DETECTION APPLIANCE AND METHOD FOR OBSERVING SLEEP-RELATED BREATHING DISORDERS
20220338800 · 2022-10-27
Assignee
Inventors
- Stefan MADAUS (Krailling, DE)
- Caspar Graf von STAUFFENBERG (Gauting, DE)
- Harald VOGELE (Gauting, DE)
- Dieter HEIDMANN (Geretsried, DE)
- Dieter KLAUS (Schopfheim, DE)
Cpc classification
A61B5/7232
HUMAN NECESSITIES
International classification
Abstract
A detection appliance and a method detect and evaluate a measuring signal that is indicative of breathing of a sleeping person, in connection with the observation of sleep-related breathing disorders. Instruments also detect signals that are indicative of breathing of a patient. The aim provides solutions that enable a reliable examination in terms of occurrence of sleep-related sleeping disorders, in the usual surroundings of the person concerned. In a first form, a mobile detection appliance is provided with a sensor device for detecting a nasal flow signal indicative of a nasal respiratory gas flow, and/or a respiratory flow signal indicative of an oral respiratory gas flow, in addition to an electronic data processing unit comprising a memory device and processing the signals indicative of temporal course of the nasal and oral respiration. The data processing device is configured to store data indicative of temporal course of the respiratory flow signals.
Claims
1. A battery powered wearable mobile device for monitoring and recording of physiological state of a person during sleep that is suitable for at home study of a sleep-related breathing disorder, comprising: a housing configured for operatively connecting with: a patient interface configured to be mounted on a user and to pass, via a port of the housing, a gas characteristic indicative of respiration of the user; a strap for fastening the wearable mobile device housing to the user; a memory, the memory comprising a memory card incorporated in the housing; an electronic data processor in the housing, the electronic data processor configured to operate for storing, in the memory, data indicative of temporal course of a plurality of signals of a sleep study, along with temporal information of a time-keeping device, and wherein the plurality of signals comprises: a respiratory airflow signal indicative of airflow at the patient interface, a signal indicative of cardiac activity detected with a device mounted on the skin of the person, and a chest expansion signal corresponding to the person's breathing movement against the strap; a data transfer interface configured to transfer the stored data of the memory to an external device, the data transmission interface comprising a universal serial bus (USB) interface; and a plurality of light indicators, visible on the housing, each of the plurality of light indicators configured to light to indicate a detection appliance functional state.
2. The battery powered wearable mobile device according to claim 1, wherein the housing comprises a compartment for a battery.
3. The battery powered wearable mobile device according to claim 1, wherein a plurality of sensors for generating signals of the plurality of signals are disposed within the housing.
4. The battery powered wearable mobile device according to claim 1, wherein the electronic data processor is configured to test a quality of a signal acquired by the battery powered wearable mobile device.
5. The battery powered wearable mobile device according to claim 1, further comprising a switch on the housing to initiate operation for recording of the chest expansion signal, the respiratory airflow signal and the signal indicative of cardiac activity onto the memory.
6. The battery powered wearable mobile device according to claim 1, wherein the respiratory airflow signal is determined with a pressure sensor in the housing.
7. The battery powered wearable mobile device according to claim 1, wherein the signal indicative of cardiac activity detected with a device mounted on the skin of the person is detected with an electro-cardiogram (ECG) device.
8. The battery powered wearable mobile device according to claim 1, wherein one or more signals of the plurality of signals enable automated evaluation by the external device to detect respiratory events comprising snoring, apnea events, and hypopnea events.
9. The battery powered wearable mobile device according to claim 8, wherein one or more of the plurality of signals enable automated evaluation by the external device to detect respiratory events comprising obstructive sleep apnea.
10. The battery powered wearable mobile device according to claim 8, wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period of at least six hours.
11. The battery powered wearable mobile device according to claim 1, wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period of at least seven hours.
12. The battery powered wearable mobile device according to claim 1, wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period comprising eight hours.
13. The battery powered wearable mobile device according to claim 1 wherein the patient interface comprises a nasal cannula.
