Detecting and treating disordered breathing

Abstract

A system for treating disordered breathing of a human being includes an implantable transvenous stimulation lead having at least one stimulation electrode and a sensor configured to detect activity level of the human being. The system includes an energy source, a pulse generator and circuitry, the circuitry operative to receive a signal indicative of the activity level of the human being from the sensor, wherein the circuitry is configured to cause the energy source and the pulse generator to deliver spaced apart stimulation signals to the at least one stimulation electrode while the activity level of the human being is sufficiently low to be indicative of sleep. Spaced apart stimulation pulses from the electrode are configured to extend a duration of a time of at least one breath being defined as the time from an onset of inhalation to the onset of inhalation of a successive breath.

What is claimed is: 
     
         1 . A system for treating disordered breathing of a patient comprising:
 a stimulation lead having a stimulation electrode, the stimulation lead being configured to be implanted into a blood vessel of the patient proximate a phrenic nerve, the stimulation electrode be configured to electrically stimulate the phrenic nerve;   a respiration sensor to provide a respiration signal;   a sensor configured to detect activity of the patient; and   an energy source, a pulse generator, and circuitry to receive a signal indicative of the activity of the patient from the sensor, the circuitry having a plurality of different treatment modes of operation to cause the energy source and the pulse generator to deliver a train of stimulation pulses to the stimulation electrode based on the activity of the patient being indicative of sleep.   
     
     
         2 . The system of  claim 1 , wherein the sensor comprises an accelerometer and/or position sensor. 
     
     
         3 . The system of  claim 1 , wherein the plurality of different treatment modes includes at least one treatment mode of operation to cause the energy source and the pulse generator to deliver the train of stimulation pulses responsive to the respiration signal. 
     
     
         4 . The system of  claim 3 , wherein the at least one treatment mode of operation includes a first treatment mode in which the train of stimulation pulses is responsive to detection of apnea-hypopnea from the respiration signal. 
     
     
         5 . The system of  claim 4 , wherein the at least one treatment mode of operation includes a second treatment mode in which the train of stimulation pulses is responsive to detection of hyperpnea from the respiration signal. 
     
     
         6 . The system of  claim 3 , wherein the plurality of different treatment modes further includes an additional treatment mode of operation to cause the energy source and the pulse generator to deliver the train of stimulation pulses without regard to the respiration signal. 
     
     
         7 . The system of  claim 6 , wherein the additional treatment mode of operation delivers the train of stimulation pulses for random periods at random intervals. 
     
     
         8 . The system of  claim 6 , wherein the additional treatment mode of operation delivers the train of stimulation pulses based on historical data. 
     
     
         9 . The system of  claim 6 , wherein the additional treatment mode of operation to cause the energy source and the pulse generator to deliver the train of stimulation pulses without regard to the respiration signal is performed subsequent to the at least one treatment mode of operation to cause the energy source and the pulse generator to deliver the train of stimulation pulses responsive to the respiration signal. 
     
     
         10 . The system of  claim 1 , wherein the plurality of different treatment modes includes a treatment mode of operation to cause the energy source and the pulse generator to deliver the train of stimulation pulses without regard to the respiration signal. 
     
     
         11 . The system of  claim 10 , wherein the treatment mode of operation delivers the train of stimulation pulses for random periods at random intervals. 
     
     
         12 . The system of  claim 10 , wherein the treatment mode of operation delivers the train of stimulation pulses based on historical data. 
     
     
         13 . The system of  claim 1 , wherein the respiration sensor is one of an impedance sensor, a pressure sensor, or an accelerometer. 
     
     
         14 . The system of  claim 1 , wherein the train of stimulation pulses begins at a base current level, transitions upward to a second level, and then transitions downward to the base current level. 
     
     
         15 . The system of  claim 14 , wherein the second level is about 2-4 mA. 
     
     
         16 . The system of  claim 14 , wherein the base current level is about 1-2 mA. 
     
     
         17 . The system of  claim 16 , wherein the second level is about 2-4 mA. 
     
     
         18 . The system of  claim 14 , wherein the transitions upward and downward are each approximately 30% of a duration of the train of stimulation pulses. 
     
     
         19 . The system of  claim 14 , wherein the transitions upward and downward are linear, exponential, or elliptical in shape. 
     
     
         20 . The system of  claim 1 , wherein the train of stimulation pulses are delivered at a frequency of 20 Hz. 
     
     
         21 . The system of  claim 20 , wherein the train of stimulation pulses has a duration of about 150 μsec. 
     
     
         22 . The system of  claim 1 , wherein, the train of stimulation pulses is configured to extend a duration of time of at least one breath, the at least one breath being defined as a time from an onset of inhalation to the onset of inhalation of a successive breath.