US20100198103A1 - System and method for neural stimulation - Google Patents

System and method for neural stimulation Download PDF

Info

Publication number
US20100198103A1
US20100198103A1 US12/681,799 US68179908A US2010198103A1 US 20100198103 A1 US20100198103 A1 US 20100198103A1 US 68179908 A US68179908 A US 68179908A US 2010198103 A1 US2010198103 A1 US 2010198103A1
Authority
US
United States
Prior art keywords
tissue
stimulus
neural stimulation
electrode
stimulation method
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US12/681,799
Inventor
Paul M. Meadows
Marcelo G. Lima
Stanley R. Craig
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Imthera Medical Inc
Original Assignee
Imthera Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Imthera Medical Inc filed Critical Imthera Medical Inc
Priority to US12/681,799 priority Critical patent/US20100198103A1/en
Assigned to IMTHERA MEDICAL, INC. reassignment IMTHERA MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CRAIG, STANLEY R, LIMA, MARCELO G, MEADOWS, PAUL M
Assigned to IMTHERA MEDICAL, INC. reassignment IMTHERA MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CRAIG, STANLEY R., LIMA, MARCELO G., MEADOWS, PAUL M.
Publication of US20100198103A1 publication Critical patent/US20100198103A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes
    • A61N1/0556Cuff electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/3611Respiration control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/37211Means for communicating with stimulators
    • A61N1/37217Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/375Constructional arrangements, e.g. casings
    • A61N1/37514Brain implants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/378Electrical supply
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/378Electrical supply
    • A61N1/3787Electrical supply from an external energy source
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36071Pain
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128Control systems
    • A61N1/36135Control systems using physiological parameters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/375Constructional arrangements, e.g. casings
    • A61N1/3758Packaging of the components within the casing

Definitions

  • the present invention relates to a system and method for adjusting neural stimulation of a target tissue, such as a nerve, muscle, or organ.
  • Neural stimulation is useful in treating various acute and chronic medical conditions, including pain, arthritis, sleep apnea, seizure, incontinence, and migraines, which are physiological conditions affecting millions of people worldwide.
  • Current treatment options range from drug intervention, non-invasive approaches such as the continuous positive air pressure (CPAP) machine for sleep apnea, to invasive surgical procedures.
  • CPAP continuous positive air pressure
  • patient acceptance and therapy compliance are well below desired levels, rendering current treatments ineffective as long-term solutions.
  • Implants are a promising alternative treatment.
  • vagus nerve stimulation is thought to affect some of its connections to areas in the brain prone to seizure activity.
  • Sacral nerve stimulation is an FDA-approved electronic stimulation therapy for reducing urge incontinence.
  • Stimulation of peripheral nerves may help treat arthritis pain.
  • pharyngeal dilation via hypoglossal nerve (XII) stimulation has been shown to be an effective treatment method for obstructive sleep apnea (OSA).
  • OSA obstructive sleep apnea
  • the nerves are stimulated using an implanted electrode.
  • the medial XII nerve branch i.e., genioglossus
  • has demonstrated significant reductions in upper airway airflow resistance i.e., increased pharyngeal caliber).
  • the present invention includes a system and method for adjusting neural stimulation of a target, such as a nerve, muscle, or organ.
  • the method includes electrically connecting at least one electrode to a first tissue, applying a stimulus to the at least one electrode, observing a response of a second tissue, identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode, and fixing the at least one electrode in place at the identified electrode position.
  • the stimulus applicator is disposable.
  • the stimulus can be a voltage signal, a current signal, and can be preprogrammed.
  • the voltage or current signal is a controlled voltage or a controlled current signal.
  • an estimated minimum stimulus is calculated, and in yet another embodiment a stimulus profile is generated.
  • the stimulated tissue may be selected from the group consisting of nerve tissue, muscle tissue, and organ tissue. Examples of a desired stimulus response include a change in airway patency, at least partial blockage of a neural impulse, and the initiation of at least one neural impulse. A response can be directly or indirectly observed, either visually or with instrumentation.
  • a neural stimulation system in another embodiment, includes at least one electrode electrically connected to a first tissue, means for applying a stimulus to the at least one electrode, means for observing a response of a second tissue, means for identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode, and means for fixing the at least one electrode in place at the identified electrode position.
  • a computer program product comprises a computer readable medium having stored thereon computer executable instructions that, when executed on a computer, causes the computer to perform a method of neural stimulation, including the steps of applying a stimulus to at least one electrode electrically connected to a first tissue, observing a response of a second tissue, and identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode.
  • a neural stimulation system in another embodiment, includes at least one electrode electrically connected to a first tissue, a gross adjustment stimulator coupled to and delivering a stimulus to the at least one electrode, a stimulus measurement subsystem in communication with the gross adjustment stimulator and having at least one sensor, the at least one sensor measuring a response of a second tissue, and a programming subsystem in communication with the stimulus measurement subsystem, the programming subsystem collecting data from the group consisting of stimulus data and tissue response data.
  • FIG. 1 illustrates an exemplary embodiment of a gross adjustment stimulation system
  • FIG. 2 illustrates an exemplary embodiment of an initial gross adjustment method
  • FIG. 3 illustrates an exemplary embodiment of a post-surgical adjustment method.
  • the present invention relates to a gross adjustment stimulation system and methods for adjusting stimulation electrode placement for treating various acute and chronic medical conditions.
  • Conditions treatable with implants include, but are not limited to, arthritis, sleep apnea, seizure, incontinence, and migraine.
  • the exemplary conditions may be treated using, for example, the methods and systems disclosed in U.S. patent application Ser. Nos. 11/707,104 and 11/707,053, both filed Feb. 16, 2007, and herein incorporated by reference in their entireties. Other exemplary methods and systems are described below.
  • Nerves may be electrically stimulated, or recruited, using electrical stimulation pulses of current. Nerves with the lowest threshold axon fibers are recruited first and preferentially. Excitation of the nerve axons by electrical stimulation occurs when nerves close to a stimulating electrode contact have activation thresholds low enough to be excited by the electrode and are depolarized above their threshold membrane voltage.
  • nerve diameter One of the major contributors to this activation threshold is nerve diameter. Due to the electrical cable properties of the nerve, large diameter nerve fibers have a lower excitation threshold than do smaller diameter fibers, and thus are more easily excited. Nerve fibers are more likely to be recruited by an electrical stimulation pulse if they are close to the activating electrode and are of larger diameter than other fibers.
  • Motor nerve excitation is typically performed at very slow stimulation rates or frequencies because of the problem of overdriving the motor units activated, and because the relatively long time constants of muscle activation reduces the need for high frequency stimulation. With every pulse of stimulation delivered to a motor nerve there is a corresponding contraction of the motor units excited. This contraction is controlled by the physical and electrochemical properties of the muscle motor unit and has a much longer time constant than the excitation of the nerve that activates it.
  • One pulse delivered to the motor unit results in a twitch, while bursts of pulses or multiple pulses at the proper frequency produce a fused contraction with little pulsatile characteristics.
  • this fusion or tetanic frequency can be as low as approximately 15 Hz for large muscles or as high as approximately 80 to 100 Hz for smaller muscles.
  • tetanic frequency can be as low as approximately 15 Hz for large muscles or as high as approximately 80 to 100 Hz for smaller muscles.
  • motor nerve stimulation is very slow.
  • multiple electrodes can be multiplexed to single pulse generators. While only one contact is active at a time, multiple muscle groups are essentially driven at the same time using an interlaced stimulation pattern. Since the muscle dynamics are so slow compared to the nerve, the contractions produced appear simultaneous and smooth.
  • Multiple contact systems also allow the activation to be shared by groups of motor units within the same pool to avoid such problems as muscle fatigue, a common problem in electrically stimulated muscle.
  • Multiple contact systems can also co-activate multiple muscle groups to achieve a desired muscle response. In activating the muscles of the hand or forearm, for instance, several contacts may be activated at the same time by delivering interlaced pulses to first one contact and then another, to activate two or more muscle groups that when added result in a force vector in the desired direction.
  • the electrodes still tend to activate the nerve fibers closest to the electrode. In that sense, they are not selective, and are constrained to activate only those neurons that are closest to the contact. To compensate for this inability to truly selectively activate the optimal pool of neurons, some stimulation systems depend upon sensors to apply stimulation at optimal times so that the desired response may still be achieved. In order to activate a selected pool of neurons located somewhere between two contacts, but that represent the only pool of neurons desired, it is desirable to use a stimulator that can deliver coincident independently controlled stimulation pulses, rather than a stimulator delivering multiplexed sequential pulses.
  • the system can simultaneously deliver currents to each contact.
  • these currents are independently controlled.
  • the system can control these currents so that they are at sub-threshold levels (i.e., below the nerve's recruitment level) for the fibers adjacent to the contact. While the fields around each contact are below the nerve's recruitment or threshold level, the fields can combine with fields from other concurrently energized electrodes to create pulses strong enough to activate a desired nerve.
  • nerve populations that do not lie directly under a stimulation electrode contact can be preferentially and selectively activated. Since the nerves can be selectively activated, sensors are not needed to help time the stimulation delivery to achieve the desired results.
  • sensors can be used to improve stimulus timing and delivery.
  • the sensors can be used in a closed-loop system, a triggered open loop, an open loop system, or some combination of the three.
  • the methods and systems used in conjunction with the present invention can be used to treat a number of conditions by stimulating nerves associated with treating a condition.
  • Stimulation can be such that the stimulus is transmitted by a nerve by activating excitatory pathways, or stimulation can be such that nerve transmission in a nerve is blocked by activating inhibitory pathways.
  • the nerve is the sacral nerve.
  • the nerve is the Vagus nerve.
  • the nerve is a peripheral nerve.
  • the target tissue can be a muscle, including muscles from the head and neck, the torso, the upper limbs and the lower limbs.
  • the target tissue can also be an organ of the body, for example, kidney, liver, lung, brain, skin, ovaries, intestines, arteries and veins, lymph nodes, bones, or joints.
  • the HGN is composed of multiple nerve fibers, each of which controls one or more tongue muscles. In certain treatments, the selected HGN nerve fibers are stimulated in order to cause movement of selected tongue muscles.
  • the invention below describes a gross adjustment stimulation system and method of placing electrodes on a target tissue to produce a desired stimulus response.
  • FIG. 1 shows an exemplary embodiment of a gross adjustment stimulation system 100 .
  • the system has at least one electrode 110 , a gross adjustment stimulator 120 , a stimulus measurement subsystem 130 , and a programming subsystem 140 . Each is described below.
  • the gross adjustment stimulator 120 is configured to produce the stimulus that will be sent to at least one implanted electrode 110 .
  • the gross adjustment stimulator 120 stimulates the implanted electrode 110 in a manner equivalent to the device to be implanted (e.g., an implantable pulse generator).
  • an electrode 110 may be a single electrode, multiple electrodes, or at least one electrode array.
  • Examples of electrodes and gross adjustment stimulators include, but are not limited to, the electrodes and implantable pulse generators described in U.S. Patent Application Nos. 60/978,519 and 61/017,614 and 61/136,102, filed on Oct. 9, 2007 and Dec. 29, 2007 and Aug. 12, 2008 respectively, which are incorporated by reference herein in their entirety.
  • the gross adjustment stimulator 120 allows the physician, physician's assistant, or technician (herein generically referred to as a physician) to start and stop stimulation, and interrogate the stimulus measurement subsystem 130 for information on proper function. In certain exemplary embodiments, the gross adjustment stimulator 120 also allows the patient to direct the system to perform these functions. In certain embodiments, the gross adjustment stimulator 120 displays the status of a communication and power link to the stimulator and status of any external controller (not shown) if, for example, the gross adjustment stimulator is used with an IPG (not shown) having an external controller.
  • the physician or patient may also choose operating modes for the stimulator, such as a sleep mode for when the patient intends to go to sleep, an exercise mode for when the patient engages in above normal levels of physical activity, and other alternative operating modes that the patient or physician may program.
  • the physician or patient may also adjust levels of stimulation using the gross adjustment stimulator 120 .
  • the gross adjustment stimulator 120 stimulation is a controlled voltage or controlled current signal, which may be preprogrammed. In certain embodiments, the gross adjustment stimulator 120 is powered and/or controlled by an RF or other wireless signal. In certain embodiments, gross adjustment stimulator 120 sends stimulation in the form of one or more stimulus signals to at least one electrode 110 . In other embodiments, the stimulation could be sent to at least two electrodes 110 , or an array of electrodes 110 . In other embodiments the stimulator sends continuous or near continuous stimulation to the electrode 110 for at least a portion of the implant procedure. Non-limiting examples include one or more pulses, a pulse train, a sinusoid, a constant source signal, or other controlled stimulation forms known to those skilled in the art. Thus, stimulation of the target tissue and its effects on a response tissue can be controlled based on patient needs, and is not limited to a particular waveform.
  • gross adjustment stimulator 120 may optionally include a crypto block (not shown).
  • a crypto block is useful in coding unique signals for only the desired electrodes 110 , without interfering with other electrodes controlled by another stimulator 120 .
  • the crypto block creates a unique signal that will interface with only the desired electrode or electrodes 110 .
  • gross adjustment stimulator 120 may also include a data storage unit and/or a recording unit (not shown) to store and/or record data, respectively.
  • the gross adjustment stimulator 120 may also include a computer interface (a wireless link, USB port, serial port, or fire wire, for example) to collect or transfer data to an external system.
  • the gross adjustment stimulator 120 is disposable.
  • the stimulus measurement subsystem 130 measures a target tissue's response to applied stimulus.
  • stimulus comes from one or more implanted electrodes 110 , which receive stimulus from the gross adjustment stimulator 120 .
  • Stimulus responses can be measured directly, indirectly, or some combination of the two. Measurements can be taken using sensors integrated with the implant, external to the implant, or some combination of the two. Direct and indirect sensing, and integrated and external sensors are discussed below.
  • Direct measurement is the measurement of one or more factors directly influencing airway patency.
  • Factors directly influencing airway patency include, but are not limited to, oral cavity size, tongue protrusion or muscle tone, and respiration airflow (i.e. airway airflow).
  • respiration airflow i.e. airway airflow
  • Oral cavity size for example, can be measured using acoustic pharyngometry.
  • Tongue protrusion or muscle tone can be measured using, for example, one or more of a proximity sensor, accelerometer, or pressure sensor.
  • the sensors may be in the mouth, ear, neck, or other suitable location known to those skilled in the art.
  • Tongue protrusion or muscle tone may also be measured with a soft tissue imaging device utilizing photography, ultrasonography or other imaging modalities known to those skilled in the art. Still other ways include observation with an endoscope, or applying a fluorescent dye pattern to the tongue surface and illuminating it using an ultraviolet or fluorescent light source.
  • Respiration airflow may be measured mechanically, electrically, with electromechanical sensors, or some combination of the above.
  • One way is to use a nasal canula or a thermistor.
  • Other ways include a respiration transducer involving thermocouples, piezo thermal sensors, pressure and differential pressure sensors, or other flow sensors known to those skilled in the art.
  • Respiration airflow may also be measured by a pneumotachograph or a respiratory inductance plethysmograph. These ways are exemplary only, and not limited to what is discussed. Other ways known to those skilled in the art may be used without departing from the scope of the invention.
  • Indirect measurement is the measurement of one or more indicators influenced by airway patency.
  • Exemplary indicators include, but are not limited to blood oxygen level, blood pressure, heart rate, torso motion (to sense, for example, relative breathing ease), and snoring. Many different sensors can measure these indirect indictors. Indirect measurements can be made using, for example, peripheral arterial tonometry.
  • blood oxygen level may be measured an oxygen sensor, pulse oximetry, an infrared (IR) sensor, or an earlobe monitoring unit.
  • Snoring can be measured using, for example, a differential pressure sensor, a vibration sensor, or a microphone. Snoring can also be detected using a nasal canula.
  • the sensor or sensors that input data to the stimulus measurement subsystem 130 may be internal to an electrode 110 or array of electrodes 110 , the gross adjustment stimulator 120 or IPG (not shown). In other exemplary embodiments, the sensor or sensors may be external to the electrode 110 or array of electrodes 110 , gross adjustment stimulator 120 , or IPG (not shown).
  • at least one internal sensor is a MEMS device, such as a pressure sensor or accelerometer. In another embodiment, at least one internal sensor is an electrical sensor capable of recording a change related to changes in muscle tone.
  • Sensor information may be retrieved in real time over a bidirectional link, (an RF or other wireless link known to those skilled in the art, for example) or through use of an interface placed below the surface of the skin.
  • the sensors are external to the electrode 110 or IPG, but still internal to the patient.
  • external sensors may be located in the ear, the nasal passage, the throat, or other measurement points known to those skilled in the art.
  • External sensors may also be located external to the patient in, for example, a medical facility, a laboratory, or a patient's home.
  • a programming subsystem 140 collects data on the stimulus applied during gross adjustment.
  • the programming subsystem 140 may also contain preprogrammed stimulus data, which may be used to apply stimulus to the at least one electrode 110 .
  • the programming subsystem 140 collects data on the stimulus response, (tissue response, for example) and in still other exemplary embodiments the programming subsystem collects data on both the applied stimulus and the stimulus response. This data can then be used to program user specific stimulus patterns to open the airway and decrease sleep disordered breathing/obstructive sleep apnea for download to hypoglossal nerve(s) implants.
  • At least one sensor collects data that protruder muscles a, c, and f are not affected by a given stimulus, but flattening muscles b, d, and e are stimulated when nerve fibers x, y, and z are stimulated at a frequency of n Hz.
  • sensor information is stored in a sensor memory (not shown) in the stimulus measurement subsystem 130 .
  • the measured data is passed to or obtained by the programming subsystem 140 , where it is be recorded and correlated with the applied stimulus patterns.
  • Sensed information data may also be passed directly to the programming subsystem 140 .
  • the programming subsystem 140 Once the data are collected and correlated, the programming subsystem 140 generates a stimulus profile based on the obtained information.
  • the stimulus profile may be downloaded into an IPG (not shown) or gross adjustment stimulator 120 .
  • the signals from these sensors can be correlated by direct observation (by a physician, patient, or other user, for example), or can be digitized and analyzed via software algorithms to create a stimulus profile. This profile can be used to apply a stimulus that generates a desired response in the targeted tissue.
  • software in the programming subsystem 140 generates an algorithm to suggest electrode combinations and stimulus levels to elicit the desired stimulus response.
  • FIG. 2 illustrates an exemplary embodiment of an initial gross adjustment method 200 .
  • at least one electrode 110 is placed in an initial position on or near the target tissue at step 210 .
  • the electrode 110 need not be physically connected to or touching the target tissue.
  • the electrode 110 only needs to be close enough to the target tissue to make an electrical connection with the tissue.
  • the target tissue may be a nerve, a muscle, or an organ of a patient's body. In certain embodiments the target tissue is the hypoglossal nerve.
  • at least one stimulus is applied to at least one electrode 110 .
  • Stimulus may be chosen manually, or it may be preprogrammed.
  • stimulus is applied by the gross adjustment stimulator 120 , but in other embodiments stimulus can be applied from another source.
  • the gross adjustment stimulator 120 is acceptable for use in an operating room environment. Exemplary guidelines for devices acceptable for use in an operating room environment are described in Draft Guidance for Industry and FDA Staff Radio - Frequency Wireless Technology in Medical Devices , released for comment on Jan. 3, 2007, which is hereby incorporated by reference in its entirety. Stimulators configured for wireless use in an operating room need not operate wirelessly, but can if desired.
  • Varying stimulus patterns involving permutations of electrode contacts, delivering stimulus of varying current amplitude, duration, and/or frequency are applied to at least one electrode 110 .
  • these varying stimulus patterns are applied under the control of a physician or technician, and may be preprogrammed.
  • These varying stimulus patterns have different effects on the nerve fibers that control tongue position, muscle tone, and size and patency of the retrolingual airway.
  • stimulus is applied independently to each targeted nerve fiber population of interest.
  • the electrode position, applied stimulus, and stimulus response are recorded to help identify the location of the electrode on the nerve that provides optimal stimulation.
  • Different levels of stimulation of the nerve fibers are applied to identify the minimum stimulus required to elicit the appropriate muscle movement required to alleviate the symptoms of the physiological condition.
  • Different levels of stimulation often elicit different responses depending on the muscle responding and depending on the different nerve or nerve fibers to be stimulated.
  • Exemplary stimulation patterns are known in the art, or taught in U.S. patent application Ser. Nos. 11/707,104 and 11/707,053.
  • the stimulation applied in step 220 can be in many forms. While stimulation may be applied at high frequencies, lowering the stimulation frequency to the lowest required for a smooth, tetanic, and comfortable contraction, for example, reduces overall power consumption and helps reduce muscle fatigue elicited by electrical stimulation. Stimulation may also be delivered as a single pulse, a burst of pulses, or multiple pulses at one or more frequencies. Each frequency can be as low as approximately 15 Hz for large targeted muscles or as high as approximately 80 to 100 Hz for smaller muscles. In other embodiments, Stimulation frequency is adjustable from a low of 1 Hz to a maximum of 100 Hz. Alternatively, stimulation is multiplexed, and in still other embodiments stimulation is delivered in coincident pulses.
  • Stimulation may be delivered to several contacts (not shown) on an electrode 110 , or stimulation may be sequentially applied by delivering interlaced pulses to one contact and then another, to create multiple electric fields that when added result in a force vector in the desired direction to stimulate the target tissue with the desired stimulation level.
  • a desired response is a blocking of a neural impulse (for example by activating an inhibitory pathway).
  • a desired response is a change in airway patency. Changes in airway patency, either directly or indirectly, are observed during or after stimulus is applied. Checking for a desired stimulus response helps determine which combinations of contacts and current patterns are most desirable. Stimulus parameters can then be adjusted according to the severity of the apnea.
  • the stimulus response may be measured using the stimulus measurement subsystem 130 , by other electronic means, such as a computer or other instrumentation, or even visual observation. These measurements can be direct or indirect.
  • the stimulus measurement subsystem 130 and measurement means are described elsewhere in this application and are not repeated here.
  • the gross adjustment stimulator 120 applies stimulus to at least one electrode 110 , and the physician checks to see if a desired stimulus response (e.g., tongue movement changes in airway patency) is achieved 230 . In certain embodiments, this helps determine which combinations of contacts and current patterns are desirable for a patient.
  • a desired response is at least partial blockage of a neural impulse, and in other exemplary embodiments a desired response is the initiation of a neural impulse.
  • Stimulus patterns producing a desired response may then be stored in the implant, patient control device, a secure archive, or the programming subsystem 140 . This stimulus may be selected by the physician, or it may be preprogrammed.
  • the physician decides at step 240 whether to apply additional stimulus. If the physician chooses to apply additional stimulus 240 , the physician repeats step 220 with the desired stimulus pattern(s). Alternatively, or in addition to step 240 , the physician decides at step 250 whether electrode repositioning is desirable. If repositioning is chosen, the physician chooses a new position by, for example, shifting at least one electrode 110 along a target tissue, and beginning at step 210 .
  • the physician decides at step 260 whether an acceptable outcome was achieved with the stimulus applied to the electrode in its current position. If so, the physician fixes the electrode in place at step 270 . If not, the physician removes the electrode at step 280 .
  • the electrode may be fixed in place using surgical means, such as sutures, glue, fasteners, or other means known to those skilled in the art.
  • the method may be performed with additional stimulus electrodes 110 , and may be performed with an array of electrodes 110 . The steps need not be performed in the order shown, nor do they all need to be performed. The method is exemplary only, and not limited to what is described.
  • Post-surgical adjustment may begin once the wound heals. Once the patient and wound have healed, the physician begins implant programming to maximize the nighttime retrolingual or pharyngeal airway.
  • Programming may include a range of stimulation values, a programmable delay between switching the implant on and stimulus commencing, a ramp in stimulus intensity over time, and an automatic shut down after a preset interval.
  • Programming may be downloaded to the implant via a wireless link, both for initial trials and for a final stimulus program for use by the patient, or it may be downloaded in USB, serial, or other connection.
  • Programming parameters may include the full range of stimulation values as well as a programmable delay between switching the implant on and stimulus commencing, a ramp in stimulus intensity over time, and an automatic shut down after a predetermined interval.
  • the IPG itself may be used to generate the signals and stimulation patterns used during gross adjustment.
  • FIG. 3 illustrates an exemplary embodiment of a post-surgical adjustment method 300 .
  • electrode stimulation is applied while the patient is awake and the upper respiratory tract (URT) is open.
  • UTR upper respiratory tract
  • tongue position is measured in response to the applied stimulus.
  • tongue position is measured with a tongue protrusion calibration device. The device is placed at the anterior of the mouth and held in place by the teeth, or lips, or other method.
  • the tongue protrusion device is configured to measure anterior tongue thrust using, for example, a pressure sensor.
  • the patient is asked at step 330 to evaluate the relative comfort of the tongue position in response to stimulation. If a desired stimulus response is not obtained, steps 310 - 330 may be repeated with another stimulus.
  • the physician evaluates whether a stimulus response is desirable. When a desired stimulus response is obtained (i.e. a stimulus that produces an open airway or change in airway patency without causing discomfort to the patient), the stimulus program is saved at step 350 for later use. Stimulus may be programmed by a physician, a physician's assistant, a technician, or even the patient.
  • Another exemplary post-surgical adjustment method is to record the level of nerve activity present when the tongue has normal daytime tone using, for example, an electroneurogram sensor.
  • the signals from the target tissue e.g., the hypoglossal nerve
  • This recording can be during the patient's normal daytime routine, or it can be done while the patient is in a laboratory or medical facility.
  • This information collected from electroneurogram sensor is used to prepare a stimulus program that mimics the daytime nerve signals to be used during while the patient sleeps to treat obstructive sleep apnea.
  • the use of an electroneurogram sensor is exemplary only. Other sensors known to those skilled in the art could also be used to obtain the information above to create a desired stimulus program without departing from the scope of the invention.
  • Yet another approach or exemplary method is to program the HGN implant(s) in a laboratory, using a stimulation protocol that minimizes URT obstruction, snoring, and apneic and or hypopneic events observed in the laboratory, in order to maximize the URT patency.
  • Programming may be downloaded to the implant via the RF link, both for initial trials and for a final stimulus program for use by the patient.

