Ventilatory Stabilization Technology

Abstract

A system for reducing central sleep apnea (CSA) is described in which certain methods of increasing a patient's rebreathing during periods of the sleep cycle are used. By increasing rebreathing during periods of overbreathing, the over-oxygenation which typically results from the overbreathing period can be reduced, thus reducing the compensating underbreathing period and effectively reducing the loop gain associated with the central sleep apnea. Nasal occlusion and a leak resistant oral interface provide control for gas leaks from a patent interface.

1 . A method comprising: 
 providing an apparatus comprising a blower and a leak resistant patient interface adapted to be fit on a patient's airway, the leak resistant patient interface operably connected using a tube to the blower, the leak resistant patient interface having an exit;    fitting the leak resistant patient interface to the patient's airway;    detecting a breathing disorder in the patient; and    treating the breathing disorder with the apparatus.    
   
   
       2 . The method of  claim 1  in which treating the breathing disorder comprises adjusting the apparatus.  
   
   
       3 . The method of  claim 2 , wherein the adjusting step comprises adjusting the apparatus to treat obstructive sleep apnea.  
   
   
       4 . The method of  claim 3 , wherein the adjusting step further comprises adjusting the apparatus to treat central sleep apnea.  
   
   
       5 . The method of  claim 4  in which, during the adjusting step of treating central sleep apnea, gas flow from the blower is less than that used to treat obstructive sleep apnea.  
   
   
       6 . The method of  claim 5 , wherein the adjusting step of treating central sleep apnea is such that gas pressure from the blower is set below four cm H 2 O pressure.  
   
   
       7 . The method of  claim 6 , wherein the adjusting step of treating central sleep apnea is such that gas pressure from the blower is set at two cm H 2 O pressure or below  
   
   
       8 . The method of  claim 4  wherein the adjusting step of treating central sleep apnea is such that during periods of increased breathing associated with the breathing disorder, some exhaled gasses flow from the patient retrograde into the tube.  
   
   
       9 . The method of  claim 8 , wherein the adjusting step of treating central sleep apnea is done such that during an initial exhale portion of increased breathing associated with the breathing disorder, some of the patient's exhaled gasses flow retrograde into the tube towards the blower and away from the exit and wash flow out of the tube such that during a next inhale portion some rebreathing occurs.  
   
   
       10 . The method of  claim 8 , wherein the adjusting step of treating central sleep apnea is done such that during normal breathing periods little rebreathing occurs.  
   
   
       11 . The method of  claim 10 , wherein the adjusting step of treating central sleep apnea is done such that during normal breathing periods some retrograde flow occurs but wash flow is sufficient to remove exhaled air before a next inhale portion.  
   
   
       12 . The method of  claim 8 , wherein the retrograde flow into the tube is influenced by gas pressure from the blower and by the size of the exit, and gas flow rate from the blower is varied without significantly affecting leak resistant patient interface pressure.  
   
   
       13 . The method of  claim 4 , wherein the obstructive sleep apnea treating step occurs before the central apnea treating step.  
   
   
       14 . The method of  claim 13  in which the central sleep apnea treating step occurs after a reduction in obstructive sleep apnea.  
   
   
       15 . The method of  claim 1  in which the leak resistant patient interface comprises a dental appliance and a nasal occlusion device, and fitting the leak resistant patient interface to the patient comprises: 
 fitting the dental appliance to the mouth of the patient; and    blocking the patient's nose with the nasal occlusion device.    
   
   
       16 . A method comprising: 
 providing an apparatus comprising a blower and a leak resistant patient interface adapted to be fit on a patient's airway, the leak resistant patient interface operably connected using a tube to the blower, the leak resistant patient interface having an exit, the resistance of the exit being set that during treatment of a breathing disorder in the patient, expiratory air from the patient flows through the tube towards the blower and away from the exit;    fitting the leak resistant patient interface to the patient's airway;    treating obstructive sleep apnea with the apparatus; and    adjusting the apparatus to treat the breathing disorder.    
   
   
       17 . The method of  claim 16  in which the leak resistant patient interface comprises a dental appliance and a nasal occlusion device, and fitting the leak resistant patient interface to the patient comprises: 
 fitting the dental appliance to the mouth of the patient; and    blocking the patient's nose with the nasal occlusion device    
   
   
       18 . The method of  claim 16  wherein the adjusting step is such that during periods of increased breathing associated with the breathing disorder, some of the patient's exhaled gasses flow retrograde into the tube.  
   
   
       19 . The method of  claim 18 , wherein the adjusting step is done such that during an initial exhale portion of increased breathing associated with the breathing disorder, some exhaled gasses from the patient flow retrograde into the tube and wash flow out of the tube such that during a next inhale portion some rebreathing occurs.  
   
   
       20 . The method of  claim 18 , wherein the adjusting step is done such that during normal breathing periods little rebreathing occurs.  
   
   
       21 . The method of  claim 20 , wherein the adjusting step is done such that during normal breathing periods some retrograde flow occurs but wash flow is sufficient to remove exhaled air before a next inhale portion.  
   
   
       22 . The method of  claim 16 , wherein treating obstructive sleep apnea comprises supplying blower pressure greater than eight cm H 2 O.  
   
   
       23 . The method of  claim 16 , wherein treating obstructive sleep apnea occurs before the adjusting step.