14. The battery powered wearable mobile device according to claim 13 further comprising a sensor for sensing oral respiration, wherein the nasal cannula is configured as a support for a projection with the sensor for sensing oral respiration.
15. A system for monitoring and recording of physiological state of a person during sleep that is suitable for at home study and for diagnosing a sleep-related breathing disorder, the system comprising: (a) a battery powered wearable mobile device for monitoring and recording of physiological state of a person during sleep, comprising: a housing configured for operatively connecting with: a patient interface configured to be mounted on a user and to pass, via a port of the housing, a gas characteristic indicative of respiration of the user; a strap for fastening the wearable mobile device housing to the user; a memory incorporated in the housing; an electronic data processor in the housing, the electronic data processor configured to operate for storing, in the memory, data indicative of temporal course of a plurality of signals of a sleep study, along with temporal information of a time-keeping device, and wherein the plurality of signals comprise: a respiratory airflow signal indicative of airflow at the patient interface, a signal indicative of cardiac activity detected with a device mounted on the skin of the person, and a chest expansion signal corresponding to the person's breathing movement against the strap; a data transfer interface configured to transfer the stored data from the memory, the data transmission interface comprising a universal serial bus (USB) interface; and a plurality of light indicators, mounted on the housing, each of the plurality of light indicators configured to light to indicate a detection appliance functional state; and (b) computing apparatus, external to the battery powered wearable mobile device, and the computing apparatus configured to receive transmissions comprising the stored data, the computing apparatus configured to analyze one or more signals of the plurality of signals to detect events of a sleep-related breathing disorder.
16. The system according to claim 15, wherein the computing apparatus comprises a computer and is configured device to detect respiratory events comprising snoring, apnea events, and hypopnea events.
17. The system according to claim 16 wherein the computing apparatus is configured to detect respiratory events comprising obstructive sleep apnea.
18. The system according to claim 17, the computing apparatus is configured to generate the stored data in a temporal course visualization on a user interface.
19. The system according to claim 15 wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period of at least six hours.
20. The system according to claim 18 wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period of at least seven hours.
21. The system according to claim 18 wherein the battery powered wearable mobile device is configured to create a quantity of data from signal collection carried out at home by the person over a continuous period comprising eight hours.
22. The system according to claim 15 wherein the patient interface comprises a nasal cannula.
23. The system according to claim 22 further comprising a sensor for sensing oral respiration, wherein the nasal cannula is configured as a support for a projection with the sensor for sensing oral respiration.
24. The system according to claim 15 wherein the computing apparatus is configured to generate evaluation features from the respiratory airflow signal and to generate at least one evaluation result based on the evaluation features.
25. The system according to claim 24 wherein the computing apparatus is configured to recognize at least snoring, apnea events, and hypopnea events based on the evaluation features.
26. The system according to claim 24, wherein the at least one evaluation result includes a severity indicator indicating a severity of a respiratory disorder during sleep.
27. The system according to claim 15, wherein the housing comprises a compartment for a battery, and wherein a plurality of sensors for generating signals of the plurality of signals are disposed within the housing.
28. The system according to claim 15, wherein the electronic data processor is configured to test a quality of a signal acquired by the battery powered wearable mobile device.
29. The system according to claim 15, further comprising a switch on the housing to initiate operation for recording of the chest expansion signal, the respiratory airflow signal and the signal indicative of cardiac activity onto the memory, and wherein the respiratory airflow signal is determined with a pressure sensor in the housing.
30. A method of a system for monitoring and recording of physiological state of a person during sleep that is suitable for at home study and for diagnosing a sleep-related breathing disorder, the method comprising: receiving, in computer apparatus external to the battery powered wearable mobile device of claim 1, transmissions comprising the stored data determined with the battery powered wearable mobile device of claim 1, analyzing, by the computer apparatus, at least one signal of the plurality of signals to detect events of a sleep-related breathing disorder.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0066] Further particulars and characteristics of the invention can be found in the following description in conjunction with the drawings. They show:
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[0072] FIG. if a sketch illustrating a concept for monitoring respiration by measuring signals that are indicative of the respiratory gas flow through the left nasal opening, the right nasal opening and the mouth of the user;
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DETAILED DESCRIPTION
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[0093] The detection appliance 1 shown is particularly suitable for use in the home, i.e. in the familiar surroundings of the affected person for the purposes of recording features characteristic of the respiration during the sleep phase in such a way that it enables the physiological state of the affected person to be evaluated in an adequately informative and standardized manner. On the basis of a standardized analysis of the measurement results obtained, an assessment can be made as whether, and if so to what degree, symptoms of OSA are present and whether a more in-depth investigation in a sleep laboratory should be recommended.