Abstract

A system and method of neural stimulation is disclosed, comprising the steps of electrically connecting at least one electrode to a first tissue, applying a stimulus to the at least one electrode, observing a response of a second tissue, identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode, and fixing the at least one electrode in place at the identified electrode position.

Description

  • This application claims the benefit of U.S. Patent Application Nos. 60/978,519 and 61/017,614 and 61/136,102, filed on Oct. 9, 2007 and Dec. 29, 2007 and Aug. 12, 2008 respectively, which are herein incorporated by reference in their entirety.
  • STATEMENT OF RELATED APPLICATION
  • This application is related to International Patent Application [Docket No. 069737-5005-WO], which also claims the benefit of U.S. Patent Application Nos. 60/978,519 and 61/017,614 and 61/136,102.
  • FIELD OF THE INVENTION
  • The present invention relates to a system and method for adjusting neural stimulation of a target tissue, such as a nerve, muscle, or organ.
  • BACKGROUND OF INVENTION
  • Neural stimulation is useful in treating various acute and chronic medical conditions, including pain, arthritis, sleep apnea, seizure, incontinence, and migraines, which are physiological conditions affecting millions of people worldwide. Current treatment options range from drug intervention, non-invasive approaches such as the continuous positive air pressure (CPAP) machine for sleep apnea, to invasive surgical procedures. In many instances, patient acceptance and therapy compliance are well below desired levels, rendering current treatments ineffective as long-term solutions.
  • Implants are a promising alternative treatment. For example, vagus nerve stimulation is thought to affect some of its connections to areas in the brain prone to seizure activity. Sacral nerve stimulation is an FDA-approved electronic stimulation therapy for reducing urge incontinence. Stimulation of peripheral nerves may help treat arthritis pain. As another example, pharyngeal dilation via hypoglossal nerve (XII) stimulation has been shown to be an effective treatment method for obstructive sleep apnea (OSA). The nerves are stimulated using an implanted electrode. In particular, the medial XII nerve branch (i.e., genioglossus), has demonstrated significant reductions in upper airway airflow resistance (i.e., increased pharyngeal caliber).
  • While electrical stimulation of nerves has been experimentally shown to remove or ameliorate certain conditions, e.g., obstructions in the upper airway in the case of sleep apnea, current implementation methods typically require accurate and selective stimulation of a target tissue. Therefore, a need exists for a system and method for identifying an optimal location on a target tissue, e.g., a muscle or nerve, and placing an implant electrode at such location to achieve optimal stimulation of such target tissue.
  • SUMMARY OF INVENTION
  • The present invention includes a system and method for adjusting neural stimulation of a target, such as a nerve, muscle, or organ. In an embodiment of the invention, the method includes electrically connecting at least one electrode to a first tissue, applying a stimulus to the at least one electrode, observing a response of a second tissue, identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode, and fixing the at least one electrode in place at the identified electrode position. In certain embodiments, the stimulus applicator is disposable.
  • The stimulus can be a voltage signal, a current signal, and can be preprogrammed. In certain embodiments, the voltage or current signal is a controlled voltage or a controlled current signal. In other embodiments, an estimated minimum stimulus is calculated, and in yet another embodiment a stimulus profile is generated. The stimulated tissue may be selected from the group consisting of nerve tissue, muscle tissue, and organ tissue. Examples of a desired stimulus response include a change in airway patency, at least partial blockage of a neural impulse, and the initiation of at least one neural impulse. A response can be directly or indirectly observed, either visually or with instrumentation.
  • In another embodiment of the invention, a neural stimulation system includes at least one electrode electrically connected to a first tissue, means for applying a stimulus to the at least one electrode, means for observing a response of a second tissue, means for identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode, and means for fixing the at least one electrode in place at the identified electrode position.
  • In still another embodiment of the invention, a computer program product comprises a computer readable medium having stored thereon computer executable instructions that, when executed on a computer, causes the computer to perform a method of neural stimulation, including the steps of applying a stimulus to at least one electrode electrically connected to a first tissue, observing a response of a second tissue, and identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode.
  • In another embodiment of the invention, a neural stimulation system includes at least one electrode electrically connected to a first tissue, a gross adjustment stimulator coupled to and delivering a stimulus to the at least one electrode, a stimulus measurement subsystem in communication with the gross adjustment stimulator and having at least one sensor, the at least one sensor measuring a response of a second tissue, and a programming subsystem in communication with the stimulus measurement subsystem, the programming subsystem collecting data from the group consisting of stimulus data and tissue response data.
  • It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention. In the drawings:
  • FIG. 1 illustrates an exemplary embodiment of a gross adjustment stimulation system;
  • FIG. 2 illustrates an exemplary embodiment of an initial gross adjustment method; and
  • FIG. 3 illustrates an exemplary embodiment of a post-surgical adjustment method.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The present invention relates to a gross adjustment stimulation system and methods for adjusting stimulation electrode placement for treating various acute and chronic medical conditions. Conditions treatable with implants include, but are not limited to, arthritis, sleep apnea, seizure, incontinence, and migraine. The exemplary conditions may be treated using, for example, the methods and systems disclosed in U.S. patent application Ser. Nos. 11/707,104 and 11/707,053, both filed Feb. 16, 2007, and herein incorporated by reference in their entireties. Other exemplary methods and systems are described below.
  • I. Electrical Stimulation and Neural Recruitment
  • Electrical stimulation has been successfully applied to activate both peripheral sensory and motor nerves, as well as the sensory and motor nerves making up the central nervous system, (e.g., the spinal cord and the brain). Generally, electrical stimulation used to cause activation in a nerve follows several simple rules, which are described below.
  • (a) Nerves closest to an activating cathodal contact are activated (recruited) before their more distant neighbors;
  • (b) Nerves with greater fiber diameters are recruited before nerves with narrow fibers; and
  • (c) Nerve recruitment is directly proportional to the amount of current delivered.
  • Nerves may be electrically stimulated, or recruited, using electrical stimulation pulses of current. Nerves with the lowest threshold axon fibers are recruited first and preferentially. Excitation of the nerve axons by electrical stimulation occurs when nerves close to a stimulating electrode contact have activation thresholds low enough to be excited by the electrode and are depolarized above their threshold membrane voltage.
  • One of the major contributors to this activation threshold is nerve diameter. Due to the electrical cable properties of the nerve, large diameter nerve fibers have a lower excitation threshold than do smaller diameter fibers, and thus are more easily excited. Nerve fibers are more likely to be recruited by an electrical stimulation pulse if they are close to the activating electrode and are of larger diameter than other fibers.
  • Motor nerve excitation is typically performed at very slow stimulation rates or frequencies because of the problem of overdriving the motor units activated, and because the relatively long time constants of muscle activation reduces the need for high frequency stimulation. With every pulse of stimulation delivered to a motor nerve there is a corresponding contraction of the motor units excited. This contraction is controlled by the physical and electrochemical properties of the muscle motor unit and has a much longer time constant than the excitation of the nerve that activates it. One pulse delivered to the motor unit results in a twitch, while bursts of pulses or multiple pulses at the proper frequency produce a fused contraction with little pulsatile characteristics. Depending upon the muscle group, this fusion or tetanic frequency can be as low as approximately 15 Hz for large muscles or as high as approximately 80 to 100 Hz for smaller muscles. Compared to sensory nerve applications, such as cochlear implant stimulation where stimulation frequencies can be many thousands of Hz, motor nerve stimulation is very slow.
  • Since the frequencies for motor nerve excitation are quite low, multiple electrodes can be multiplexed to single pulse generators. While only one contact is active at a time, multiple muscle groups are essentially driven at the same time using an interlaced stimulation pattern. Since the muscle dynamics are so slow compared to the nerve, the contractions produced appear simultaneous and smooth.
  • Multiple contact systems also allow the activation to be shared by groups of motor units within the same pool to avoid such problems as muscle fatigue, a common problem in electrically stimulated muscle. Multiple contact systems can also co-activate multiple muscle groups to achieve a desired muscle response. In activating the muscles of the hand or forearm, for instance, several contacts may be activated at the same time by delivering interlaced pulses to first one contact and then another, to activate two or more muscle groups that when added result in a force vector in the desired direction.
  • Even with a multiplexed multiple contact system however, the electrodes still tend to activate the nerve fibers closest to the electrode. In that sense, they are not selective, and are constrained to activate only those neurons that are closest to the contact. To compensate for this inability to truly selectively activate the optimal pool of neurons, some stimulation systems depend upon sensors to apply stimulation at optimal times so that the desired response may still be achieved. In order to activate a selected pool of neurons located somewhere between two contacts, but that represent the only pool of neurons desired, it is desirable to use a stimulator that can deliver coincident independently controlled stimulation pulses, rather than a stimulator delivering multiplexed sequential pulses.
  • With a stimulator that delivers coincident stimulation pulses, the system can simultaneously deliver currents to each contact. In certain embodiments, these currents are independently controlled. The system can control these currents so that they are at sub-threshold levels (i.e., below the nerve's recruitment level) for the fibers adjacent to the contact. While the fields around each contact are below the nerve's recruitment or threshold level, the fields can combine with fields from other concurrently energized electrodes to create pulses strong enough to activate a desired nerve. Thus, nerve populations that do not lie directly under a stimulation electrode contact can be preferentially and selectively activated. Since the nerves can be selectively activated, sensors are not needed to help time the stimulation delivery to achieve the desired results.
  • With selective stimulation and a multiple independent current source system and site specific multiple contact electrodes design, in combination with patient specific stimulus programming, only those portions of the nerve fiber or fibers responsible for non-timing dependent activation are recruited and activated, providing the opportunity for a successful open-loop stimulation application. If desired, sensors can be used to improve stimulus timing and delivery. The sensors can be used in a closed-loop system, a triggered open loop, an open loop system, or some combination of the three.
  • A. Sample Conditions Treatable With Implants
  • The methods and systems used in conjunction with the present invention can be used to treat a number of conditions by stimulating nerves associated with treating a condition. Stimulation can be such that the stimulus is transmitted by a nerve by activating excitatory pathways, or stimulation can be such that nerve transmission in a nerve is blocked by activating inhibitory pathways. In an exemplary embodiment, the nerve is the sacral nerve. In another embodiment, the nerve is the Vagus nerve. In yet another embodiment, the nerve is a peripheral nerve. Alternatively, the target tissue can be a muscle, including muscles from the head and neck, the torso, the upper limbs and the lower limbs. The target tissue can also be an organ of the body, for example, kidney, liver, lung, brain, skin, ovaries, intestines, arteries and veins, lymph nodes, bones, or joints.
  • B. Exemplary Embodiment Obstructive Sleep Apnea
  • The HGN is composed of multiple nerve fibers, each of which controls one or more tongue muscles. In certain treatments, the selected HGN nerve fibers are stimulated in order to cause movement of selected tongue muscles. The invention below describes a gross adjustment stimulation system and method of placing electrodes on a target tissue to produce a desired stimulus response.
  • II. Gross Adjustment Stimulation System
  • FIG. 1 shows an exemplary embodiment of a gross adjustment stimulation system 100. The system has at least one electrode 110, a gross adjustment stimulator 120, a stimulus measurement subsystem 130, and a programming subsystem 140. Each is described below.
  • A. Gross Adjustment Stimulator
  • In the exemplary embodiment shown in FIG. 1, the gross adjustment stimulator 120 is configured to produce the stimulus that will be sent to at least one implanted electrode 110. The gross adjustment stimulator 120 stimulates the implanted electrode 110 in a manner equivalent to the device to be implanted (e.g., an implantable pulse generator). As described herein, an electrode 110 may be a single electrode, multiple electrodes, or at least one electrode array. Examples of electrodes and gross adjustment stimulators include, but are not limited to, the electrodes and implantable pulse generators described in U.S. Patent Application Nos. 60/978,519 and 61/017,614 and 61/136,102, filed on Oct. 9, 2007 and Dec. 29, 2007 and Aug. 12, 2008 respectively, which are incorporated by reference herein in their entirety.
  • In certain embodiments, the gross adjustment stimulator 120 allows the physician, physician's assistant, or technician (herein generically referred to as a physician) to start and stop stimulation, and interrogate the stimulus measurement subsystem 130 for information on proper function. In certain exemplary embodiments, the gross adjustment stimulator 120 also allows the patient to direct the system to perform these functions. In certain embodiments, the gross adjustment stimulator 120 displays the status of a communication and power link to the stimulator and status of any external controller (not shown) if, for example, the gross adjustment stimulator is used with an IPG (not shown) having an external controller. In certain embodiments, the physician or patient may also choose operating modes for the stimulator, such as a sleep mode for when the patient intends to go to sleep, an exercise mode for when the patient engages in above normal levels of physical activity, and other alternative operating modes that the patient or physician may program. In certain embodiments, the physician or patient may also adjust levels of stimulation using the gross adjustment stimulator 120.
  • In certain exemplary embodiments, the gross adjustment stimulator 120 stimulation is a controlled voltage or controlled current signal, which may be preprogrammed. In certain embodiments, the gross adjustment stimulator 120 is powered and/or controlled by an RF or other wireless signal. In certain embodiments, gross adjustment stimulator 120 sends stimulation in the form of one or more stimulus signals to at least one electrode 110. In other embodiments, the stimulation could be sent to at least two electrodes 110, or an array of electrodes 110. In other embodiments the stimulator sends continuous or near continuous stimulation to the electrode 110 for at least a portion of the implant procedure. Non-limiting examples include one or more pulses, a pulse train, a sinusoid, a constant source signal, or other controlled stimulation forms known to those skilled in the art. Thus, stimulation of the target tissue and its effects on a response tissue can be controlled based on patient needs, and is not limited to a particular waveform.
  • In an embodiment of the invention, gross adjustment stimulator 120 may optionally include a crypto block (not shown). A crypto block is useful in coding unique signals for only the desired electrodes 110, without interfering with other electrodes controlled by another stimulator 120. Thus, where there are two or more gross adjustment stimulators 120 in the same vicinity, the crypto block creates a unique signal that will interface with only the desired electrode or electrodes 110.
  • In another embodiment, gross adjustment stimulator 120 may also include a data storage unit and/or a recording unit (not shown) to store and/or record data, respectively. The gross adjustment stimulator 120 may also include a computer interface (a wireless link, USB port, serial port, or fire wire, for example) to collect or transfer data to an external system. In certain embodiments, the gross adjustment stimulator 120 is disposable.
