Methods and apparatuses for performing remote titration of mandibular protrusion

Abstract

Methods and apparatus for performing system validation and providing predictive criteria during remote titration of mandibular protrusion are disclosed herein. The effectiveness of oral appliance therapy can possibly be improved by screening obstructive sleep apnea subjects and prospectively identifying subjects suitable for oral appliance therapy. The methods and apparatus for performing system validation on an oral appliance therapy titration system are disclosed. In addition, methods and apparatus for providing predictive criteria during remote titration of mandibular protrusion are disclosed. Further, methods and apparatus for display results of remote titration of mandibular protrusion are disclosed.

What is claimed: 
     
         1 . An oral appliance titration system, comprising:
 a mandibular protruder;   a drive motor configured to effect relative displacement of the mandibular protruder; and   a controller comprising a processor and a memory, the memory having computer-executable instructions stored thereon that, when executed by the processor, cause the processor to:   command the mandibular protruder to a plurality of positions;   receive an actual physical position of the mandibular protruder at each of the plurality of commanded positions;   compare the actual physical position to an expected position of the mandibular protruder at each of the plurality of commanded positions; and   detect whether the oral appliance titration system is validly operating based on the comparison.   
     
     
         2 . The oral appliance titration system of  claim 1 , wherein comparing the actual physical position to an expected position of the mandibular protruder further comprises calculating a deviation between the actual physical position and a detected feedback position of the mandibular protruder for each of the plurality of commanded positions, and wherein detecting whether the oral appliance titration system is operating validly is based on the calculated deviation for each of the plurality of commanded positions. 
     
     
         3 . The oral appliance titration system of  claim 2 , wherein the detected feedback position is related to calibration data for the drive motor, the calibration data defining a response of the drive motor within a predetermined tolerance. 
     
     
         4 . The oral appliance titration system of  claim 3 , wherein the response of the drive motor is linear, and wherein the calibration data comprises an n-character string defining the linear response of the drive motor. 
     
     
         5 . The oral appliance titration system of  claim 3 , wherein the oral appliance titration system is validly operating when the deviation at each of the plurality of commanded positions is within the predetermined tolerance. 
     
     
         6 . The oral appliance titration system of  claim 5 , wherein the predetermined tolerance is +/−0.5 mm. 
     
     
         7 . The oral appliance titration system of  claim 2 , wherein the actual physical position of the mandibular protruder is determined using a scale on the mandibular protruder. 
     
     
         8 . The oral appliance titration system of  claim 2 , wherein the detected feedback position is related to a detected voltage and calibration data for the drive motor. 
     
     
         9 . The oral appliance titration system of  claim 1 , wherein commanding the mandibular protruder to a plurality of positions further comprises commanding the mandibular protruder to at least three positions. 
     
     
         10 . The oral appliance titration system of  claim 9 , wherein the at least three positions are a fully retruded position of the mandibular protruder, a fully protruded position of the mandibular protruder and a position between the fully retruded and fully protruded positions. 
     
     
         11 . The oral appliance titration system of  claim 3 , wherein the deviation at one or more of the plurality of commanded positions is not within the predetermined tolerance, and wherein the memory has further computer-executable instructions stored thereon that, when executed by the processor, cause the processor to:
 calculate a suggested adjustment for the mandibular protruder;   determine whether the suggested adjustment is within a predetermined range; and   in response to determining that the suggested adjustment is within the predetermined range, adjust an initial position of the mandibular protruder based on the suggested adjustment.   
     
     
         12 . The oral appliance titration system of  claim 11 , wherein the suggested adjustment comprises an average of the deviations for the plurality of commanded positions. 
     
     
         13 . The oral appliance titration system of  claim 11 , wherein the memory has further computer-executable instructions stored thereon that, when executed by the processor, cause the processor to:
 re-command the mandibular protruder to the plurality of commanded positions;   receive an updated actual physical position of the mandibular protruder at each of the plurality of commanded positions;   calculate an updated deviation between the updated actual physical position and an updated detected feedback position of the mandibular protruder for each of the plurality of commanded positions; and   detect whether the oral appliance titration system is validly operating based on the calculated updated deviation for each of the plurality of commanded positions.   
     
     
         14 . The oral appliance titration system of  claim 13 , wherein the oral appliance titration system is validly operating when the updated deviation at each of the plurality of commanded positions is within the predetermined tolerance. 
     
     
         15 . The oral appliance titration system of  claim 11 , wherein the memory has further computer-executable instructions stored thereon that, when executed by the processor, cause the processor to, in response to determining that the suggested adjustment is not within the predetermined range, recommend replacing the mandibular protruder. 
     