[0094] The data processing unit is configured in such a way that it checks whether the acquired respiratory flow signal fulfils prescribed signal quality criteria. In the event that the acquired signal does not fulfil certain criteria, signal recording is suppressed and a data entry is performed that indicates the time locations of periods with signals that were classified as invalid.
[0095] The data processing unit is designed in such a way that it has access to a time-keeping device so that the data indicative of the respiratory flow signal can be recorded in conjunction with time information.
[0096] The data compression system implemented in conjunction with the data processing unit allows the acquired time-dependent signals to be recorded in compressed form.
[0097] The data processing unit is configured in such as way that the recording process is initiated by a switching impulse initiated by the user. Activation occurs when the switch button 3 is pressed for a prescribed minimum duration of, for example, 3 seconds.
[0098] The data processing unit is configured in such a way that it starts recording or saves data when the acquired respiratory flow signal fulfils a certain criterion, e.g. a predefined periodicity criterion.
[0099] The detection appliance 1 exhibits a first pressure measurement connection 4 to which can be connected a measurement cannula 5.
[0100] As shown in
[0101] It is possible to equip the detection appliance 1 with a second pressure measurement connection for acquiring a second pressure measurement signal. The ability to acquire two pressure measurement signals makes it possible to operate the detection appliance 1 in such a way that it can separately acquire the respiratory flow signals from the left and right nasal openings 7a, 7b respectively.
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[0103] The mask interior defined by this mouth protection which acts as a diaphragm is connected to the detection appliance via the measurement cannula 5. It is possible to provide the mask with flap or valve devices 18, 19 that facilitate the inhalation process. These valve or flap devices, in particular the degree in which they are open, can also be used to acquire signals that are indicative of the respiration. The signal transmission can occur by wireless means, in particular optically for example using infrared light.
[0104] The signal that is indicative of the respiratory gas flow can also be acquired by means of other measurement equipment, in particular measurement diaphragms or volumetric flow sensors.
[0105] The detection appliance 1 can provide a device 8 for detecting chest expansion. As shown in
[0106] The detection appliance 1 can be provided with electrode devices through which the ECG signals from the user can be acquired by locating the detection appliance directly onto the skin of the user. These ECG signals can also be recorded with temporal information.
[0107] The recording process can be initiated by the user by means of the switch button 3. It is also possible to configure the detection appliance 1 in such a way that the recording process is ended as a result of the fulfilment of a time criterion. In particular, it is possible to end the recording process when it has reached a prescribed duration of, for example, 9.5 h.
[0108] The recording process is also ended under switch control if the acquired respiratory flow signal fulfils a certain switch-off criterion within a certain switch-off time window.
[0109] The detection appliance 1 is provided with an interface device 14 for transmitting the recorded data to an external analysis system. Here this interface device is implemented as a USB interface. The detection appliance also comprises an infrared interface for potential-free signal acquisition. The generated signals relating to the respiration that are obtained can be extracted for further analysis via this infrared interface while the appliance is in operation. The detection appliance 1 can thus be operated as a measurement transducer.
[0110] It is also possible to design the detection appliance 1 in such a way that the memory device is incorporated in the detection appliance 1 in a replaceable manner or can be attached thereto. Such a memory device can be in the form of a card or, in particular, a USB flash stick. By first creating an entry in the memory device, it is possible to record personal data on the storage medium. On the basis of this initial recording, it is possible to pre-configure the detection appliance 1 or ensure that the acquired data is correctly assigned to the specific user.