  • B. Stimulus Measurement Subsystem
  • In the exemplary embodiment shown in FIG. 1, the stimulus measurement subsystem 130 measures a target tissue's response to applied stimulus. In certain embodiments, stimulus comes from one or more implanted electrodes 110, which receive stimulus from the gross adjustment stimulator 120. Stimulus responses can be measured directly, indirectly, or some combination of the two. Measurements can be taken using sensors integrated with the implant, external to the implant, or some combination of the two. Direct and indirect sensing, and integrated and external sensors are discussed below.
  • 1. Direct Measurement
  • Direct measurement is the measurement of one or more factors directly influencing airway patency. Factors directly influencing airway patency include, but are not limited to, oral cavity size, tongue protrusion or muscle tone, and respiration airflow (i.e. airway airflow). There are many different ways to measure these factors. These factors may be visually measured, or they can be measured using mechanical, electrical, or electromechanical sensors. Oral cavity size, for example, can be measured using acoustic pharyngometry. Tongue protrusion or muscle tone can be measured using, for example, one or more of a proximity sensor, accelerometer, or pressure sensor. The sensors may be in the mouth, ear, neck, or other suitable location known to those skilled in the art. Tongue protrusion or muscle tone may also be measured with a soft tissue imaging device utilizing photography, ultrasonography or other imaging modalities known to those skilled in the art. Still other ways include observation with an endoscope, or applying a fluorescent dye pattern to the tongue surface and illuminating it using an ultraviolet or fluorescent light source.
  • Respiration airflow may be measured mechanically, electrically, with electromechanical sensors, or some combination of the above. One way is to use a nasal canula or a thermistor. Other ways include a respiration transducer involving thermocouples, piezo thermal sensors, pressure and differential pressure sensors, or other flow sensors known to those skilled in the art. Respiration airflow may also be measured by a pneumotachograph or a respiratory inductance plethysmograph. These ways are exemplary only, and not limited to what is discussed. Other ways known to those skilled in the art may be used without departing from the scope of the invention.
  • 2. Indirect Measurement
  • Indirect measurement is the measurement of one or more indicators influenced by airway patency. Exemplary indicators include, but are not limited to blood oxygen level, blood pressure, heart rate, torso motion (to sense, for example, relative breathing ease), and snoring. Many different sensors can measure these indirect indictors. Indirect measurements can be made using, for example, peripheral arterial tonometry. In other examples, blood oxygen level may be measured an oxygen sensor, pulse oximetry, an infrared (IR) sensor, or an earlobe monitoring unit. Snoring can be measured using, for example, a differential pressure sensor, a vibration sensor, or a microphone. Snoring can also be detected using a nasal canula.
  • 3. Sensors
  • The ability to sense and measure airway patency, directly or indirectly, increases the ease and accuracy of evaluating patient response to the stimulus patterns. In the exemplary embodiment shown in FIG. 1, the sensor or sensors that input data to the stimulus measurement subsystem 130 may be internal to an electrode 110 or array of electrodes 110, the gross adjustment stimulator 120 or IPG (not shown). In other exemplary embodiments, the sensor or sensors may be external to the electrode 110 or array of electrodes 110, gross adjustment stimulator 120, or IPG (not shown). In certain embodiments, at least one internal sensor is a MEMS device, such as a pressure sensor or accelerometer. In another embodiment, at least one internal sensor is an electrical sensor capable of recording a change related to changes in muscle tone. Sensor information (from internal and/or external sensors for example) may be retrieved in real time over a bidirectional link, (an RF or other wireless link known to those skilled in the art, for example) or through use of an interface placed below the surface of the skin. In certain embodiments, the sensors are external to the electrode 110 or IPG, but still internal to the patient. For example, external sensors may be located in the ear, the nasal passage, the throat, or other measurement points known to those skilled in the art. External sensors may also be located external to the patient in, for example, a medical facility, a laboratory, or a patient's home.
  • C. Programming Subsystem
  • In the exemplary embodiment of FIG. 1, a programming subsystem 140 collects data on the stimulus applied during gross adjustment. The programming subsystem 140 may also contain preprogrammed stimulus data, which may be used to apply stimulus to the at least one electrode 110. In other embodiments, the programming subsystem 140 collects data on the stimulus response, (tissue response, for example) and in still other exemplary embodiments the programming subsystem collects data on both the applied stimulus and the stimulus response. This data can then be used to program user specific stimulus patterns to open the airway and decrease sleep disordered breathing/obstructive sleep apnea for download to hypoglossal nerve(s) implants. In a certain embodiment, for example, at least one sensor collects data that protruder muscles a, c, and f are not affected by a given stimulus, but flattening muscles b, d, and e are stimulated when nerve fibers x, y, and z are stimulated at a frequency of n Hz. In certain exemplary embodiments, sensor information is stored in a sensor memory (not shown) in the stimulus measurement subsystem 130. The measured data is passed to or obtained by the programming subsystem 140, where it is be recorded and correlated with the applied stimulus patterns.
  • Sensed information data may also be passed directly to the programming subsystem 140. Once the data are collected and correlated, the programming subsystem 140 generates a stimulus profile based on the obtained information. The stimulus profile may be downloaded into an IPG (not shown) or gross adjustment stimulator 120. The signals from these sensors (internal or external) can be correlated by direct observation (by a physician, patient, or other user, for example), or can be digitized and analyzed via software algorithms to create a stimulus profile. This profile can be used to apply a stimulus that generates a desired response in the targeted tissue. In certain embodiments, software in the programming subsystem 140 generates an algorithm to suggest electrode combinations and stimulus levels to elicit the desired stimulus response.
  • III. Initial Gross Adjustment
  • FIG. 2 illustrates an exemplary embodiment of an initial gross adjustment method 200. In the exemplary method shown, at least one electrode 110 is placed in an initial position on or near the target tissue at step 210. The electrode 110 need not be physically connected to or touching the target tissue. The electrode 110 only needs to be close enough to the target tissue to make an electrical connection with the tissue. The target tissue may be a nerve, a muscle, or an organ of a patient's body. In certain embodiments the target tissue is the hypoglossal nerve. In step 220, at least one stimulus is applied to at least one electrode 110. Stimulus may be chosen manually, or it may be preprogrammed. In the exemplary method shown, stimulus is applied by the gross adjustment stimulator 120, but in other embodiments stimulus can be applied from another source. In certain embodiments, the gross adjustment stimulator 120 is acceptable for use in an operating room environment. Exemplary guidelines for devices acceptable for use in an operating room environment are described in Draft Guidance for Industry and FDA Staff Radio-Frequency Wireless Technology in Medical Devices, released for comment on Jan. 3, 2007, which is hereby incorporated by reference in its entirety. Stimulators configured for wireless use in an operating room need not operate wirelessly, but can if desired.
  • Varying stimulus patterns involving permutations of electrode contacts, delivering stimulus of varying current amplitude, duration, and/or frequency are applied to at least one electrode 110. In certain embodiments, these varying stimulus patterns are applied under the control of a physician or technician, and may be preprogrammed. These varying stimulus patterns have different effects on the nerve fibers that control tongue position, muscle tone, and size and patency of the retrolingual airway. In order to identify which nerve fibers produce the desired stimulus response in the muscles in the tongue to open the airway, stimulus is applied independently to each targeted nerve fiber population of interest. In certain embodiments, the electrode position, applied stimulus, and stimulus response are recorded to help identify the location of the electrode on the nerve that provides optimal stimulation.
  • Different levels of stimulation of the nerve fibers are applied to identify the minimum stimulus required to elicit the appropriate muscle movement required to alleviate the symptoms of the physiological condition. Different levels of stimulation often elicit different responses depending on the muscle responding and depending on the different nerve or nerve fibers to be stimulated. Exemplary stimulation patterns are known in the art, or taught in U.S. patent application Ser. Nos. 11/707,104 and 11/707,053.
  • The stimulation applied in step 220 can be in many forms. While stimulation may be applied at high frequencies, lowering the stimulation frequency to the lowest required for a smooth, tetanic, and comfortable contraction, for example, reduces overall power consumption and helps reduce muscle fatigue elicited by electrical stimulation. Stimulation may also be delivered as a single pulse, a burst of pulses, or multiple pulses at one or more frequencies. Each frequency can be as low as approximately 15 Hz for large targeted muscles or as high as approximately 80 to 100 Hz for smaller muscles. In other embodiments, Stimulation frequency is adjustable from a low of 1 Hz to a maximum of 100 Hz. Alternatively, stimulation is multiplexed, and in still other embodiments stimulation is delivered in coincident pulses. Stimulation may be delivered to several contacts (not shown) on an electrode 110, or stimulation may be sequentially applied by delivering interlaced pulses to one contact and then another, to create multiple electric fields that when added result in a force vector in the desired direction to stimulate the target tissue with the desired stimulation level.
  • In step 230, the physician, physician's assistant, or technician (herein generically referred to as a physician) checks to see if a desired stimulus response is achieved. This step is performed during or after step 220. In certain exemplary embodiments, a desired response is a blocking of a neural impulse (for example by activating an inhibitory pathway). In certain other exemplary embodiments, a desired response is a change in airway patency. Changes in airway patency, either directly or indirectly, are observed during or after stimulus is applied. Checking for a desired stimulus response helps determine which combinations of contacts and current patterns are most desirable. Stimulus parameters can then be adjusted according to the severity of the apnea.
  • The stimulus response may be measured using the stimulus measurement subsystem 130, by other electronic means, such as a computer or other instrumentation, or even visual observation. These measurements can be direct or indirect. The stimulus measurement subsystem 130 and measurement means are described elsewhere in this application and are not repeated here. In the exemplary embodiment shown, the gross adjustment stimulator 120 applies stimulus to at least one electrode 110, and the physician checks to see if a desired stimulus response (e.g., tongue movement changes in airway patency) is achieved 230. In certain embodiments, this helps determine which combinations of contacts and current patterns are desirable for a patient. In other exemplary embodiments, a desired response is at least partial blockage of a neural impulse, and in other exemplary embodiments a desired response is the initiation of a neural impulse. Stimulus patterns producing a desired response may then be stored in the implant, patient control device, a secure archive, or the programming subsystem 140. This stimulus may be selected by the physician, or it may be preprogrammed.
  • If a desired stimulus response is not obtained, the physician decides at step 240 whether to apply additional stimulus. If the physician chooses to apply additional stimulus 240, the physician repeats step 220 with the desired stimulus pattern(s). Alternatively, or in addition to step 240, the physician decides at step 250 whether electrode repositioning is desirable. If repositioning is chosen, the physician chooses a new position by, for example, shifting at least one electrode 110 along a target tissue, and beginning at step 210.
  • If repositioning is not desired, the physician decides at step 260 whether an acceptable outcome was achieved with the stimulus applied to the electrode in its current position. If so, the physician fixes the electrode in place at step 270. If not, the physician removes the electrode at step 280. The electrode may be fixed in place using surgical means, such as sutures, glue, fasteners, or other means known to those skilled in the art. The method may be performed with additional stimulus electrodes 110, and may be performed with an array of electrodes 110. The steps need not be performed in the order shown, nor do they all need to be performed. The method is exemplary only, and not limited to what is described.
  • IV. Post-Surgical Adjustment
  • Post-surgical adjustment may begin once the wound heals. Once the patient and wound have healed, the physician begins implant programming to maximize the nighttime retrolingual or pharyngeal airway. Programming may include a range of stimulation values, a programmable delay between switching the implant on and stimulus commencing, a ramp in stimulus intensity over time, and an automatic shut down after a preset interval. Programming may be downloaded to the implant via a wireless link, both for initial trials and for a final stimulus program for use by the patient, or it may be downloaded in USB, serial, or other connection. Programming parameters may include the full range of stimulation values as well as a programmable delay between switching the implant on and stimulus commencing, a ramp in stimulus intensity over time, and an automatic shut down after a predetermined interval. In other embodiments, the IPG itself may be used to generate the signals and stimulation patterns used during gross adjustment.
  • FIG. 3 illustrates an exemplary embodiment of a post-surgical adjustment method 300. In step 310 of the exemplary method shown, electrode stimulation is applied while the patient is awake and the upper respiratory tract (URT) is open. In step 320, tongue position is measured in response to the applied stimulus. In an exemplary embodiment, tongue position is measured with a tongue protrusion calibration device. The device is placed at the anterior of the mouth and held in place by the teeth, or lips, or other method. In certain methods, the tongue protrusion device is configured to measure anterior tongue thrust using, for example, a pressure sensor.
  • The patient is asked at step 330 to evaluate the relative comfort of the tongue position in response to stimulation. If a desired stimulus response is not obtained, steps 310-330 may be repeated with another stimulus. At step 340 the physician evaluates whether a stimulus response is desirable. When a desired stimulus response is obtained (i.e. a stimulus that produces an open airway or change in airway patency without causing discomfort to the patient), the stimulus program is saved at step 350 for later use. Stimulus may be programmed by a physician, a physician's assistant, a technician, or even the patient.
  • Another exemplary post-surgical adjustment method is to record the level of nerve activity present when the tongue has normal daytime tone using, for example, an electroneurogram sensor. Under this approach, the signals from the target tissue (e.g., the hypoglossal nerve) are recorded while the patient is awake. This recording can be during the patient's normal daytime routine, or it can be done while the patient is in a laboratory or medical facility. This information collected from electroneurogram sensor is used to prepare a stimulus program that mimics the daytime nerve signals to be used during while the patient sleeps to treat obstructive sleep apnea. The use of an electroneurogram sensor is exemplary only. Other sensors known to those skilled in the art could also be used to obtain the information above to create a desired stimulus program without departing from the scope of the invention.
  • Yet another approach or exemplary method is to program the HGN implant(s) in a laboratory, using a stimulation protocol that minimizes URT obstruction, snoring, and apneic and or hypopneic events observed in the laboratory, in order to maximize the URT patency. Programming may be downloaded to the implant via the RF link, both for initial trials and for a final stimulus program for use by the patient.
  • It will be apparent to those skilled in the art that various modifications and variations can be made in the device of the present invention without departing from the scope of the invention. Thus, it is intended that the present invention cover the modifications and variations of the present invention.

