The medical system of claim 1 ,
wherein, for each of the plurality of therapy parameter sets, the processor determines the value of the overall sleep quality metric by applying a function or look-up table to the determined values of each of the plurality of sleep quality metrics associated with that particular therapy parameter set, the system further comprising a computing device that presents a list of the therapy parameter sets and the associated value of the overall sleep quality metric to a user.

12 . The medical system of claim 1 , wherein the medical device comprises the processor.

13 . The medical system of claim 1 , wherein the monitor comprises the processor.

14 . The medical system of claim 1 , further comprising one or more computing devices separate from the medical device, wherein the one or more computing devices comprise the processor.

15 . The medical system of claim 1 , wherein the processor is configured to detect the at least one of arousals or apneas based on sudden ST segment elevation in the electrocardiogram.

16 . The medical system of claim 1 , wherein each value of the plurality of values of the sleep quality metric indicates a number of the arousals or apneas per occurrence of sleep.

17 . The medical system of claim 1 , wherein the medical device comprises an implantable medical device.

18 . The medical system of claim 17 , wherein the implantable medical device comprises a cardiac rhythm management device configured to deliver cardiac pacing to the patient.

19 . A medical system comprising:
an implantable medical device comprising a plurality of electrodes and configured to deliver at least one of a cardiac pacing therapy or a neurostimulation therapy to a patient according to a plurality of different therapy parameter sets; a processor configured to:
monitor one or more electrocardiogram morphological features based on an electrocardiogram sensed via the plurality of electrodes,
determine when the patient is asleep, and detect at least one of arousals or apneas when the patient is asleep based on sudden changes in one or more electrocardiogram morphological features,
associate each of the detected arousals or apneas with one of the plurality of therapy parameter sets according to which the medical device delivered the therapy when the arousal or apnea was detected,
for each of the plurality of therapy parameter sets:
determine a plurality of values of a sleep quality metric based on the arousals or apneas associated with the therapy parameter set, each value of the plurality of values of the sleep quality metric indicating a number of the arousals or apneas over a period of time, and
determine a representative value of the sleep quality metric for the therapy parameter set based on the plurality of values of the sleep quality metric associated with the therapy parameter set, and

automatically adjust the delivery of the at least one of the cardiac pacing therapy or the neurostimulation therapy to the patient by the implantable medical device based on the determined representative values;
a memory configured to store the representative values of the sleep quality metric and an indication of the association of the therapy parameter sets with the respective represe

Assignees

• Medtronic Inc

Inventors

• Heruth Kenneth T
• Miesel Keith A

Classifications

• A61N1/3614

  based on impedance measurement · CPC title

• A61N1/36071

  Pain · CPC title

• A61N1/36078

  Inducing or controlling sleep or relaxation (non-implantable stimulator A61M21/00) · CPC title

• A61B5/686

  Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence) · CPC title

• A61N1/36514

  controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585) · CPC title