[0111] The configuration of the data processing unit is set by a data processing program, where this data processing program is in preference modifiable or substitutable. The reproduction of the data processing program in the detection appliance 1 can occur via a ROM device or a RAM device, in particular via the previously mentioned interface device 14, additional interface devices or the storage medium.
[0112] Along with the in preference intuitive and easy-to-use switch device 3, the detection appliance 1 is also provided with indicator devices 15 for indicating the operational readiness or the functional state of the detection appliance. In the embodiment shown, the recording readiness of the detection appliance is indicated by the periodic blinking of a green signal diode.
[0113] The detection appliance 1 comprises a power supplying device which in this case takes the form of a battery unit. The battery unit is in a compact form so that the detection appliance can be designed to be flat and miniature and possess little weight.
[0114] The data processing unit is coupled to a calibration device for calibrating the respiratory flow signal. The calibration device is designed in such a way that it can perform an automatic adjustment of the system to the acquired signal level.
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[0116] FIG. if shows a sketch illustrating a concept for monitoring respiration by registering signals X1, X2, X3 that are indicative of the respiratory gas flow through the left nasal opening, the right nasal opening and the mouth of the user respectively. These signals can, in particular, be registered via pressure measurement cannulae. The signals X1, X2 can, for example, be collected as back-pressure signals using a nasal spectacle device. The signal X3 can be acquired using a measurement cannula inserted in the flow area in the region of the upper lip of the user where gas exchange occurs during oral respiration. It is possible to collectively evaluate the signals X1, X2, X3 in such a way that the sum of the signals fulfils a plausibility criterion, for example with regard to the tidal volume.
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[0118] The base body 30 is provided with a sensor device 33 for registering an event that is indicative of oral respiration, in particular, a pressure fluctuation. This pressure fluctuation can also be transported for further recording via a measurement channel or other signal transmission device. The application of the measurement device provided for registering oral respiration to the structure sitting on the nose of the user guarantees an especially advantageous, in particular positionally stable and reproducible arrangement of this measurement device.
[0119] The measuring diaphragm 32 can take the form of a mesh, screen or even woven fabric element. As later remarked in connection with
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[0122] The base body 30 comprises a mounting ridge 36 following the bridge of the nose. The mounting ridge 36 has been provided with mounting wings 37. The mounting ridge 36 and the mounting wings 37 can be fixed in place on the user by means of adhesive strips or, if necessary, can be designed to be self-adhesive in specific areas. Flexible inserts, in particular wire segments can be incorporated into the mounting ridge 36 and/or mounting wings 37 allowing the acquisition device to be adapted to the particular nasal structure of the user.
[0123] The base body 31 defines an air exit section 38 through which a displacement of respiratory gas from/to the nasal air passages and the surroundings can occur. The air exit section 38 can be designed so as to provide a defined flow resistance so that a signal based on the prevailing pressure in the enclosed measurement space and indicative of the respiration can be acquired, e.g. via the cannula 5 shown here.
[0124] The base body 31 can be designed in such a way, in particular in the area adjacent to the nasal openings when in the applied position, that an especially advantageous acquisition of the nasal respiratory gas flow is possible. An especially suitable construction is sketched in
[0125] It is not essential for the base body 31 to be produced from plastic material. It is also possible to produce it from paper, cellulose, fibre or other materials, in particular those suitable for once-off use. Sections of the interior of the base body can be provided with foam material or other padding material in order to achieve airtightness or padding, in particular in the nose bridge area.
[0126] The base body 31 presented in cross-section and in a simplified manner in
[0127] The enclosed measurement space contains an air-guiding structure that sits on the nose of the user in the area surrounding the nasal openings. In this embodiment example, the air-guiding structure is designed in such a way that it allows separate signals for the left and right nasal flow to be collected.
[0128] The air-guiding structure comprises a baffle 41 that diverts the air flowing through the nasal openings. A pressure measurement port 42 is provided in a typical back-pressure location of the diversion path created by the baffle. The pressure prevailing in each of the pressure measurement ports can be acquired via a measurement cannula 5.