Claims (30)

1. A method of neural stimulation, comprising the steps of:
electrically connecting at least one electrode to a first tissue;
applying a stimulus to the at least one electrode;
observing a response of a second tissue;
identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode; and
fixing the at least one electrode in place at the identified electrode position.
2. The neural stimulation method of claim 1, wherein the applied stimulus is a voltage signal.
3. The neural stimulation method of claim 1, wherein the applied stimulus is a controlled voltage signal.
4. The neural stimulation method of claim 1, wherein the applied stimulus is a current signal.
5. The neural stimulation method of claim 1, wherein the applied stimulus is a controlled current signal
6. The neural stimulation method of claim 1, wherein the applied stimulus is preprogrammed.
7. The neural stimulation method of claim 1, wherein the stimulus applicator is disposable.
8. The neural stimulation method of claim 1, further comprising the step of applying an additional stimulus to the at least one electrode.
9. The neural stimulation method of claim 1, further comprising the step of repositioning the at least one electrode.
10. The neural stimulation method of claim 1, further comprising the step of calculating an estimated minimum stimulus level to achieve the desired response.
11. The neural stimulation method of claim 1, further comprising the step of generating a stimulus profile.
12. The neural stimulation method of claim 11, wherein the stimulus profile comprises suggested electrode combinations and stimulus levels to elicit the desired response.
13. The neural stimulation method of claim 1, wherein the first and second tissues are selected from the group consisting of nerve tissue, muscle tissue, and organ tissue.
14. The neural stimulation method of claim 13, wherein the first tissue is nerve tissue.
15. The neural stimulation method of claim 14, wherein the nerve tissue is a hypoglossal nerve fiber.
16. The neural stimulation method of claim 13, wherein the second tissue is tongue muscle tissue.
17. The neural stimulation method of claim 16, wherein the tongue muscle tissue is a tongue flattening muscle.
18. The neural stimulation method of claim 16, wherein the tongue muscle tissue is a tongue protruding muscle.
19. The neural stimulation method of claim 1, wherein the desired response is a change in airway patency.
20. The neural stimulation method of claim 1, wherein the desired response is the at least partial blockage of a neural impulse.
21. The neural stimulation method of claim 1, wherein the desired response is the initiation of at least one neural impulse.
22. The neural stimulation method of claim 1, wherein the response of a second tissue is observed visually.
23. The neural stimulation method of claim 1, wherein the response of a second tissue is observed using instrumentation.
24. The neural stimulation method of claim 1, wherein the response of a second tissue is directly observed.
25. The neural stimulation method of claim 1, wherein the response of a second tissue is indirectly observed.
26. The neural stimulation method of claim 1, wherein the response of a second tissue is observed by a sensor internal to the patient.
27. The neural stimulation method of claim 1, wherein the response of a second tissue is observed by a sensor external to the patient.
28. A neural stimulation system, comprising:
at least one electrode electrically connected to a first tissue;
means for applying a stimulus to the at least one electrode;
means for observing a response of a second tissue; means for identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode; and
means for fixing the at least one electrode in place at the identified electrode position.
29. A computer program product comprising computer readable medium having stored thereon computer executable instructions that, when executed on a computer, causes the computer to perform a method of neural stimulation comprising the steps of:
applying a stimulus to at least one electrode electrically connected to a first tissue;
observing a response of a second tissue; and
identifying an electrode position on the first tissue wherein a desired response occurs on the second tissue when the stimulus is applied to the at least one electrode.
30. A neural stimulation system, comprising:
at least one electrode electrically connected to a first tissue;
a gross adjustment stimulator coupled to and delivering a stimulus to the at least one electrode;
a stimulus measurement subsystem in communication with the gross adjustment stimulator and having at least one sensor, the at least one sensor measuring a response of a second tissue; and
a programming subsystem in communication with the stimulus measurement subsystem, the programming subsystem collecting data from a group consisting of stimulus data and tissue response data.
US12/681,799 2007-10-09 2008-10-09 System and method for neural stimulation Abandoned US20100198103A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US12/681,799 US20100198103A1 (en) 2007-10-09 2008-10-09 System and method for neural stimulation

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US97851907P 2007-10-09 2007-10-09
US1761407P 2007-12-29 2007-12-29
US13610208P 2008-08-12 2008-08-12
PCT/US2008/011599 WO2009048581A1 (en) 2007-10-09 2008-10-09 System and method for neural stimulation
US12/681,799 US20100198103A1 (en) 2007-10-09 2008-10-09 System and method for neural stimulation

Publications (1)

Publication Number Publication Date
US20100198103A1 true US20100198103A1 (en) 2010-08-05

Family

ID=40549467

Family Applications (6)

Application Number Title Priority Date Filing Date
US12/681,799 Abandoned US20100198103A1 (en) 2007-10-09 2008-10-09 System and method for neural stimulation
US12/681,812 Abandoned US20100241195A1 (en) 2007-10-09 2008-10-09 Apparatus, system and method for selective stimulation
US13/775,349 Active 2028-11-24 US9849288B2 (en) 2007-10-09 2013-02-25 Apparatus, system, and method for selective stimulation
US14/811,171 Active US9884191B2 (en) 2007-10-09 2015-07-28 Apparatus, system, and method for selective stimulation
US15/851,964 Active US10646714B2 (en) 2007-10-09 2017-12-22 Apparatus, system, and method for selective stimulation
US16/870,455 Active US11351364B2 (en) 2007-10-09 2020-05-08 Apparatus, system, and method for selective stimulation

Family Applications After (5)

Application Number Title Priority Date Filing Date
US12/681,812 Abandoned US20100241195A1 (en) 2007-10-09 2008-10-09 Apparatus, system and method for selective stimulation
US13/775,349 Active 2028-11-24 US9849288B2 (en) 2007-10-09 2013-02-25 Apparatus, system, and method for selective stimulation
US14/811,171 Active US9884191B2 (en) 2007-10-09 2015-07-28 Apparatus, system, and method for selective stimulation
US15/851,964 Active US10646714B2 (en) 2007-10-09 2017-12-22 Apparatus, system, and method for selective stimulation
US16/870,455 Active US11351364B2 (en) 2007-10-09 2020-05-08 Apparatus, system, and method for selective stimulation

Country Status (8)

Country Link
US (6) US20100198103A1 (en)
EP (2) EP2197536A1 (en)
JP (2) JP2011500143A (en)
CN (2) CN101939043A (en)
AU (2) AU2008311312A1 (en)
BR (2) BRPI0818654A2 (en)
CA (2) CA2697826A1 (en)
WO (2) WO2009048580A1 (en)

Cited By (39)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090276024A1 (en) * 2008-05-02 2009-11-05 Bonde Eric H Self expanding electrode cuff
US20100145221A1 (en) * 2008-12-08 2010-06-10 Brunnett William C Nerve electrode
US20110152706A1 (en) * 2008-05-15 2011-06-23 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
US20110147046A1 (en) * 2008-05-02 2011-06-23 Medtronic, Inc. Self expanding electrode cuff
US8761897B2 (en) 2012-08-31 2014-06-24 Greatbatch Ltd. Method and system of graphical representation of lead connector block and implantable pulse generators on a clinician programmer
US8757485B2 (en) 2012-09-05 2014-06-24 Greatbatch Ltd. System and method for using clinician programmer and clinician programming data for inventory and manufacturing prediction and control
US8812125B2 (en) 2012-08-31 2014-08-19 Greatbatch Ltd. Systems and methods for the identification and association of medical devices
US8868199B2 (en) 2012-08-31 2014-10-21 Greatbatch Ltd. System and method of compressing medical maps for pulse generator or database storage
US8903496B2 (en) 2012-08-31 2014-12-02 Greatbatch Ltd. Clinician programming system and method
US8934992B2 (en) 2011-09-01 2015-01-13 Inspire Medical Systems, Inc. Nerve cuff
US8938299B2 (en) 2008-11-19 2015-01-20 Inspire Medical Systems, Inc. System for treating sleep disordered breathing
US8983572B2 (en) 2010-10-29 2015-03-17 Inspire Medical Systems, Inc. System and method for patient selection in treating sleep disordered breathing
US8983616B2 (en) 2012-09-05 2015-03-17 Greatbatch Ltd. Method and system for associating patient records with pulse generators
US9180302B2 (en) 2012-08-31 2015-11-10 Greatbatch Ltd. Touch screen finger position indicator for a spinal cord stimulation programming device
US9259577B2 (en) 2012-08-31 2016-02-16 Greatbatch Ltd. Method and system of quick neurostimulation electrode configuration and positioning
US9375582B2 (en) 2012-08-31 2016-06-28 Nuvectra Corporation Touch screen safety controls for clinician programmer
US9471753B2 (en) 2012-08-31 2016-10-18 Nuvectra Corporation Programming and virtual reality representation of stimulation parameter Groups
US9486628B2 (en) 2009-03-31 2016-11-08 Inspire Medical Systems, Inc. Percutaneous access for systems and methods of treating sleep apnea
US9507912B2 (en) 2012-08-31 2016-11-29 Nuvectra Corporation Method and system of simulating a pulse generator on a clinician programmer
US9594877B2 (en) 2012-08-31 2017-03-14 Nuvectra Corporation Virtual reality representation of medical devices
US9615788B2 (en) 2012-08-31 2017-04-11 Nuvectra Corporation Method and system of producing 2D representations of 3D pain and stimulation maps and implant models on a clinician programmer
US9643022B2 (en) 2013-06-17 2017-05-09 Nyxoah SA Flexible control housing for disposable patch
US9767255B2 (en) 2012-09-05 2017-09-19 Nuvectra Corporation Predefined input for clinician programmer data entry
US9814402B2 (en) 2013-02-15 2017-11-14 Acacia Designs Bv Electrode systems for use with medical monitoring systems
US9849289B2 (en) 2009-10-20 2017-12-26 Nyxoah SA Device and method for snoring detection and control
US9855032B2 (en) 2012-07-26 2018-01-02 Nyxoah SA Transcutaneous power conveyance device
US9889299B2 (en) 2008-10-01 2018-02-13 Inspire Medical Systems, Inc. Transvenous method of treating sleep apnea
US9888864B2 (en) 2010-03-12 2018-02-13 Inspire Medical Systems, Inc. Method and system for identifying a location for nerve stimulation
US9943686B2 (en) 2009-10-20 2018-04-17 Nyxoah SA Method and device for treating sleep apnea based on tongue movement
US10052097B2 (en) 2012-07-26 2018-08-21 Nyxoah SA Implant unit delivery tool
US10583297B2 (en) 2011-08-11 2020-03-10 Inspire Medical Systems, Inc. Method and system for applying stimulation in treating sleep disordered breathing
US10668276B2 (en) 2012-08-31 2020-06-02 Cirtec Medical Corp. Method and system of bracketing stimulation parameters on clinician programmers
US10751537B2 (en) 2009-10-20 2020-08-25 Nyxoah SA Arced implant unit for modulation of nerves
US10814137B2 (en) 2012-07-26 2020-10-27 Nyxoah SA Transcutaneous power conveyance device
US10888696B2 (en) * 2009-05-29 2021-01-12 Cochlear Limited Vestibular stimulation device
US10898709B2 (en) 2015-03-19 2021-01-26 Inspire Medical Systems, Inc. Stimulation for treating sleep disordered breathing
US11000208B2 (en) * 2011-01-28 2021-05-11 Livanova Usa, Inc. Screening devices and methods for obstructive sleep apnea therapy
US11253712B2 (en) 2012-07-26 2022-02-22 Nyxoah SA Sleep disordered breathing treatment apparatus
US11298540B2 (en) 2017-08-11 2022-04-12 Inspire Medical Systems, Inc. Cuff electrode

