Coordinated use of respiratory and cardiac therapies for sleep disoredered breathing

Abstract

Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.

What is claimed is: 
     
         1 . A method for delivering therapy to a patient, comprising:
 identifying one or more conditions; and   coordinating delivery of a first therapy and a second therapy via an implantable device by shifting therapy burden from the first therapy or the second therapy to the other of the first therapy or the second therapy based on the one or more identified conditions.   
     
     
         2 . The method of  claim 1 , wherein the first therapy includes an electrical stimulation therapy. 
     
     
         3 . The method of  claim 2 , wherein the electrical stimulation therapy includes cardiac pacing. 
     
     
         4 . The method of  claim 2 , wherein the electrical stimulation therapy includes nerve stimulation. 
     
     
         5 . The method of  claim 4 , wherein the nerve stimulation includes hypoglossal nerve stimulation. 
     
     
         6 . The method of  claim 4 , wherein the nerve stimulation includes phrenic nerve stimulation. 
     
     
         7 . The method of  claim 2 , wherein the electrical stimulation therapy includes muscle stimulation. 
     
     
         8 . The method of  claim 1 , wherein the first therapy includes cardiac pacing and the second therapy includes nerve stimulation. 
     
     
         9 . The method of  claim 8 , wherein the nerve stimulation includes hypoglossal nerve stimulation. 
     
     
         10 . The method of  claim 8 , wherein the nerve stimulation includes phrenic nerve stimulation. 
     
     
         11 . The method of  claim 1 , wherein the first therapy includes drug delivery. 
     
     
         12 . The method of  claim 1 , wherein the first therapy includes anti-hypertensive therapy. 
     
     
         13 . The method of  claim 1 , wherein the coordinating delivery includes shifting therapy burden from the first therapy to the second therapy by initiating or increasing the second therapy and terminating or decreasing the first therapy. 
     
     
         14 . The method of  claim 1 , wherein the implantable device includes a Cardiac Rhythm Management (CRM) device, and wherein the CRM device coordinates the delivery of the first therapy and the second therapy. 
     
     
         15 . The method of  claim 1 , wherein the therapy is delivered to treat a respiratory condition. 
     
     
         16 . The method of  claim 1 , wherein the shifting therapy burden includes adjusting one or more parameters of the first therapy and/or one or more parameters of the second therapy. 
     
     
         17 . The method of  claim 1 , wherein the one or more identified conditions relate to one or more of body movement, patient activity, heart rate, heart rate variability, QT interval, ventricular filling pressure, eye movement, body movements, respiration rate, transthoracic impedance, tidal volume, minute ventilation, body posture, brain activity, cardiac activity, muscle tone, body temperature, time of day, historical sleep times, blood pressure, blood chemistry, proximity to bed, snoring, pulmonary congestion, sympathetic nerve activity, battery consumption of the implantable device, and expected battery life of the implantable device. 
     
     
         18 . A system, comprising:
 one or more therapy delivery devices for delivering a first therapy and a second therapy to a patient, at least one of the one or more therapy deliver devices is implantable;   a memory for storing one or more parameters, wherein the one or more parameters are based on one or more sensed or derived conditions; and   a coordination processor in communication with the memory and the one or more therapy delivery devices for coordinating delivery of the first therapy and the second therapy by shifting therapy burden between the first therapy and the second therapy based on the one or more parameters.   
     
     
         19 . The system of  claim 18 , wherein the coordinating delivery includes shifting therapy burden from the first therapy to the second therapy by initiating or increasing the second therapy and terminating or decreasing the first therapy. 
     
     
         20 . An implantable medical device, comprising:
 a memory for storing a number of parameters, wherein the number of parameters are based on one or more sensed or derived conditions; and   a coordination processor in communication with the memory for coordinating delivery of a first therapy and a second therapy by shifting therapy burden from the first therapy or the second therapy to the other of the first therapy or the second therapy based on the one or more parameters.