Stimulation suspension in response to patient discomfort or state

Abstract

Systems and methods are provided for delivering neurostimulation therapies to patients. Stimulation from an implantable medical device (IMD) may be suspended in response to detecting a patient discomfort event, such as a cough, throat irritation, or voice alteration. The suspension period may be based on at least one of a severity level of the patient discomfort event and a patient physical state, such as being asleep or lying down. Detection of a patient discomfort event may be calibrated.

1 - 20 . (canceled) 
     
     
         21 . A method of modifying stimulation delivered to a patient from an implantable neurostimulation device, the method comprising:
 detecting a patient discomfort event;   qualifying the patient discomfort event as being associated with the stimulation; and   in response to qualifying the patient discomfort event as being associated with the stimulation, modifying the stimulation to reduce a severity of the patient discomfort event.   
     
     
         22 . The method of  claim 21 , wherein the patient discomfort event is detected during a stimulation titration process. 
     
     
         23 . The method of  claim 22 , wherein the stimulation titration process includes a first titration period and a second titration period, and modifying the stimulation comprises:
 upon detecting the patient discomfort event during the first titration period, applying a first modification to the stimulation; and   upon detecting the patient discomfort event during the second titration period, applying a second modification to the stimulation, the second modification being different than the first modification.   
     
     
         24 . The method of  claim 22 , wherein the stimulation titration process has a target stimulation intensity and modifying the stimulation is performed based on a proximity of the stimulation titration process to reaching the target stimulation intensity. 
     
     
         25 . The method of  claim 21 , wherein modifying the stimulation comprises suspending the stimulation for a first period of time, and the method further comprises:
 detecting a subsequent patient discomfort event;   qualifying the subsequent patient discomfort event as being associated with the stimulation; and   in response to qualifying the subsequent patient discomfort event as being associated with the stimulation, suspending the stimulation for a second period of time, the second period of time being longer than the first period of time.   
     
     
         26 . The method of  claim 21 , wherein modifying the stimulation is performed based on a body position of the patient. 
     
     
         27 . The method of  claim 21 , wherein qualifying the patient discomfort event comprises determining that the patient discomfort event occurred within a predetermined window of time after the stimulation was initiated. 
     
     
         28 . The method of  claim 27 , wherein the predetermined window of time varies over a stimulation titration process. 
     
     
         29 . The method of  claim 21 , wherein qualifying the patient discomfort event comprises determining that the patient discomfort event is a second patient discomfort event that has been preceded by a first patient discomfort event. 
     
     
         30 . The method of  claim 21 , wherein modifying the stimulation comprises adjusting a stimulation burst ramp up period. 
     
     
         31 . The method of  claim 21 , further comprising:
 quantifying the severity of the patient discomfort event based on a value received from a patient input sensor; and   comparing the quantified severity of the patient discomfort event to a patient discomfort event threshold,   wherein modifying the stimulation is performed based on the comparison between the quantified severity of the patient discomfort event and the patient discomfort event threshold.   
     
     
         32 . The method of  claim 31 , wherein the patient input sensor is at least one of an accelerometer or an acoustic sensor. 
     
     
         33 . An implantable neurostimulation device comprising:
 a sensor;   a processor coupled to the sensor; and   a memory operably coupled to the processor and comprising instructions that, when executed by the processor, cause the processor to:
 detect a patient discomfort event via the sensor; 
 qualify the patient discomfort event as being associated with stimulation delivered from the implantable neurostimulation device; and 
 in response to qualifying the patient discomfort event as being associated with the stimulation, modifying the stimulation to reduce a severity of the patient discomfort event. 
   
     
     
         34 . The device of  claim 33 , wherein modifying the stimulation comprises suspending the stimulation for a first period of time, and the instructions further cause the processor to:
 detect a subsequent patient discomfort event;   qualify the subsequent patient discomfort event as being associated with the stimulation; and   in response to qualifying the subsequent patient discomfort event as being associated with the stimulation, suspend the stimulation for a second period of time, the second period of time being longer than the first period of time.   
     
     
         35 . The device of  claim 33 , wherein modifying the stimulation comprises adjusting a stimulation burst ramp up period. 
     
     
         36 . The device of  claim 33 , wherein qualifying the patient discomfort event comprises determining that the patient discomfort event occurred within a predetermined window of time after the stimulation was initiated. 
     
     
         37 . The device of  claim 33 , wherein the instructions further cause the processor to:
 quantify the severity of the patient discomfort event based on a value received from the sensor; and   compare the quantified severity of the patient discomfort event to a patient discomfort event threshold,   wherein modifying the stimulation is performed based on the comparison between the quantified severity of the patient discomfort event and the patient discomfort event threshold.   
     
     
         38 . A method of modifying stimulation delivered to a patient from an implantable neurostimulation device, the method comprising:
 detecting a patient discomfort event;   qualifying the patient discomfort event as being associated with the stimulation based on a determination that the patient discomfort event occurred within a predetermined window of time after the stimulation was initiated; and   in response to qualifying the patient discomfort event as being associated with the stimulation, modifying the stimulation to reduce a severity of the patient discomfort event.   
     
     
         39 . The method of  claim 38 , wherein the patient discomfort event is detected during a stimulation titration process including a first titration period and a second titration period, and modifying the stimulation comprises:
 upon detecting the patient discomfort event during the first titration period, applying a first modification to the stimulation; and   upon detecting the patient discomfort event during the second titration period, applying a second modification to the stimulation, the second modification being different than the first modification.   
     
     
         40 . The method of  claim 38 , further comprising:
 quantifying the severity of the patient discomfort event based on a value received from a patient input sensor; and   comparing the quantified severity of the patient discomfort event to a patient discomfort event threshold,   wherein modifying the stimulation is performed based on the comparison between the quantified severity of the patient discomfort event and the patient discomfort event threshold.