Families Citing this family (130)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6907295B2 (en) 2001-08-31 2005-06-14 Biocontrol Medical Ltd. Electrode assembly for nerve control
US8565896B2 (en) * 2010-11-22 2013-10-22 Bio Control Medical (B.C.M.) Ltd. Electrode cuff with recesses
US7904176B2 (en) * 2006-09-07 2011-03-08 Bio Control Medical (B.C.M.) Ltd. Techniques for reducing pain associated with nerve stimulation
US20090005845A1 (en) * 2007-06-26 2009-01-01 Tamir Ben David Intra-Atrial parasympathetic stimulation
US8615294B2 (en) 2008-08-13 2013-12-24 Bio Control Medical (B.C.M.) Ltd. Electrode devices for nerve stimulation and cardiac sensing
US7778711B2 (en) * 2001-08-31 2010-08-17 Bio Control Medical (B.C.M.) Ltd. Reduction of heart rate variability by parasympathetic stimulation
US8880192B2 (en) 2012-04-02 2014-11-04 Bio Control Medical (B.C.M.) Ltd. Electrode cuffs
US8718791B2 (en) * 2003-05-23 2014-05-06 Bio Control Medical (B.C.M.) Ltd. Electrode cuffs
US20070233204A1 (en) 2006-02-16 2007-10-04 Lima Marcelo G RFID-based apparatus, system, and method for therapeutic treatment of a patient
US10368146B2 (en) * 2016-09-20 2019-07-30 General Electric Company Systems and methods for environment sensing
US20100198103A1 (en) 2007-10-09 2010-08-05 Imthera Medical, Inc. System and method for neural stimulation
CA2738479C (en) 2008-10-09 2017-11-28 Imthera Medical, Inc. Method of stimulating a hypoglossal nerve for controlling the position of a patient's tongue
CN102481449A (en) * 2009-01-27 2012-05-30 澳大利亚神经刺激器具技术有限公司 Electrical neurostimulator package
US9211410B2 (en) * 2009-05-01 2015-12-15 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9415215B2 (en) 2009-10-20 2016-08-16 Nyxoah SA Methods for treatment of sleep apnea
US8705783B1 (en) * 2009-10-23 2014-04-22 Advanced Bionics Methods and systems for acoustically controlling a cochlear implant system
KR20120101650A (en) 2009-11-10 2012-09-14 임테라 메디칼, 인코포레이티드 System for stimulating a hypoglossal nerve for controlling the position of a patient's tongue
US8788045B2 (en) 2010-06-08 2014-07-22 Bluewind Medical Ltd. Tibial nerve stimulation
CN101904743B (en) * 2010-07-22 2012-02-01 上海诺诚电气有限公司 Constant current stimulator and current stimulator system
US9186504B2 (en) 2010-11-15 2015-11-17 Rainbow Medical Ltd Sleep apnea treatment
US9457186B2 (en) 2010-11-15 2016-10-04 Bluewind Medical Ltd. Bilateral feedback
US9821159B2 (en) 2010-11-16 2017-11-21 The Board Of Trustees Of The Leland Stanford Junior University Stimulation devices and methods
CA2817589A1 (en) 2010-11-16 2012-05-24 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for treatment of dry eye
JP5602612B2 (en) * 2010-12-22 2014-10-08 オリンパス株式会社 Electrode unit and tissue stimulation system
BR112013025671A2 (en) * 2011-04-07 2017-12-12 Oculeve Inc stimulation methods and devices
WO2012158882A1 (en) 2011-05-17 2012-11-22 Boston Scientific Neuromodulation Corporation Display of region of activation in neurostimulation programming screen
AU2012313968A1 (en) 2011-09-30 2014-05-01 Adi Mashiach Apparatus and method for extending implant life using a dual power scheme
US8929986B2 (en) 2011-11-04 2015-01-06 Nevro Corporation Medical device communication and charging assemblies for use with implantable signal generators, and associated systems and methods
USD736383S1 (en) 2012-11-05 2015-08-11 Nevro Corporation Implantable signal generator
US8892205B2 (en) * 2011-12-07 2014-11-18 Otologics, Llc Sleep apnea control device
US20150018728A1 (en) 2012-01-26 2015-01-15 Bluewind Medical Ltd. Wireless neurostimulators
US10632309B2 (en) 2012-03-15 2020-04-28 Spr Therapeutics, Inc. Systems and methods related to the treatment of back pain
AU2013231842A1 (en) 2012-03-15 2014-10-02 SPR Therapeutics, LLC. Systems and methods related to the treatment of back pain
US9504828B2 (en) 2012-07-26 2016-11-29 Nyxoah SA Electrical contacts on a medical device patch
DE102012107835A1 (en) * 2012-08-24 2014-02-27 Albert-Ludwigs-Universität Freiburg Medical implant and method for its production
US20140135868A1 (en) * 2012-11-09 2014-05-15 Jacob Bashyam Bashyam Non-invasive intraoral electrical stimulator system and method for treatment of obstructive sleep apnea (osa)
CN103845803B (en) * 2012-11-30 2016-03-16 苏州景昱医疗器械有限公司 A kind of implantable medical device and system with radio communication function
CN103845802B (en) * 2012-11-30 2016-03-16 苏州景昱医疗器械有限公司 A kind of implantable medical device and system with radio antenna
WO2014087337A1 (en) 2012-12-06 2014-06-12 Bluewind Medical Ltd. Delivery of implantable neurostimulators
CN103845793A (en) * 2012-12-07 2014-06-11 苏州景昱医疗器械有限公司 Implantable nerve stimulator, system and method for combining multiple sets of stimulus parameters
EP2967817B1 (en) 2013-03-12 2021-03-10 Oculeve, Inc. Implant delivery devices and systems
NZ745920A (en) 2013-04-19 2020-01-31 Oculeve Inc Nasal stimulation devices and methods
KR102363552B1 (en) 2013-05-30 2022-02-15 그라함 에이치. 크리시 Topical neurological stimulation
US11229789B2 (en) 2013-05-30 2022-01-25 Neurostim Oab, Inc. Neuro activator with controller
US9427566B2 (en) 2013-08-14 2016-08-30 Syntilla Medical LLC Implantable neurostimulation lead for head pain
US9839777B2 (en) 2013-08-14 2017-12-12 Syntilla Medical LLC Implantable neurostimulation lead for head pain
US9042991B2 (en) 2013-08-14 2015-05-26 Syntilla Medical LLC Implantable head mounted neurostimulation system for head pain
WO2015039108A2 (en) 2013-09-16 2015-03-19 The Board Of Trustees Of The Leland Stanford Junior University Multi-element coupler for generation of electromagnetic energy
EP3403692A1 (en) * 2013-09-26 2018-11-21 Oticon Medical A/S A device implantable under skin
US10258805B2 (en) 2013-10-23 2019-04-16 Syntilla Medical, Llc Surgical method for implantable head mounted neurostimulation system for head pain
US10960215B2 (en) 2013-10-23 2021-03-30 Nuxcel, Inc. Low profile head-located neurostimulator and method of fabrication
WO2015077283A1 (en) 2013-11-19 2015-05-28 The Cleveland Clinic Foundation System for treating obstructive sleep apnea
CN111298285A (en) 2014-02-25 2020-06-19 奥库利维公司 Polymer formulations for nasolacrimal stimulation
US20160336813A1 (en) 2015-05-15 2016-11-17 NeuSpera Medical Inc. Midfield coupler
CN110289700A (en) 2014-05-18 2019-09-27 诺伊斯佩拉医疗有限公司 Midfield coupler
US9597517B2 (en) * 2014-07-03 2017-03-21 Boston Scientific Neuromodulation Corporation Neurostimulation system with flexible patterning and waveforms
EP3673952A1 (en) 2014-07-25 2020-07-01 Oculeve, Inc. Stimulation patterns for treating dry eye
AU2015335776B2 (en) 2014-10-22 2020-09-03 Oculeve, Inc. Stimulation devices and methods for treating dry eye
AU2015335774B2 (en) 2014-10-22 2020-07-16 Oculeve, Inc. Implantable nasal stimulator systems and methods
WO2016065211A1 (en) 2014-10-22 2016-04-28 Oculeve, Inc. Contact lens for increasing tear production
CA2973657A1 (en) * 2015-01-14 2016-07-21 Neurotrix Llc Systems and methods for determining neurovascular reactivity to brain stimulation
US9764146B2 (en) 2015-01-21 2017-09-19 Bluewind Medical Ltd. Extracorporeal implant controllers
US9597521B2 (en) 2015-01-21 2017-03-21 Bluewind Medical Ltd. Transmitting coils for neurostimulation
US10004896B2 (en) 2015-01-21 2018-06-26 Bluewind Medical Ltd. Anchors and implant devices
GB201501983D0 (en) 2015-02-06 2015-03-25 Morgan Innovation & Technology Ltd Treatment of snoring and sleep apnoea
US11077301B2 (en) 2015-02-21 2021-08-03 NeurostimOAB, Inc. Topical nerve stimulator and sensor for bladder control
JP6583699B2 (en) * 2015-04-02 2019-10-02 国立大学法人 東京大学 Coil design apparatus and coil design method
US20160287112A1 (en) * 2015-04-03 2016-10-06 Medtronic Xomed, Inc. System And Method For Omni-Directional Bipolar Stimulation Of Nerve Tissue Of A Patient Via A Bipolar Stimulation Probe
CN107454832A (en) * 2015-05-08 2017-12-08 赫尔实验室有限公司 Closed loop for carrying on the back lateral prefrontal cortex and/or motor cortex senses and the montage of nerve stimulation designs
US9782589B2 (en) 2015-06-10 2017-10-10 Bluewind Medical Ltd. Implantable electrostimulator for improving blood flow
KR101656723B1 (en) * 2015-06-30 2016-09-12 재단법인 오송첨단의료산업진흥재단 Feedthrough making method
US10195428B2 (en) * 2015-09-29 2019-02-05 Medtronic, Inc. Neural stimulation to treat sleep apnea
WO2017067939A1 (en) * 2015-10-19 2017-04-27 Sorin Crm Sas Implantable probe comprising a perforated sleeve
US10105540B2 (en) 2015-11-09 2018-10-23 Bluewind Medical Ltd. Optimization of application of current
US9713707B2 (en) 2015-11-12 2017-07-25 Bluewind Medical Ltd. Inhibition of implant migration
US10426958B2 (en) 2015-12-04 2019-10-01 Oculeve, Inc. Intranasal stimulation for enhanced release of ocular mucins and other tear proteins
US9717917B2 (en) 2016-01-06 2017-08-01 Syntilla Medical LLC Charging system incorporating independent charging and communication with multiple implanted devices
US10252048B2 (en) 2016-02-19 2019-04-09 Oculeve, Inc. Nasal stimulation for rhinitis, nasal congestion, and ocular allergies
US9713722B1 (en) * 2016-04-29 2017-07-25 Medtronic Bakken Research Center B.V. Alternative electrode configurations for reduced power consumption
US10918864B2 (en) 2016-05-02 2021-02-16 Oculeve, Inc. Intranasal stimulation for treatment of meibomian gland disease and blepharitis
WO2018085665A1 (en) * 2016-11-04 2018-05-11 Galvani Bioelectronics Limited System for wirelessly coupling in vivo
US10124178B2 (en) 2016-11-23 2018-11-13 Bluewind Medical Ltd. Implant and delivery tool therefor
EP3544495A4 (en) * 2016-11-25 2020-08-19 Kinaptic, LLC Haptic human machine interface and wearable electronics methods and apparatus
RU2019118600A (en) 2016-12-02 2021-01-11 Окулив, Инк. APPARATUS AND METHOD FOR MAKING DRY EYE SYNDROME PREDICTION AND TREATMENT RECOMMENDATIONS
CN106730336B (en) * 2016-12-21 2023-05-02 北京品驰医疗设备有限公司 Epileptic sleep apnea prevention system
CN106669033B (en) * 2016-12-22 2023-05-02 北京品驰医疗设备有限公司 Epileptic sleep apnea preventing system capable of being charged safely and rapidly
CN106726091B (en) * 2016-12-22 2021-11-23 北京品驰医疗设备有限公司 Epileptic sleep apnea prevention system capable of achieving quick charging
CN110290767A (en) * 2016-12-22 2019-09-27 艾琳医药股份有限公司 Soft palate treatment
US11806071B2 (en) 2016-12-22 2023-11-07 Aerin Medical Inc. Soft palate treatment
KR101874231B1 (en) 2017-01-25 2018-07-03 주식회사 싸이버메딕 Electrode module for Transcranial DC Stimulation and Functional near infrared spectroscopy
US20180353764A1 (en) 2017-06-13 2018-12-13 Bluewind Medical Ltd. Antenna configuration
US11612751B2 (en) 2017-08-11 2023-03-28 Boston Scientific Neuromodulation Corporation Stimulation configuration variation to control evoked temporal patterns
KR102062252B1 (en) * 2017-08-30 2020-01-03 부산대학교 산학협력단 Intraoperative Neuromonitoring System Using Bio-pressure Sensor
US11723579B2 (en) 2017-09-19 2023-08-15 Neuroenhancement Lab, LLC Method and apparatus for neuroenhancement
CN111601636A (en) 2017-11-07 2020-08-28 Oab神经电疗科技公司 Non-invasive neural activator with adaptive circuit
KR102050319B1 (en) * 2017-11-30 2019-12-02 주식회사 싸이버메딕 A cranial nerve adjustifing apparatus
KR102100696B1 (en) * 2017-11-30 2020-04-16 주식회사 싸이버메딕 A cranial nerve adjustifing apparatus using complex stimulation of central and peripherial nerves
KR102032620B1 (en) * 2017-11-30 2019-10-15 주식회사 싸이버메딕 Measuring module apparatus of a cerebral activity using Transcranial Current Stimulation and Functional near-infrared spectroscopy
US11717686B2 (en) 2017-12-04 2023-08-08 Neuroenhancement Lab, LLC Method and apparatus for neuroenhancement to facilitate learning and performance
US11273283B2 (en) 2017-12-31 2022-03-15 Neuroenhancement Lab, LLC Method and apparatus for neuroenhancement to enhance emotional response
WO2019204769A1 (en) 2018-04-19 2019-10-24 Iota Biosciences, Inc. Implants using ultrasonic communication for modulating splenic nerve activity
US11364361B2 (en) 2018-04-20 2022-06-21 Neuroenhancement Lab, LLC System and method for inducing sleep by transplanting mental states
US10509426B2 (en) * 2018-05-02 2019-12-17 Analog Devices Global Unlimited Company Methods and circuits for controlling and/or reducing current leakage during a low-power or inactive mode
US11565112B2 (en) * 2018-09-05 2023-01-31 Vanderbilt University Active titration of one or more nerve stimulators to treat obstructive sleep apnea
WO2020056418A1 (en) 2018-09-14 2020-03-19 Neuroenhancement Lab, LLC System and method of improving sleep
WO2020079437A1 (en) * 2018-10-17 2020-04-23 Signifier Medical Technologies Limited Oral muscle training
CA3129376A1 (en) * 2019-02-08 2020-08-13 Boston Scientific Neuromodulation Corporation Fitting algorithm to determine best stimulation parameter in a spinal cord stimulation system
US11266837B2 (en) * 2019-03-06 2022-03-08 Medtronic Xomed, Inc. Position sensitive lingual muscle simulation system for obstructive sleep apnea
JP2022531007A (en) 2019-05-02 2022-07-05 トゥウェルブ メディカル インコーポレイテッド Systems and methods for improving sleep-disordered breathing
US11458311B2 (en) 2019-06-26 2022-10-04 Neurostim Technologies Llc Non-invasive nerve activator patch with adaptive circuit
EP4045134A1 (en) 2019-10-15 2022-08-24 XII Medical, Inc. Biased neuromodulation lead and method of using same
EP4045133A4 (en) * 2019-10-17 2023-11-22 Iota Biosciences, Inc. Helical nerve cuff and related implantable devices
KR20220115802A (en) 2019-12-16 2022-08-18 뉴로스팀 테크놀로지스 엘엘씨 Non-invasive neural activator with boost charge transfer function
AU2021205493A1 (en) 2020-01-10 2022-08-04 Nuxcel2, L.L.C. Systems and methods for stimulation of cranial nerves
US11198002B2 (en) 2020-01-24 2021-12-14 Medtronic Xomed, Inc. Needle and introducer used in lead placement for obstructive sleep apnea treatment
US11819233B2 (en) 2020-01-24 2023-11-21 Medtronic Xomed, Inc. Devices and techniques for separating tissue
US11426201B2 (en) 2020-01-24 2022-08-30 Medtronic Xomed, Inc. Treatment of obstructive sleep apnea (OSA)
US11273305B2 (en) 2020-01-24 2022-03-15 Medtronic Xomed, Inc. Medical lead for treating obstructive sleep apnea (OSA) with electrical stimulation
US11666751B2 (en) 2020-01-24 2023-06-06 Medtronic Xomed, Inc. Combination obstructive sleep apnea trialing lead and chronic lead
EP4110454A4 (en) * 2020-02-28 2024-03-20 ResMed Pty Ltd Systems and methods for aiding a user in breathing using implantable devices
EP4240241A1 (en) * 2020-11-04 2023-09-13 Invicta Medical, Inc. Implantable electrodes with remote power delivery for treating sleep apnea, and associated systems and methods
US11691010B2 (en) 2021-01-13 2023-07-04 Xii Medical, Inc. Systems and methods for improving sleep disordered breathing
EP4098316A1 (en) * 2021-06-03 2022-12-07 INBRAIN Neuroelectronics SL Neurostimulation system
EP4101499A1 (en) * 2021-06-09 2022-12-14 Oticon Medical A/S Cochlear hearing aid implant including an improved connection between an electrode lead and an implant
WO2023282922A1 (en) 2021-07-09 2023-01-12 The Alfred E. Mann Foundation For Scientific Research Electrode leads having multi-application helical nerve cuffs and associated systems and methods
CN113499572A (en) * 2021-08-10 2021-10-15 杭州程天科技发展有限公司 Rehabilitation robot with myoelectric stimulation function and control method thereof
US11400299B1 (en) 2021-09-14 2022-08-02 Rainbow Medical Ltd. Flexible antenna for stimulator
US11925804B2 (en) 2021-11-03 2024-03-12 Medtronic Xomed, LLC Multi-device obstructive sleep apnea (OSA) treatment
WO2023130102A1 (en) * 2022-01-03 2023-07-06 Axonics, Inc. Header and antenna for a neurostimulator
WO2024010990A1 (en) * 2022-07-05 2024-01-11 The Alfred E. Mann Foundation For Scientific Research Tissue stimulation apparatus and methods of making the same