     
         16 . The oral appliance titration system of  claim 3 , wherein the deviation at one or more of the plurality of commanded positions is not within the predetermined tolerance, and wherein the memory has further computer-executable instructions stored thereon that, when executed by the processor, cause the processor to:
 calculate a suggested adjustment for the mandibular protruder;   calculate a difference between the deviation at each of the plurality of commanded positions and the suggested adjustment;   determine whether the difference is within a drive motor tolerance range; and   in response to determining that the difference is not within the drive motor tolerance range, recommend replacing the drive motor.   
     
     
         17 . The oral appliance titration system of  claim 16 , wherein the suggested adjustment comprises an average of the deviations for the plurality of commanded positions. 
     
     
         18 . The oral appliance titration system of  claim 5 , wherein the oral appliance titration system further includes a polysomnogram, and wherein the memory has further computer-executable instructions stored thereon that, when executed by the processor, cause the processor to calibrate a channel of the polysomnogram, wherein calibrating the channel of the polysomnogram further comprises:
 receiving an upper limit and a lower limit for the mandibular protruder;   commanding the mandibular protruder to the upper limit and the lower limit;   receiving an actual physical position of the mandibular protruder at each of the upper limit and the lower limit;   calculating a deviation between the actual physical position and a detected feedback position of the mandibular protruder for each of the upper limit and the lower limit; and   determining whether the channel of the polysomnogram is calibrated based on the calculated deviation for each of the upper limit and the lower limit.   
     
     
         19 . The oral appliance titration system of  claim 18 , wherein the channel of the polysomnogram is calibrated when the deviation at each of the upper limit and the lower limit is within the predetermined tolerance. 
     
     
         20 . The oral appliance titration system of  claim 19 , wherein the predetermined tolerance is +/−0.5 mm. 
     
     
         21 . The oral appliance titration system of  claim 19 , wherein the upper limit and the lower limit are patient-specific limits. 
     
     
         22 . The oral appliance titration system of  claim 21 , wherein the upper limit and the lower limit are related to a fully protruded and a fully retruded position of a patient's jaw. 
     
     
         23 . A non-transitory computer-readable recording medium for validating operation of an oral appliance titration system including a mandibular protruder having a drive motor, the non-transitory computer-readable recording medium having computer-executable instructions stored thereon that, when executed by a computing device, cause the computing device to:
 command the mandibular protruder to a plurality of positions;   receive an actual physical position of the mandibular protruder at each of the plurality of commanded positions;   compare the actual physical position to an expected position of the mandibular protruder at each of the plurality of commanded positions; and   detect whether the oral appliance titration system is validly operating based on the comparison.   
     
     
         24 . The non-transitory computer-readable recording medium of  claim 23 , wherein comparing the actual physical position to an expected position of the mandibular protruder further comprises calculating a deviation between the actual physical position and a detected feedback position of the mandibular protruder for each of the plurality of commanded positions, and wherein detecting whether the oral appliance titration system is operating validly is based on the calculated deviation for each of the plurality of commanded positions. 
     
     
         25 . The non-transitory computer-readable recording medium of  claim 24 , wherein the detected feedback position is related to calibration data for the drive motor, the calibration data defining a response of the drive motor within a predetermined tolerance. 
     
     
         26 . The non-transitory computer-readable recording medium of  claim 25 , wherein the oral appliance titration system is validly operating when the deviation at each of the plurality of commanded positions is within the predetermined tolerance. 
     
     
         27 . The non-transitory computer-readable recording medium of  claim 24 , wherein the actual physical position of the mandibular protruder is determined using a scale on the mandibular protruder. 
     
     
         28 . A method for validating operation of an oral appliance titration system including a mandibular protruder having a drive motor, the method comprising:
 commanding the mandibular protruder to a plurality of positions;   receiving an actual physical position of the mandibular protruder at each of the plurality of commanded positions;   comparing the actual physical position to an expected position of the mandibular protruder at each of the plurality of commanded positions; and   detecting whether the oral appliance titration system is validly operating based on the comparison.   
     
     
         29 . The method of  claim 28 , wherein comparing the actual physical position to an expected position of the mandibular protruder further comprises calculating a deviation between the actual physical position and a detected feedback position of the mandibular protruder for each of the plurality of commanded positions, and wherein detecting whether the oral appliance titration system is operating validly is based on the calculated deviation for each of the plurality of commanded positions. 
     
     
         30 . The method of  claim 29 , wherein the detected feedback position is related to calibration data for the drive motor, the calibration data defining a response of the drive motor within a predetermined tolerance. 
     
     
         31 . The method of  claim 30 , wherein the oral appliance titration system is validly operating when the deviation at each of the plurality of commanded positions is within the predetermined tolerance. 
     
     
         32 . The method of  claim 28 , wherein the actual physical position of the mandibular protruder is determined using a scale on the mandibular protruder.