[0129] The base body 31 shown here in cross-section has been produced from an elastomeric material. Elastic insertion channels 43 are provided in the area of each pressure measurement port into which can be inserted a plug-in connector 44 for attaching the respective cannula 5.
[0130] The diversion path is designed in such a way that it diverts the air flow by about 180.degree. Each pressure measurement port 42 is located in the area where diversion occurs.
[0131] The baffle 41 can be designed in such a way that is elastically flexible and provides a passage of larger cross-sectional area at higher respiratory gas flow rates. It is also possible to detect the respiratory gas flow based on the deflection of the baffle. To avoid blockage of the pressure measurement port 42, it is possible to introduce a purging air flow, either permanently or intermittently, into the measurement cannula 5.
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[0135] The acquisition device forms two measurement channels 55, 56 that are in connection with the surroundings via diaphragm or flap elements 57, 58. The flap elements 57, 58 are set into a circumferential groove located in the opening region of each measurement channel 55, 56.
[0136] Acquisition of each respective pressure signal in the region of the measurement channels occurs via the pressure measurement port sections 59, 60.
[0137] The signal collection can, as previously described, occur via a cannula 5 or a directly connectable or insertable measuring transducer 61. A signal that is indicative of the pressure in the respective measurement channel can be converted to an electrical or optical signal by means of the measurement transducer 61.
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[0139] The air displacement occurring between the enclosed measurement space and the surroundings can be detected by means of a pneumotachograph 71 and recorded for further analysis by the detection appliance 1. The thereby produced offset of the respiratory gas flow signal can be taken into consideration in the analysis procedure. The purging-air line 70 can have a small cross-section of, for example, 10 mm.sup.2. The purging volume can vary within the range of 1 to 5 l/min.
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[0141] The detection appliance 1 is designed in such a way that it comprises a base module 23 to which a recording transfer module 20 can be coupled.
[0142] This recording transfer module 20 is designed as a Game Boy compatible structure. This enables the recorded data to be visualized via an intuitive, simply-to-understand user interface on a conventional end-user device 21 and, if necessary, to be analysed and processed with regard to selected properties. This makes it possible, in particular, to output a summary result in the form of a severity bar 28. This bar chart clearly indicates whether—and to what extent—a treatment-relevant disorder is present, or not.
[0143] The supply of power, and the conversion of the pressure signal acquired from the user via the cannula 5, occurs in preference in the base module 23. To this end, the base module 23 comprises a battery compartment and a pressure sensor as well as a switch device 24.
[0144] The recording module 20 comprises a data processing unit that is configured in such a way that it records onto a memory device data that is indicative of the temporal course of the breathing. The recording module 20 can be provided with an interface device 14 for reading the recorded data. It is possible to connect the memory device 25 to the recording module 20 in a detachable manner so that is possible to separate the memory device 25 from the recording module and introduce it into another system for further analysis and visualization.
[0145] The acquisition of the respiratory signal can, as an alternative to acquisition using a nasal cannulation arrangement 5, also occur by means of other measuring equipment.
[0146] Using the previously stated detection appliance 1, it is possible to obtain an evaluation result that is based on the measurement signals associated with the breathing of the person and which is indicative of the physiological state of the user, whereby evaluation characteristics are generated from said measurement signals through the use of standardized analysis systems and a least one evaluation result is generated from a result generation step based thereon that indicates the severity of any illness present according to prescribed evaluation criteria, in particular through visualization, for example, in the form of a bar chart.
[0147] The entire captured data can be input to further evaluation procedures and, as depicted in
[0148] The inventive detection appliance, and the signal processing method that can be performed therewith, provide an advantageous means of creating a quantity of data from the signal collection carried out at home by the user over a continuous period of approx. 6 to 8 hours based on which evaluation characteristics can be generated from which can be produced reliable evaluation results obtained in a standardized repeatable manner that can in an advantageous manner form the basis of a subsequent diagnosis and thereby contribute to a standardized evaluation.
[0149] Further particulars, in particular relating to the classification and automated evaluation of the respiration, can be found in the description that follows.
[0150] The breath 1 depicted in
[0151] The respiratory gas flow trace depicted in
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