Citations (88)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4424812A (en) * 1980-10-09 1984-01-10 Cordis Corporation Implantable externally programmable microprocessor-controlled tissue stimulator
US4602624A (en) * 1984-10-11 1986-07-29 Case Western Reserve University Implantable cuff, method of manufacture, and method of installation
US5094242A (en) * 1988-11-07 1992-03-10 Regents Of The University Of California Implantable nerve stimulation device
US5095905A (en) * 1990-06-07 1992-03-17 Medtronic, Inc. Implantable neural electrode
US5123425A (en) * 1990-09-06 1992-06-23 Edentec Obstructive sleep apnea collar
US5133354A (en) * 1990-11-08 1992-07-28 Medtronic, Inc. Method and apparatus for improving muscle tone
US5146918A (en) * 1991-03-19 1992-09-15 Medtronic, Inc. Demand apnea control of central and obstructive sleep apnea
US5158080A (en) * 1990-11-08 1992-10-27 Medtronic, Inc. Muscle tone
US5174287A (en) * 1991-05-28 1992-12-29 Medtronic, Inc. Airway feedback measurement system responsive to detected inspiration and obstructive apnea event
US5190053A (en) * 1991-02-28 1993-03-02 Jeffrey A. Meer, Revocable Living Trust Method and apparatus for electrical sublingual stimulation
US5211173A (en) * 1991-01-09 1993-05-18 Medtronic, Inc. Servo muscle control
US5215082A (en) * 1991-04-02 1993-06-01 Medtronic, Inc. Implantable apnea generator with ramp on generator
US5281219A (en) * 1990-11-23 1994-01-25 Medtronic, Inc. Multiple stimulation electrodes
US5300094A (en) * 1991-01-09 1994-04-05 Medtronic, Inc. Servo muscle control
US5344438A (en) * 1993-04-16 1994-09-06 Medtronic, Inc. Cuff electrode
US5483969A (en) * 1994-09-21 1996-01-16 Medtronic, Inc. Method and apparatus for providing a respiratory effort waveform for the treatment of obstructive sleep apnea
US5522862A (en) * 1994-09-21 1996-06-04 Medtronic, Inc. Method and apparatus for treating obstructive sleep apnea
US5540732A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for impedance detecting and treating obstructive airway disorders
US5540733A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for detecting and treating obstructive sleep apnea
US5540731A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for pressure detecting and treating obstructive airway disorders
US5545201A (en) * 1995-03-29 1996-08-13 Pacesetter, Inc. Bipolar active fixation lead for sensing and pacing the heart
US5546952A (en) * 1994-09-21 1996-08-20 Medtronic, Inc. Method and apparatus for detection of a respiratory waveform
US5591216A (en) * 1995-05-19 1997-01-07 Medtronic, Inc. Method for treatment of sleep apnea by electrical stimulation
US5713922A (en) * 1996-04-25 1998-02-03 Medtronic, Inc. Techniques for adjusting the locus of excitation of neural tissue in the spinal cord or brain
US5771891A (en) * 1995-05-10 1998-06-30 Massachusetts Inst Technology Apparatus and method for non-invasive blood analyte measurement
US5837006A (en) * 1996-09-10 1998-11-17 Medtronic, Inc. Retraction stop for helical medical lead electrode
US5871512A (en) * 1997-04-29 1999-02-16 Medtronic, Inc. Microprocessor capture detection circuit and method
US6021352A (en) * 1996-06-26 2000-02-01 Medtronic, Inc, Diagnostic testing methods and apparatus for implantable therapy devices
US6051017A (en) * 1996-02-20 2000-04-18 Advanced Bionics Corporation Implantable microstimulator and systems employing the same
US6132384A (en) * 1996-06-26 2000-10-17 Medtronic, Inc. Sensor, method of sensor implant and system for treatment of respiratory disorders
US6175767B1 (en) * 1998-04-01 2001-01-16 James H. Doyle, Sr. Multichannel implantable inner ear stimulator
US6212435B1 (en) * 1998-11-13 2001-04-03 Respironics, Inc. Intraoral electromuscular stimulation device and method
US20010000346A1 (en) * 1998-06-18 2001-04-19 Stephane Ruton Process for determining respiratory phases of the sleep of a user
US20010001125A1 (en) * 1997-02-26 2001-05-10 Schulman Joseph H. System of implantable devices for monitoring and/or affecting body parameters
US6240316B1 (en) * 1998-08-14 2001-05-29 Advanced Bionics Corporation Implantable microstimulation system for treatment of sleep apnea
US6251126B1 (en) * 1998-04-23 2001-06-26 Medtronic Inc Method and apparatus for synchronized treatment of obstructive sleep apnea
US6266560B1 (en) * 1998-06-19 2001-07-24 Genetronics, Inc. Electrically assisted transdermal method and apparatus for the treatment of erectile dysfunction
US6269269B1 (en) * 1998-04-23 2001-07-31 Medtronic Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US20010015204A1 (en) * 1999-03-26 2001-08-23 Mallinckrodt Inc. Method and combination for treating sleep apnea using a cantilever mask attachment device
US20010018557A1 (en) * 1992-08-19 2001-08-30 Lawrence A. Lynn Microprocessor system for the simplified diagnosis of sleep apnea
US20010027793A1 (en) * 2000-01-11 2001-10-11 W.M.J. Tielemans Oral orthesis to reduce snoring and sleep apnea symptoms
US20010041719A1 (en) * 1998-08-28 2001-11-15 Cesare Mondadori The use of R (+)-alpha- (2,3-Dimethoxyphenyl) -1- [ 2- (4-fluorophenyl) ethyl] -4-piper idinemethanol for the treatment of sleep disorders
US20010046988A1 (en) * 1999-08-13 2001-11-29 Vela Pharmaceuticals, Inc. Methods and compositions for treating or preventing sleep disturbances and associated illnesses using very low doses of cyclobenzaprine
US20020007127A1 (en) * 1987-06-26 2002-01-17 Sullivan Colin E. Device for monitoring breathing during sleep and ramped control of CPAP treatment
US20020015740A1 (en) * 2000-02-22 2002-02-07 Ackman C. Bruce Methods and compositions for improving sleep
US20020037533A1 (en) * 2000-04-28 2002-03-28 Olivier Civelli Screening and therapeutic methods for promoting wakefulness and sleep
US20020049479A1 (en) * 2000-10-20 2002-04-25 Pitts Walter C. Method and apparatus for creating afferents to prevent obstructive sleep apnea
US20020059935A1 (en) * 2000-03-13 2002-05-23 Wood Thomas J. Ventilation interface for sleep apnea therapy
US6415174B1 (en) * 1998-11-09 2002-07-02 Board Of Regents The University Of Texas System ECG derived respiratory rhythms for improved diagnosis of sleep apnea
US20020086870A1 (en) * 1998-02-27 2002-07-04 The Board Of Trustees Of The University Of Illinois Pharmacological treatment for sleep apnea
US20020095076A1 (en) * 2001-01-17 2002-07-18 Individual Monitoring Systems, Inc. Sleep disorder breathing event counter
US20020092527A1 (en) * 2000-03-13 2002-07-18 Wood Thomas J. Ventilation interface for sleep apnea therapy
US20020099033A1 (en) * 1997-04-16 2002-07-25 Wisconsin Alumni Research Foundation Method and composition for treating sleep apnea
US20020100477A1 (en) * 1987-06-26 2002-08-01 Resmed Limited Method and apparatus useful in the diagnosis of obstructive sleep apnea of a patient
US6427689B1 (en) * 1991-11-01 2002-08-06 Respironics, Inc. Sleep apnea treatment apparatus
US6432956B1 (en) * 1990-02-12 2002-08-13 William C. Dement Method for treatment of sleep apneas
US20020124849A1 (en) * 2000-05-26 2002-09-12 Taema Nasal breathing mask with adjustable thermistor for treating respiratory disorders of sleep
US6456866B1 (en) * 1999-09-28 2002-09-24 Dustin Tyler Flat interface nerve electrode and a method for use
US6454724B1 (en) * 2000-10-25 2002-09-24 Safe Flight Instrument Corporation Sleep apnea detection system and method
US20020144684A1 (en) * 2001-04-06 2002-10-10 Moone Samuel Joseph BI/PAP mask for sleep apnea and other related clinical uses
US20020144685A1 (en) * 2001-04-02 2002-10-10 Ivanovich Bredov Vladimir Multipurpose device for preventing and treating snoring and sleep apnea and /or preventing gnashing of teeth
US6475156B1 (en) * 1999-06-14 2002-11-05 Taema Apparatus for the diagnosis or treatment of respiratory sleep disorders and operating process
US20020165462A1 (en) * 2000-12-29 2002-11-07 Westbrook Philip R. Sleep apnea risk evaluation
US20020165246A1 (en) * 2001-03-05 2002-11-07 Andrew Holman Administration of sleep restorative agents
US20020169384A1 (en) * 2001-01-30 2002-11-14 Peter Kowallik Method and device for sleep monitoring
US20020175821A1 (en) * 2001-04-04 2002-11-28 Ruppel Edward G. Sleep delay apparatus for drivers
US6488634B1 (en) * 1992-05-07 2002-12-03 New York University Method and apparatus for optimizing the continuous positive airway pressure for treating obstructive sleep apnea
US20020183306A1 (en) * 2001-05-30 2002-12-05 Pfizer Inc. Combination treatment for sleep disorders including sleep apnea
US20020193839A1 (en) * 2001-06-07 2002-12-19 Cho Yong Kyun Method for providing a therapy to a patient involving modifying the therapy after detecting an onset of sleep in the patient, and implantable medical device embodying same
US20020193697A1 (en) * 2001-04-30 2002-12-19 Cho Yong Kyun Method and apparatus to detect and treat sleep respiratory events
US20030004423A1 (en) * 2000-03-02 2003-01-02 Itamar Medical Ltd. Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system
US20030015198A1 (en) * 2001-06-18 2003-01-23 Heeke David W. Method and device for addressing sleep apnea and related breathing disorders
US20030021772A1 (en) * 2001-06-29 2003-01-30 Birkmayer Joerg G. D. Method for treating effects of sleep deprivation and jet lag with NADPH and NADPH
US6516805B1 (en) * 1993-09-29 2003-02-11 W. Keith Thornton Apparatus for prevention of snoring and improved breathing during sleep
US20030055348A1 (en) * 2001-09-14 2003-03-20 University College Dublin Apparatus for detecting sleep apnea using electrocardiogram signals
US20030053956A1 (en) * 2001-01-24 2003-03-20 Thomas Hofmann Alkylaryl polyether alcohol polymers for treatment and prophylaxis of snoring, sleep apnea, sudden infant death syndrome and for improvement of nasal breathing
US6536439B1 (en) * 1995-03-30 2003-03-25 Richard George Palmisano Apparatus and methods for treatment of conditions including obstructive sleep apnea and snoring
US20030056785A1 (en) * 2001-09-27 2003-03-27 Matsuda Narihiko Device for preventing sleep apnea
US6555564B1 (en) * 1999-03-04 2003-04-29 The Board Of Trustees Of The University Of Illinois Neuropharmacological treatments of sleep-related breathing disorders
US20030083241A1 (en) * 2001-11-01 2003-05-01 Young Charles W. Use of somatostatin receptor agonists in the treatment of human disorders of sleep hypoxia and oxygen deprivation
US20030093131A1 (en) * 2000-09-13 2003-05-15 Alfred E. Mann Institute Method and apparatus for conditioning muscles during sleep
US6574507B1 (en) * 1998-07-06 2003-06-03 Ela Medical S.A. Active implantable medical device for treating sleep apnea syndrome by electrostimulation
US6580944B1 (en) * 2000-11-28 2003-06-17 The United States Of America As Represented By The Secretary Of The Navy Method and apparatus for diagnosing sleep breathing disorders while a patient in awake
US6587725B1 (en) * 1998-07-27 2003-07-01 Dominique Durand Method and apparatus for closed-loop stimulation of the hypoglossal nerve in human patients to treat obstructive sleep apnea
US20030130266A1 (en) * 2001-12-14 2003-07-10 Miodrag Radulovacki Pharmacological treatment for sleep apnea
US20070179557A1 (en) * 2006-01-27 2007-08-02 Maschino Steven E Controlling neuromodulation using stimulus modalities
US20070288064A1 (en) * 2006-03-09 2007-12-13 Butson Christopher R Systems and methods for determining volume of activation for deep brain stimulation
US7809442B2 (en) * 2006-10-13 2010-10-05 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods

