Method for treating a subject having neuromuscular impairment of the diaphragm

Abstract

A method for treating a subject is provided where at least two types of electrical stimulation are provided to cause diaphragm contraction. At least one type of stimulation is configured to bias lung volume of a subject. The stimulation method may include without being limited to a method to treat a subject having neuromuscular impairment of the diaphragm. The stimulation method may also include without being limited to a method to treat a subject who has been diagnosed with central sleep apnea.

1 . A method of treating a subject who has been diagnosed with central sleep apnea comprising:
 providing a first electrical stimulation to cause a diaphragm contraction to thereby elicit a lung volume bias; and   subsequently providing a second electrical stimulation to elicit at least one breath.   
   
   
       2 . The method of  claim 1  wherein the first electrical stimulation is provided after detection of a decreased respiratory drive. 
   
   
       3 . The method of  claim 1  wherein the second electrical stimulation is provided after detection of central apnea. 
   
   
       4 . The method of  claim 1  wherein at least a portion of the first stimulation overlaps at least a portion of the second stimulation. 
   
   
       5 . A method for treating a subject having neuromuscular impairment of the diaphragm comprising:
 providing a first electrical stimulation to elicit a diaphragm contraction and thereby elicit a lung volume bias immediately prior to:   providing a breathing assist stimulation to elicit diaphragm contraction to increase ventilation of a subject.   
   
   
       6 . The method of  claim 5  wherein the subject having a neuromuscular impairment is a subject having paralysis impairing diaphragm movement. 
   
   
       7 . The method of  claim 5  wherein the subject having a neuromuscular impairment is a subject having ALS. 
   
   
       8 . The method of  claim 5  wherein the step of providing breathing assist stimulation comprises providing stimulation configured to increase tidal volume of the subject. 
   
   
       9 . The method of  claim 8  wherein the step of providing stimulation configured to increase tidal volume of the subject comprises providing stimulation to augment intrinsic breathing. 
   
   
       10 . The method of  claim 8  wherein the step of providing stimulation configured to increase tidal volume comprises providing stimulation to create breaths. 
   
   
       11 . A method for treating a subject comprising;
 providing a first electrical stimulation to elicit a diaphragm contraction and thereby elicit a lung volume bias immediately prior to or after:   providing a second therapeutic electrical stimulation to elicit a diaphragm contraction wherein the second therapeutic electrical stimulation is selected from a group comprising: breathing augmentation stimulation, deep inspiration therapy, increasing inspiration duration; and manipulating duty cycle of inspiration with respect to a respiration cycle.   
   
   
       12 . The method of  claim 11  further comprising the step of providing the first electrical stimulation during the second electrical stimulation.