Family Cites Families (167)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2843643A1 (en) * 1978-10-06 1980-04-24 Clinicon Int Gmbh CUFF FOR SPHYGMOMANOMETER
US4649936A (en) * 1984-10-11 1987-03-17 Case Western Reserve University Asymmetric single electrode cuff for generation of unidirectionally propagating action potentials for collision blocking
US4920979A (en) * 1988-10-12 1990-05-01 Huntington Medical Research Institute Bidirectional helical electrode for nerve stimulation
US5233983A (en) 1991-09-03 1993-08-10 Medtronic, Inc. Method and apparatus for apnea patient screening
US6629527B1 (en) 1991-10-17 2003-10-07 Respironics, Inc. Sleep apnea treatment apparatus
US7013892B2 (en) 1991-11-01 2006-03-21 Ric Investments, Llc Sleep apnea treatment apparatus
US6729335B1 (en) 1993-04-13 2004-05-04 Silent Knights Ventures Inc. Dental appliance for treatment of snoring and obstructive sleep apnea
US5400784A (en) * 1993-10-15 1995-03-28 Case Western Reserve University Slowly penetrating inter-fascicular nerve cuff electrode and method of using
US5505201A (en) * 1994-04-20 1996-04-09 Case Western Reserve University Implantable helical spiral cuff electrode
US7090672B2 (en) 1995-06-07 2006-08-15 Arthrocare Corporation Method for treating obstructive sleep disorder includes removing tissue from the base of tongue
US5833714A (en) * 1996-01-18 1998-11-10 Loeb; Gerald E. Cochlear electrode array employing tantalum metal
ATE274974T1 (en) * 1997-01-13 2004-09-15 Neurodan As IMPLANTABLE ELECTRODE FOR NERVE STIMULATION
US5988171A (en) 1997-06-26 1999-11-23 Influence Medical Technologies, Ltd. Methods and devices for the treatment of airway obstruction, sleep apnea and snoring
US5824027A (en) * 1997-08-14 1998-10-20 Simon Fraser University Nerve cuff having one or more isolated chambers
AU1093099A (en) 1997-10-17 1999-05-10 Penn State Research Foundation; The Muscle stimulating device and method for diagnosing and treating a breathin g disorder
AU4433399A (en) 1998-06-15 2000-01-05 Sepracor, Inc. Use of optically pure (+)-norcisapride for treating apnea, bulimia and other disorders
US6939879B2 (en) 1998-08-28 2005-09-06 Aventis Pharmaceuticals Inc. Use of R (+)-α-(2,3-dimethoxyphenyl)-1-[2-(4-fluorophenyl)ethyl]-4-piperidinemethanol for the treatment of substance induced insomnia
DE19847446B4 (en) * 1998-10-08 2010-04-22 Biotronik Gmbh & Co. Kg Nerve electrode assembly
US7076307B2 (en) 2002-05-09 2006-07-11 Boveja Birinder R Method and system for modulating the vagus nerve (10th cranial nerve) with electrical pulses using implanted and external components, to provide therapy neurological and neuropsychiatric disorders
FR2789592A1 (en) 1999-02-12 2000-08-18 Mallinckrodt Dev France APPARATUS FOR PROVIDING AIR PRESSURE TO A PATIENT WITH SLEEP DISORDERS AND ITS CONTROL METHODS
FR2789593B1 (en) 1999-05-21 2008-08-22 Mallinckrodt Dev France APPARATUS FOR SUPPLYING AIR PRESSURE TO A PATIENT WITH SLEEP DISORDERS AND METHODS OF CONTROLLING THE SAME
FR2789594A1 (en) 1999-05-21 2000-08-18 Nellcor Puritan Bennett France APPARATUS FOR PROVIDING AIR PRESSURE TO A PATIENT WITH SLEEP DISORDERS AND ITS CONTROL METHODS
US6594370B1 (en) * 1999-07-16 2003-07-15 James C. Anderson Wireless personal communication apparatus in the form of a necklace
AU6615300A (en) 1999-07-30 2001-02-19 Board Of Trustees Of The Leland Stanford Junior University Hypocretin and hypocretin receptors in regulation of sleep and related disorders
US6553263B1 (en) 1999-07-30 2003-04-22 Advanced Bionics Corporation Implantable pulse generators using rechargeable zero-volt technology lithium-ion batteries
US6778858B1 (en) * 1999-09-16 2004-08-17 Advanced Bionics N.V. Cochlear implant
US6636767B1 (en) 1999-09-29 2003-10-21 Restore Medical, Inc. Implanatable stimulation device for snoring treatment
US6358281B1 (en) * 1999-11-29 2002-03-19 Epic Biosonics Inc. Totally implantable cochlear prosthesis
SE0000601D0 (en) 2000-02-24 2000-02-24 Jan Hedner Methods to treat and diagnose respiratory disorders in sleep and agents to perform the procedure
US7059328B2 (en) 2000-03-13 2006-06-13 Innomed Technologies, Inc. Ventilation interface for sleep apnea therapy
US6666830B1 (en) 2000-08-17 2003-12-23 East River Ventures, Lp System and method for detecting the onset of an obstructive sleep apnea event
US7499742B2 (en) 2001-09-26 2009-03-03 Cvrx, Inc. Electrode structures and methods for their use in cardiovascular reflex control
US6842647B1 (en) 2000-10-20 2005-01-11 Advanced Bionics Corporation Implantable neural stimulator system including remote control unit for use therewith
US20070173893A1 (en) 2000-10-20 2007-07-26 Pitts Walter C Method and apparatus for preventing obstructive sleep apnea
SE523042C2 (en) 2000-11-15 2004-03-23 Bjoern Wennerholm Hormone treatment of obstructive sleep apnea, comprises oral administration of melatonin
US6788975B1 (en) 2001-01-30 2004-09-07 Advanced Bionics Corporation Fully implantable miniature neurostimulator for stimulation as a therapy for epilepsy
JP2004524088A (en) 2001-02-16 2004-08-12 レスメッド・リミテッド Monitoring pneumatic signals in devices for treating sleep-disordered breathing
US6901292B2 (en) 2001-03-19 2005-05-31 Medtronic, Inc. Control of externally induced current in an implantable pulse generator
CA2443105C (en) 2001-04-06 2011-11-08 The Board Of Trustees Of The University Of Illinois Functional role for cannabinoids in autonomic stability during sleep
US7916013B2 (en) 2005-03-21 2011-03-29 Greatbatch Ltd. RFID detection and identification system for implantable medical devices
US7206635B2 (en) 2001-06-07 2007-04-17 Medtronic, Inc. Method and apparatus for modifying delivery of a therapy in response to onset of sleep
US6999819B2 (en) 2001-08-31 2006-02-14 Medtronic, Inc. Implantable medical electrical stimulation lead fixation method and apparatus
US7004941B2 (en) 2001-11-08 2006-02-28 Arthrocare Corporation Systems and methods for electrosurigical treatment of obstructive sleep disorders
DE10155963A1 (en) 2001-11-09 2003-05-22 Beiersdorf Ag Cosmetic and dermatological light protection formulations containing hydroxybenzophenones, triazine and / or benzotriazole derivatives
US6993384B2 (en) 2001-12-04 2006-01-31 Advanced Bionics Corporation Apparatus and method for determining the relative position and orientation of neurostimulation leads
FR2833177B1 (en) 2001-12-07 2004-06-04 Ela Medical Sa ACTIVE MEDICAL DEVICE INCLUDING ADVANCED MEANS OF DISCRIMINATION IN THE WAKING AND SLEEPING PHASES
FR2833496B1 (en) * 2001-12-14 2004-02-13 Ela Medical Sa ACTIVE MEDICAL DEVICE COMPRISING IMPROVED MEANS OF DIAGNOSING SLEEP APNEA SYNDROME
US20040097871A1 (en) 2002-01-03 2004-05-20 Israel Yerushalmy Apparatus for treating sleep disorders
US20040146873A1 (en) 2002-01-11 2004-07-29 Louis Ptacek Advanced sleep phase syndrome gen in humans
AU2003210598A1 (en) 2002-01-18 2003-09-04 Hypnion Inc Treatment of sleep disorders using sleep target modulators
WO2003061471A1 (en) 2002-01-22 2003-07-31 Medcare Flaga Hf. Analysis of sleep apnea
US20030176788A1 (en) 2002-01-28 2003-09-18 New Health Sciences, Inc. Detecting, assessing, and diagnosing sleep apnea
US6999817B2 (en) 2002-02-14 2006-02-14 Packsetter, Inc. Cardiac stimulation device including sleep apnea prevention and treatment
US6904320B2 (en) 2002-02-14 2005-06-07 Pacesetter, Inc. Sleep apnea therapy device using dynamic overdrive pacing
US6928324B2 (en) 2002-02-14 2005-08-09 Pacesetter, Inc. Stimulation device for sleep apnea prevention, detection and treatment
FR2836049B1 (en) 2002-02-15 2004-12-24 Ela Medical Sa ACTIVE MEDICAL DEVICE, ESPECIALLY A CARDIAC STIMULATOR, INCLUDING IMPROVED MEANS FOR DETECTING AND TREATING SLEEP VENTILATORY DISORDERS
US20030167018A1 (en) 2002-03-04 2003-09-04 Robert Wyckoff Sleep apnea device and method thereof
JP2005519680A (en) * 2002-03-14 2005-07-07 ブレインズゲート リミティド Blood pressure control technology
US6857149B2 (en) 2002-03-15 2005-02-22 Todd Damon Hoggatt Sleep support system
US7239912B2 (en) 2002-03-22 2007-07-03 Leptos Biomedical, Inc. Electric modulation of sympathetic nervous system
US7000611B2 (en) 2002-03-26 2006-02-21 Klemperer Walter G Mouthpiece, nasal seal, head appliance, apparatus, and methods of treating sleep apnea
US20030195571A1 (en) 2002-04-12 2003-10-16 Burnes John E. Method and apparatus for the treatment of central sleep apnea using biventricular pacing
US20030204213A1 (en) 2002-04-30 2003-10-30 Jensen Donald N. Method and apparatus to detect and monitor the frequency of obstructive sleep apnea
US20030216789A1 (en) 2002-05-14 2003-11-20 The Foundry, Inc. Method and system for treating sleep apnea
US7003352B1 (en) 2002-05-24 2006-02-21 Advanced Bionics Corporation Treatment of epilepsy by brain stimulation
US6881192B1 (en) 2002-06-12 2005-04-19 Pacesetter, Inc. Measurement of sleep apnea duration and evaluation of response therapies using duration metrics
US8559649B2 (en) 2002-06-24 2013-10-15 Kurzweil Technologies, Inc. Sleep-aide device
US7117036B2 (en) 2002-06-27 2006-10-03 Pacesetter, Inc. Using activity-based rest disturbance as a metric of sleep apnea
US7282027B2 (en) 2002-08-07 2007-10-16 Apneos Corporation Service center system and method as a component of a population diagnostic for sleep disorders
US20050113646A1 (en) 2003-11-24 2005-05-26 Sotos John G. Method and apparatus for evaluation of sleep disorders
US6938620B2 (en) 2002-08-09 2005-09-06 Charles E. Payne, Jr. Headwear for use by a sleep apnea patient
US20050061326A1 (en) 2002-08-09 2005-03-24 Payne Charles E. Headwear for use by a sleep apnea patient
US7328069B2 (en) 2002-09-06 2008-02-05 Medtronic, Inc. Method, system and device for treating disorders of the pelvic floor by electrical stimulation of and the delivery of drugs to the left and right pudendal nerves
US7244235B2 (en) 2002-10-30 2007-07-17 Mallinckrodt, Inc. Split-night sleep diagnostic system
US6878121B2 (en) 2002-11-01 2005-04-12 David T. Krausman Sleep scoring apparatus and method
US20050075680A1 (en) 2003-04-18 2005-04-07 Lowry David Warren Methods and systems for intracranial neurostimulation and/or sensing
US7189204B2 (en) 2002-12-04 2007-03-13 Cardiac Pacemakers, Inc. Sleep detection using an adjustable threshold
WO2004052459A1 (en) * 2002-12-09 2004-06-24 Medtronic, Inc. Concavity of an implantable medical device
FR2848861B1 (en) 2002-12-24 2005-09-30 Ela Medical Sa ACTIVE MEDICAL DEVICE, IN PARTICULAR IMPLANTABLE DEVICE SUCH AS CARDIAC STIMULATOR, DEFIBRILLATOR, CARDIOVERTER OR MULTISITE DEVICE, COMPRISING MEANS FOR DETECTING SLEEP DISORDERS
US7992566B2 (en) 2002-12-30 2011-08-09 Quiescence Medical, Inc. Apparatus and methods for treating sleep apnea
AU2004204771B2 (en) 2003-01-09 2009-11-12 The Research Foundation Of State University Of New York Method of treating functional somatic syndromes and diagnosing sleep disorders based on functional somatic syndrome symptoms
US7025730B2 (en) 2003-01-10 2006-04-11 Medtronic, Inc. System and method for automatically monitoring and delivering therapy for sleep-related disordered breathing
US7512448B2 (en) * 2003-01-10 2009-03-31 Phonak Ag Electrode placement for wireless intrabody communication between components of a hearing system
US7331349B2 (en) 2003-01-23 2008-02-19 Surgical Devices, Ltd., Co. Morningstar Holding Ltd. Method and device for the prevention of snoring and sleep apnea
US7092755B2 (en) 2003-03-18 2006-08-15 Pacesetter, Inc. System and method of cardiac pacing during sleep apnea
US20040187873A1 (en) 2003-03-28 2004-09-30 Brown C. Stephen Human jaw supportive device for reducing snoring and obstructive sleep apnea
CA2519771C (en) * 2003-04-02 2011-11-29 Neurostream Technologies Inc. Implantable nerve signal sensing and stimulation device for treating foot drop and other neurological disorders
US7570997B2 (en) 2003-04-11 2009-08-04 Cardiac Pacemakers, Inc. Subcutaneous cardiac rhythm management with asystole prevention therapy
US6671907B1 (en) 2003-04-15 2004-01-06 Najeeb Zuberi Sleep apnea avoidance process and apparatus
US7155278B2 (en) 2003-04-21 2006-12-26 Medtronic, Inc. Neurostimulation to treat effects of sleep apnea
KR100552681B1 (en) 2003-04-25 2006-02-20 삼성전자주식회사 Apparatus and method for diagnosing sleep apnea
US20040235807A1 (en) 2003-05-21 2004-11-25 Weinrich Karl P. Formulations including a topical decongestant and a topical corticosteroid suitable for nasal administration and method for treating obstructive sleep apnea
US6766802B1 (en) 2003-06-05 2004-07-27 Bryan Keropian Sleep appliance
US7190995B2 (en) 2003-06-13 2007-03-13 The Regents Of The University Of Michigan System and method for analysis of respiratory cycle-related EEG changes in sleep-disordered breathing
US6942626B2 (en) 2003-07-24 2005-09-13 Predictive Technologies, Inc. Apparatus and method for identifying sleep disordered breathing
US7311103B2 (en) 2003-07-29 2007-12-25 Checkmate Holding Company, Llc Method for treating obstructive sleep apnea syndrome
US20050031688A1 (en) 2003-08-04 2005-02-10 Ayala William J. Positive wakeup pharmaceutical sleep system with compatible pre-bedtime administration
CA2535613A1 (en) 2003-08-13 2005-02-24 Janssen Pharmaceutica, N.V. Treatment of sleep disorders with cholinesterase inhibitors
US7591265B2 (en) 2003-09-18 2009-09-22 Cardiac Pacemakers, Inc. Coordinated use of respiratory and cardiac therapies for sleep disordered breathing
US7757690B2 (en) 2003-09-18 2010-07-20 Cardiac Pacemakers, Inc. System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep
US8192376B2 (en) 2003-08-18 2012-06-05 Cardiac Pacemakers, Inc. Sleep state classification
US7469697B2 (en) 2003-09-18 2008-12-30 Cardiac Pacemakers, Inc. Feedback system and method for sleep disordered breathing therapy
US7887493B2 (en) 2003-09-18 2011-02-15 Cardiac Pacemakers, Inc. Implantable device employing movement sensing for detecting sleep-related disorders
US7572225B2 (en) 2003-09-18 2009-08-11 Cardiac Pacemakers, Inc. Sleep logbook
US8002553B2 (en) 2003-08-18 2011-08-23 Cardiac Pacemakers, Inc. Sleep quality data collection and evaluation
JP4472294B2 (en) 2003-08-22 2010-06-02 株式会社サトー Sleep apnea syndrome diagnosis apparatus, signal analysis apparatus and method thereof
US20050045190A1 (en) 2003-08-29 2005-03-03 Janet Bennett Method and system of treating sleep disorders
JP2007506731A (en) 2003-09-26 2007-03-22 ファイザー・プロダクツ・インク Treatment of neurological disorders associated with rapid eye movement (REM) sleep disturbance by NPYY5 receptor antagonists
US7115097B2 (en) 2003-10-09 2006-10-03 Johnson Joseph L Positive airway pressure notification system for treatment of breathing disorders during sleep
US20050085874A1 (en) 2003-10-17 2005-04-21 Ross Davis Method and system for treating sleep apnea
US7130687B2 (en) 2003-10-24 2006-10-31 Medtronic, Inc Implantable medical device and method for delivering therapy for sleep-disordered breathing
US20050108133A1 (en) 2003-11-14 2005-05-19 Infravio, Inc. Service shopping and provisioning system and method
JP2007518469A (en) 2003-11-26 2007-07-12 タイラー ミッシェル ユージン System and method for modifying vestibular biomechanics
US20050133026A1 (en) 2003-12-23 2005-06-23 Katie Seleznev Device for the treatment of snoring and obstructive sleep apnea
US6964641B2 (en) 2003-12-24 2005-11-15 Medtronic, Inc. Implantable medical device with sleep disordered breathing monitoring
US7524279B2 (en) 2003-12-31 2009-04-28 Raphael Auphan Sleep and environment control method and system
US7164941B2 (en) 2004-01-06 2007-01-16 Dale Julian Misczynski Method and system for contactless monitoring and evaluation of sleep states of a user
US20050150504A1 (en) 2004-01-14 2005-07-14 Heeke David W. Method and device for addressing sleep apnea and related breathing disorders
US7697990B2 (en) 2004-02-20 2010-04-13 Resmed Limited Method and apparatus for detection and treatment of respiratory disorder by implantable device
US7366572B2 (en) 2004-03-16 2008-04-29 Medtronic, Inc. Controlling therapy based on sleep quality
US7245971B2 (en) 2004-04-21 2007-07-17 Pacesetter, Inc. System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device
US7240833B2 (en) 2004-05-20 2007-07-10 Cardiac Pacemakers, Inc. System and method of managing information for an implantable medical device
WO2006022993A2 (en) 2004-06-10 2006-03-02 Ndi Medical, Llc Implantable generator for muscle and nerve stimulation
US7613520B2 (en) 2004-10-21 2009-11-03 Advanced Neuromodulation Systems, Inc. Spinal cord stimulation to treat auditory dysfunction
US8489189B2 (en) 2004-10-29 2013-07-16 Medtronic, Inc. Expandable fixation mechanism
US7642915B2 (en) * 2005-01-18 2010-01-05 Checkpoint Systems, Inc. Multiple frequency detection system
US8788044B2 (en) 2005-01-21 2014-07-22 Michael Sasha John Systems and methods for tissue stimulation in medical treatment
US7680538B2 (en) * 2005-03-31 2010-03-16 Case Western Reserve University Method of treating obstructive sleep apnea using electrical nerve stimulation
US7751884B2 (en) 2005-04-28 2010-07-06 Cardiac Pacemakers, Inc. Flexible neural stimulation engine
US7644714B2 (en) 2005-05-27 2010-01-12 Apnex Medical, Inc. Devices and methods for treating sleep disorders
US8620436B2 (en) 2005-07-08 2013-12-31 Boston Scientific Neuromodulation Corporation Current generation architecture for an implantable stimulator device having coarse and fine current control
US8175717B2 (en) 2005-09-06 2012-05-08 Boston Scientific Neuromodulation Corporation Ultracapacitor powered implantable pulse generator with dedicated power supply
US7684858B2 (en) 2005-09-21 2010-03-23 Boston Scientific Neuromodulation Corporation Methods and systems for placing an implanted stimulator for stimulating tissue
US20070100411A1 (en) 2005-10-27 2007-05-03 Medtronic, Inc. Implantable medical electrical stimulation lead fixation method and apparatus
US8016776B2 (en) 2005-12-02 2011-09-13 Medtronic, Inc. Wearable ambulatory data recorder
US7672728B2 (en) 2005-12-28 2010-03-02 Cardiac Pacemakers, Inc. Neural stimulator to treat sleep disordered breathing
EP1981584B1 (en) 2006-02-03 2015-05-13 Interventional Autonomics Corporation Intravascular device for neuromodulation
US20070233204A1 (en) * 2006-02-16 2007-10-04 Lima Marcelo G RFID-based apparatus, system, and method for therapeutic treatment of a patient
ES2635714T3 (en) 2006-04-07 2017-10-04 Boston Scientific Neuromodulation Corporation System that uses multiple timing channels for electrode adjustment during configuration of an implanted stimulator device
US20070255367A1 (en) 2006-04-27 2007-11-01 Medtronic, Inc. Implantable Medical Electrical Stimulation Lead Fixation Method and Apparatus
US8135476B2 (en) 2006-04-27 2012-03-13 Medtronic, Inc. Implantable medical electrical stimulation lead fixation method and apparatus
US20080021506A1 (en) 2006-05-09 2008-01-24 Massachusetts General Hospital Method and device for the electrical treatment of sleep apnea and snoring
WO2007140584A1 (en) 2006-06-02 2007-12-13 William Toderan Method and apparatus for treating sleep apnea and snoring
US7660632B2 (en) 2006-06-30 2010-02-09 Ric Investments, Llc Method and apparatus for hypoglossal nerve stimulation
US20080039904A1 (en) 2006-08-08 2008-02-14 Cherik Bulkes Intravascular implant system
US20080039916A1 (en) 2006-08-08 2008-02-14 Olivier Colliou Distally distributed multi-electrode lead
US8874214B2 (en) 2006-08-28 2014-10-28 Cardiac Pacemakers, Inc. Implantable pulse generator with a stacked capacitor, battery, and electronics
EP2063778A4 (en) 2006-09-19 2011-08-24 Neurostream Technologies General Partnership Method and system for the monitoring of respiratory activity and for the treatment of breathing disorders such as sleep apnea
US8249723B2 (en) 2006-09-27 2012-08-21 Huntington Medical Research Institutes Apparatus and method for treating obstructive sleep apnea
US8588927B2 (en) 2006-10-06 2013-11-19 Neurostream Technologies General Partnership Implantable pulse generator
US7979126B2 (en) 2006-10-18 2011-07-12 Boston Scientific Neuromodulation Corporation Orientation-independent implantable pulse generator
US20080109047A1 (en) 2006-10-26 2008-05-08 Pless Benjamin D Apnea treatment device
US20080103544A1 (en) 2006-10-28 2008-05-01 Weiner Richard L Method of treating female sexual dysfunction
US20080114230A1 (en) 2006-11-14 2008-05-15 Bruce Addis Electrode support
US7979140B2 (en) 2006-12-12 2011-07-12 Alfred E. Mann Foundation For Scientific Research Segmented electrode
US7890178B2 (en) * 2006-12-15 2011-02-15 Medtronic Xomed, Inc. Method and apparatus for assisting deglutition
US8010205B2 (en) 2007-01-11 2011-08-30 Boston Scientific Neuromodulation Corporation Multiple telemetry and/or charging coil configurations for an implantable medical device system
US8082034B2 (en) * 2007-01-26 2011-12-20 Medtronic, Inc. Graphical configuration of electrodes for electrical stimulation
US7932696B2 (en) 2007-05-14 2011-04-26 Boston Scientific Neuromodulation Corporation Charger alignment indicator with adjustable threshold
US20100198103A1 (en) 2007-10-09 2010-08-05 Imthera Medical, Inc. System and method for neural stimulation
US8498716B2 (en) 2007-11-05 2013-07-30 Boston Scientific Neuromodulation Corporation External controller for an implantable medical device system with coupleable external charging coil assembly
US20110112604A1 (en) 2008-02-01 2011-05-12 The Governors Of The University Of Alberta Mitigation of pressure ulcers using electrical stimulation
WO2009100531A1 (en) 2008-02-15 2009-08-20 Angeltear Solutions Inc. Adjustable tissue or nerve cuff and method of use
WO2009132127A1 (en) 2008-04-23 2009-10-29 Allergan, Inc. Remotely adjustable gastric banding system
WO2009140636A2 (en) 2008-05-15 2009-11-19 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
EP2331201B1 (en) 2008-10-01 2020-04-29 Inspire Medical Systems, Inc. System for treating sleep apnea transvenously
EP3184045B1 (en) 2008-11-19 2023-12-06 Inspire Medical Systems, Inc. System treating sleep disordered breathing

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4424812A (en) * 1980-10-09 1984-01-10 Cordis Corporation Implantable externally programmable microprocessor-controlled tissue stimulator
US4602624A (en) * 1984-10-11 1986-07-29 Case Western Reserve University Implantable cuff, method of manufacture, and method of installation
US20020124848A1 (en) * 1987-06-26 2002-09-12 Sullivan Colin Edward Method and apparatus useful in the diagnosis of obstructive sleep apnea of a patient
US20020007127A1 (en) * 1987-06-26 2002-01-17 Sullivan Colin E. Device for monitoring breathing during sleep and ramped control of CPAP treatment
US20020100477A1 (en) * 1987-06-26 2002-08-01 Resmed Limited Method and apparatus useful in the diagnosis of obstructive sleep apnea of a patient
US5094242A (en) * 1988-11-07 1992-03-10 Regents Of The University Of California Implantable nerve stimulation device
US6432956B1 (en) * 1990-02-12 2002-08-13 William C. Dement Method for treatment of sleep apneas
US5095905A (en) * 1990-06-07 1992-03-17 Medtronic, Inc. Implantable neural electrode
US5123425A (en) * 1990-09-06 1992-06-23 Edentec Obstructive sleep apnea collar
US5133354A (en) * 1990-11-08 1992-07-28 Medtronic, Inc. Method and apparatus for improving muscle tone
US5158080A (en) * 1990-11-08 1992-10-27 Medtronic, Inc. Muscle tone
US5281219A (en) * 1990-11-23 1994-01-25 Medtronic, Inc. Multiple stimulation electrodes
US5300094A (en) * 1991-01-09 1994-04-05 Medtronic, Inc. Servo muscle control
US5211173A (en) * 1991-01-09 1993-05-18 Medtronic, Inc. Servo muscle control
US5190053A (en) * 1991-02-28 1993-03-02 Jeffrey A. Meer, Revocable Living Trust Method and apparatus for electrical sublingual stimulation
US5146918A (en) * 1991-03-19 1992-09-15 Medtronic, Inc. Demand apnea control of central and obstructive sleep apnea
US5215082A (en) * 1991-04-02 1993-06-01 Medtronic, Inc. Implantable apnea generator with ramp on generator
US5174287A (en) * 1991-05-28 1992-12-29 Medtronic, Inc. Airway feedback measurement system responsive to detected inspiration and obstructive apnea event
US6427689B1 (en) * 1991-11-01 2002-08-06 Respironics, Inc. Sleep apnea treatment apparatus
US20030055346A1 (en) * 1992-05-07 2003-03-20 Rapoport David M. Method and apparatus for optimizing the continuous positive airway pressure for treating obstructive sleep apnea
US6488634B1 (en) * 1992-05-07 2002-12-03 New York University Method and apparatus for optimizing the continuous positive airway pressure for treating obstructive sleep apnea
US20020173707A1 (en) * 1992-08-19 2002-11-21 Lynn Lawrence A. Microprocessor system for the simplified diagnosis of sleep apnea
US20010018557A1 (en) * 1992-08-19 2001-08-30 Lawrence A. Lynn Microprocessor system for the simplified diagnosis of sleep apnea
US5344438A (en) * 1993-04-16 1994-09-06 Medtronic, Inc. Cuff electrode
US6516805B1 (en) * 1993-09-29 2003-02-11 W. Keith Thornton Apparatus for prevention of snoring and improved breathing during sleep
US5483969A (en) * 1994-09-21 1996-01-16 Medtronic, Inc. Method and apparatus for providing a respiratory effort waveform for the treatment of obstructive sleep apnea
US5540731A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for pressure detecting and treating obstructive airway disorders
US5522862A (en) * 1994-09-21 1996-06-04 Medtronic, Inc. Method and apparatus for treating obstructive sleep apnea
US5540732A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for impedance detecting and treating obstructive airway disorders
US5546952A (en) * 1994-09-21 1996-08-20 Medtronic, Inc. Method and apparatus for detection of a respiratory waveform
US5540733A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for detecting and treating obstructive sleep apnea
US5545201A (en) * 1995-03-29 1996-08-13 Pacesetter, Inc. Bipolar active fixation lead for sensing and pacing the heart
US6536439B1 (en) * 1995-03-30 2003-03-25 Richard George Palmisano Apparatus and methods for treatment of conditions including obstructive sleep apnea and snoring
US5771891A (en) * 1995-05-10 1998-06-30 Massachusetts Inst Technology Apparatus and method for non-invasive blood analyte measurement
US5591216A (en) * 1995-05-19 1997-01-07 Medtronic, Inc. Method for treatment of sleep apnea by electrical stimulation
US6051017A (en) * 1996-02-20 2000-04-18 Advanced Bionics Corporation Implantable microstimulator and systems employing the same
US5713922A (en) * 1996-04-25 1998-02-03 Medtronic, Inc. Techniques for adjusting the locus of excitation of neural tissue in the spinal cord or brain
US6021352A (en) * 1996-06-26 2000-02-01 Medtronic, Inc, Diagnostic testing methods and apparatus for implantable therapy devices
US6572543B1 (en) * 1996-06-26 2003-06-03 Medtronic, Inc Sensor, method of sensor implant and system for treatment of respiratory disorders
US6132384A (en) * 1996-06-26 2000-10-17 Medtronic, Inc. Sensor, method of sensor implant and system for treatment of respiratory disorders
US5837006A (en) * 1996-09-10 1998-11-17 Medtronic, Inc. Retraction stop for helical medical lead electrode
US20010001125A1 (en) * 1997-02-26 2001-05-10 Schulman Joseph H. System of implantable devices for monitoring and/or affecting body parameters
US20020099033A1 (en) * 1997-04-16 2002-07-25 Wisconsin Alumni Research Foundation Method and composition for treating sleep apnea
US5871512A (en) * 1997-04-29 1999-02-16 Medtronic, Inc. Microprocessor capture detection circuit and method
US20020086870A1 (en) * 1998-02-27 2002-07-04 The Board Of Trustees Of The University Of Illinois Pharmacological treatment for sleep apnea
US6175767B1 (en) * 1998-04-01 2001-01-16 James H. Doyle, Sr. Multichannel implantable inner ear stimulator
US6269269B1 (en) * 1998-04-23 2001-07-31 Medtronic Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US6251126B1 (en) * 1998-04-23 2001-06-26 Medtronic Inc Method and apparatus for synchronized treatment of obstructive sleep apnea
US6409676B2 (en) * 1998-06-18 2002-06-25 Taema Process for determining respiratory phases of the sleep of a user
US20010000346A1 (en) * 1998-06-18 2001-04-19 Stephane Ruton Process for determining respiratory phases of the sleep of a user
US6266560B1 (en) * 1998-06-19 2001-07-24 Genetronics, Inc. Electrically assisted transdermal method and apparatus for the treatment of erectile dysfunction
US6574507B1 (en) * 1998-07-06 2003-06-03 Ela Medical S.A. Active implantable medical device for treating sleep apnea syndrome by electrostimulation
US6587725B1 (en) * 1998-07-27 2003-07-01 Dominique Durand Method and apparatus for closed-loop stimulation of the hypoglossal nerve in human patients to treat obstructive sleep apnea
US6240316B1 (en) * 1998-08-14 2001-05-29 Advanced Bionics Corporation Implantable microstimulation system for treatment of sleep apnea
US20010010010A1 (en) * 1998-08-14 2001-07-26 Richmond Francis J.R. Method of treating obstructive sleep apnea using implantable electrodes
US6345202B2 (en) * 1998-08-14 2002-02-05 Advanced Bionics Corporation Method of treating obstructive sleep apnea using implantable electrodes
US20010041719A1 (en) * 1998-08-28 2001-11-15 Cesare Mondadori The use of R (+)-alpha- (2,3-Dimethoxyphenyl) -1- [ 2- (4-fluorophenyl) ethyl] -4-piper idinemethanol for the treatment of sleep disorders
US6415174B1 (en) * 1998-11-09 2002-07-02 Board Of Regents The University Of Texas System ECG derived respiratory rhythms for improved diagnosis of sleep apnea
US6212435B1 (en) * 1998-11-13 2001-04-03 Respironics, Inc. Intraoral electromuscular stimulation device and method
US6555564B1 (en) * 1999-03-04 2003-04-29 The Board Of Trustees Of The University Of Illinois Neuropharmacological treatments of sleep-related breathing disorders
US20010015204A1 (en) * 1999-03-26 2001-08-23 Mallinckrodt Inc. Method and combination for treating sleep apnea using a cantilever mask attachment device
US6516802B2 (en) * 1999-03-26 2003-02-11 Mallinckrodt, Inc. Method and combination for treating sleep apnea using a cantilever mask attachment device
US6475156B1 (en) * 1999-06-14 2002-11-05 Taema Apparatus for the diagnosis or treatment of respiratory sleep disorders and operating process
US20010046988A1 (en) * 1999-08-13 2001-11-29 Vela Pharmaceuticals, Inc. Methods and compositions for treating or preventing sleep disturbances and associated illnesses using very low doses of cyclobenzaprine
US6456866B1 (en) * 1999-09-28 2002-09-24 Dustin Tyler Flat interface nerve electrode and a method for use
US20010027793A1 (en) * 2000-01-11 2001-10-11 W.M.J. Tielemans Oral orthesis to reduce snoring and sleep apnea symptoms
US6408852B2 (en) * 2000-01-11 2002-06-25 Tnv Research And Development Oral orthesis to reduce snoring and sleep apnea symptoms
US20020015740A1 (en) * 2000-02-22 2002-02-07 Ackman C. Bruce Methods and compositions for improving sleep
US6586478B2 (en) * 2000-02-22 2003-07-01 Cellegy Canada Methods and compositions for improving sleep
US20030004423A1 (en) * 2000-03-02 2003-01-02 Itamar Medical Ltd. Method and apparatus for the non-invasive detection of particular sleep-state conditions by monitoring the peripheral vascular system
US20020059935A1 (en) * 2000-03-13 2002-05-23 Wood Thomas J. Ventilation interface for sleep apnea therapy
US20020092527A1 (en) * 2000-03-13 2002-07-18 Wood Thomas J. Ventilation interface for sleep apnea therapy
US20020037533A1 (en) * 2000-04-28 2002-03-28 Olivier Civelli Screening and therapeutic methods for promoting wakefulness and sleep
US20020124849A1 (en) * 2000-05-26 2002-09-12 Taema Nasal breathing mask with adjustable thermistor for treating respiratory disorders of sleep
US20030093131A1 (en) * 2000-09-13 2003-05-15 Alfred E. Mann Institute Method and apparatus for conditioning muscles during sleep
US20020049479A1 (en) * 2000-10-20 2002-04-25 Pitts Walter C. Method and apparatus for creating afferents to prevent obstructive sleep apnea
US6454724B1 (en) * 2000-10-25 2002-09-24 Safe Flight Instrument Corporation Sleep apnea detection system and method
US6580944B1 (en) * 2000-11-28 2003-06-17 The United States Of America As Represented By The Secretary Of The Navy Method and apparatus for diagnosing sleep breathing disorders while a patient in awake
US20020165462A1 (en) * 2000-12-29 2002-11-07 Westbrook Philip R. Sleep apnea risk evaluation
US20020095076A1 (en) * 2001-01-17 2002-07-18 Individual Monitoring Systems, Inc. Sleep disorder breathing event counter
US6529752B2 (en) * 2001-01-17 2003-03-04 David T. Krausman Sleep disorder breathing event counter
US20030053956A1 (en) * 2001-01-24 2003-03-20 Thomas Hofmann Alkylaryl polyether alcohol polymers for treatment and prophylaxis of snoring, sleep apnea, sudden infant death syndrome and for improvement of nasal breathing
US20020169384A1 (en) * 2001-01-30 2002-11-14 Peter Kowallik Method and device for sleep monitoring
US20020165246A1 (en) * 2001-03-05 2002-11-07 Andrew Holman Administration of sleep restorative agents
US20020144685A1 (en) * 2001-04-02 2002-10-10 Ivanovich Bredov Vladimir Multipurpose device for preventing and treating snoring and sleep apnea and /or preventing gnashing of teeth
US20020175821A1 (en) * 2001-04-04 2002-11-28 Ruppel Edward G. Sleep delay apparatus for drivers
US20020144684A1 (en) * 2001-04-06 2002-10-10 Moone Samuel Joseph BI/PAP mask for sleep apnea and other related clinical uses
US20020193697A1 (en) * 2001-04-30 2002-12-19 Cho Yong Kyun Method and apparatus to detect and treat sleep respiratory events
US20020183306A1 (en) * 2001-05-30 2002-12-05 Pfizer Inc. Combination treatment for sleep disorders including sleep apnea
US20020193839A1 (en) * 2001-06-07 2002-12-19 Cho Yong Kyun Method for providing a therapy to a patient involving modifying the therapy after detecting an onset of sleep in the patient, and implantable medical device embodying same
US20030015198A1 (en) * 2001-06-18 2003-01-23 Heeke David W. Method and device for addressing sleep apnea and related breathing disorders
US20030021772A1 (en) * 2001-06-29 2003-01-30 Birkmayer Joerg G. D. Method for treating effects of sleep deprivation and jet lag with NADPH and NADPH
US20030055348A1 (en) * 2001-09-14 2003-03-20 University College Dublin Apparatus for detecting sleep apnea using electrocardiogram signals
US20030056785A1 (en) * 2001-09-27 2003-03-27 Matsuda Narihiko Device for preventing sleep apnea
US20030083241A1 (en) * 2001-11-01 2003-05-01 Young Charles W. Use of somatostatin receptor agonists in the treatment of human disorders of sleep hypoxia and oxygen deprivation
US20030130266A1 (en) * 2001-12-14 2003-07-10 Miodrag Radulovacki Pharmacological treatment for sleep apnea
US20070179557A1 (en) * 2006-01-27 2007-08-02 Maschino Steven E Controlling neuromodulation using stimulus modalities
US20070288064A1 (en) * 2006-03-09 2007-12-13 Butson Christopher R Systems and methods for determining volume of activation for deep brain stimulation
US7809442B2 (en) * 2006-10-13 2010-10-05 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods

Cited By (76)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9227053B2 (en) 2008-05-02 2016-01-05 Medtronic, Inc. Self expanding electrode cuff
US20110147046A1 (en) * 2008-05-02 2011-06-23 Medtronic, Inc. Self expanding electrode cuff
US20110160827A1 (en) * 2008-05-02 2011-06-30 Medtronic. Inc. Electrode lead system
US8340785B2 (en) 2008-05-02 2012-12-25 Medtronic, Inc. Self expanding electrode cuff
US20090276024A1 (en) * 2008-05-02 2009-11-05 Bonde Eric H Self expanding electrode cuff
US10932682B2 (en) 2008-05-15 2021-03-02 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
US20110152706A1 (en) * 2008-05-15 2011-06-23 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
US9889299B2 (en) 2008-10-01 2018-02-13 Inspire Medical Systems, Inc. Transvenous method of treating sleep apnea
US11083899B2 (en) 2008-10-01 2021-08-10 Inspire Medical Systems, Inc. Transvenous method of treating sleep apnea
US11806537B2 (en) 2008-10-01 2023-11-07 Inspire Medical Systems, Inc. Transvenous method of treating sleep apnea
US8938299B2 (en) 2008-11-19 2015-01-20 Inspire Medical Systems, Inc. System for treating sleep disordered breathing
US10888267B2 (en) 2008-11-19 2021-01-12 Inspire Medical Systems, Inc. Method of treating sleep disordered breathing
US8515520B2 (en) 2008-12-08 2013-08-20 Medtronic Xomed, Inc. Nerve electrode
US20100145221A1 (en) * 2008-12-08 2010-06-10 Brunnett William C Nerve electrode
US9931045B2 (en) 2008-12-08 2018-04-03 Medtronic Xomed, Inc. Nerve electrode
US9486628B2 (en) 2009-03-31 2016-11-08 Inspire Medical Systems, Inc. Percutaneous access for systems and methods of treating sleep apnea
US10543366B2 (en) 2009-03-31 2020-01-28 Inspire Medical Systems, Inc. Percutaneous access for systems and methods of treating sleep-related disordered breathing
US11596786B2 (en) 2009-05-29 2023-03-07 Cochlear Limited Vestibular stimulation device
US10888696B2 (en) * 2009-05-29 2021-01-12 Cochlear Limited Vestibular stimulation device
US10898717B2 (en) 2009-10-20 2021-01-26 Nyxoah SA Device and method for snoring detection and control
US9950166B2 (en) 2009-10-20 2018-04-24 Nyxoah SA Acred implant unit for modulation of nerves
US11857791B2 (en) 2009-10-20 2024-01-02 Nyxoah SA Arced implant unit for modulation of nerves
US9943686B2 (en) 2009-10-20 2018-04-17 Nyxoah SA Method and device for treating sleep apnea based on tongue movement
US11273307B2 (en) 2009-10-20 2022-03-15 Nyxoah SA Method and device for treating sleep apnea
US9849289B2 (en) 2009-10-20 2017-12-26 Nyxoah SA Device and method for snoring detection and control
US10751537B2 (en) 2009-10-20 2020-08-25 Nyxoah SA Arced implant unit for modulation of nerves
US10716940B2 (en) 2009-10-20 2020-07-21 Nyxoah SA Implant unit for modulation of small diameter nerves
US11304648B2 (en) 2010-03-12 2022-04-19 Inspire Medical Systems, Inc. Method and system for identifying a location for nerve stimulation
US9888864B2 (en) 2010-03-12 2018-02-13 Inspire Medical Systems, Inc. Method and system for identifying a location for nerve stimulation
US8983572B2 (en) 2010-10-29 2015-03-17 Inspire Medical Systems, Inc. System and method for patient selection in treating sleep disordered breathing
US11000208B2 (en) * 2011-01-28 2021-05-11 Livanova Usa, Inc. Screening devices and methods for obstructive sleep apnea therapy
US10583297B2 (en) 2011-08-11 2020-03-10 Inspire Medical Systems, Inc. Method and system for applying stimulation in treating sleep disordered breathing
US11511117B2 (en) 2011-08-11 2022-11-29 Inspire Medical Systems, Inc. Method and system for applying stimulation in treating sleep disordered breathing
US11285315B2 (en) 2011-09-01 2022-03-29 Inspire Medical Systems, Inc. Nerve cuff
US11806525B2 (en) 2011-09-01 2023-11-07 Inspire Medical Systems, Inc. Nerve cuff
US8934992B2 (en) 2011-09-01 2015-01-13 Inspire Medical Systems, Inc. Nerve cuff
US10286206B2 (en) 2011-09-01 2019-05-14 Inspire Medical Systems, Inc. Nerve cuff
US10716560B2 (en) 2012-07-26 2020-07-21 Nyxoah SA Implant unit delivery tool
US11730469B2 (en) 2012-07-26 2023-08-22 Nyxoah SA Implant unit delivery tool
US9855032B2 (en) 2012-07-26 2018-01-02 Nyxoah SA Transcutaneous power conveyance device
US11253712B2 (en) 2012-07-26 2022-02-22 Nyxoah SA Sleep disordered breathing treatment apparatus
US10052097B2 (en) 2012-07-26 2018-08-21 Nyxoah SA Implant unit delivery tool
US10918376B2 (en) 2012-07-26 2021-02-16 Nyxoah SA Therapy protocol activation triggered based on initial coupling
US10814137B2 (en) 2012-07-26 2020-10-27 Nyxoah SA Transcutaneous power conveyance device
US10376701B2 (en) 2012-08-31 2019-08-13 Nuvectra Corporation Touch screen safety controls for clinician programmer
US9594877B2 (en) 2012-08-31 2017-03-14 Nuvectra Corporation Virtual reality representation of medical devices
US9471753B2 (en) 2012-08-31 2016-10-18 Nuvectra Corporation Programming and virtual reality representation of stimulation parameter Groups
US9776007B2 (en) 2012-08-31 2017-10-03 Nuvectra Corporation Method and system of quick neurostimulation electrode configuration and positioning
US10668276B2 (en) 2012-08-31 2020-06-02 Cirtec Medical Corp. Method and system of bracketing stimulation parameters on clinician programmers
US8761897B2 (en) 2012-08-31 2014-06-24 Greatbatch Ltd. Method and system of graphical representation of lead connector block and implantable pulse generators on a clinician programmer
US9259577B2 (en) 2012-08-31 2016-02-16 Greatbatch Ltd. Method and system of quick neurostimulation electrode configuration and positioning
US9901740B2 (en) 2012-08-31 2018-02-27 Nuvectra Corporation Clinician programming system and method
US10347381B2 (en) 2012-08-31 2019-07-09 Nuvectra Corporation Programming and virtual reality representation of stimulation parameter groups
US9615788B2 (en) 2012-08-31 2017-04-11 Nuvectra Corporation Method and system of producing 2D representations of 3D pain and stimulation maps and implant models on a clinician programmer
US10141076B2 (en) 2012-08-31 2018-11-27 Nuvectra Corporation Programming and virtual reality representation of stimulation parameter groups
US9180302B2 (en) 2012-08-31 2015-11-10 Greatbatch Ltd. Touch screen finger position indicator for a spinal cord stimulation programming device
US8903496B2 (en) 2012-08-31 2014-12-02 Greatbatch Ltd. Clinician programming system and method
US10083261B2 (en) 2012-08-31 2018-09-25 Nuvectra Corporation Method and system of simulating a pulse generator on a clinician programmer
US8868199B2 (en) 2012-08-31 2014-10-21 Greatbatch Ltd. System and method of compressing medical maps for pulse generator or database storage
US9314640B2 (en) 2012-08-31 2016-04-19 Greatbatch Ltd. Touch screen finger position indicator for a spinal cord stimulation programming device
US8812125B2 (en) 2012-08-31 2014-08-19 Greatbatch Ltd. Systems and methods for the identification and association of medical devices
US9507912B2 (en) 2012-08-31 2016-11-29 Nuvectra Corporation Method and system of simulating a pulse generator on a clinician programmer
US9555255B2 (en) 2012-08-31 2017-01-31 Nuvectra Corporation Touch screen finger position indicator for a spinal cord stimulation programming device
US9375582B2 (en) 2012-08-31 2016-06-28 Nuvectra Corporation Touch screen safety controls for clinician programmer
US8757485B2 (en) 2012-09-05 2014-06-24 Greatbatch Ltd. System and method for using clinician programmer and clinician programming data for inventory and manufacturing prediction and control
US9767255B2 (en) 2012-09-05 2017-09-19 Nuvectra Corporation Predefined input for clinician programmer data entry
US8983616B2 (en) 2012-09-05 2015-03-17 Greatbatch Ltd. Method and system for associating patient records with pulse generators
US9814402B2 (en) 2013-02-15 2017-11-14 Acacia Designs Bv Electrode systems for use with medical monitoring systems
US11298549B2 (en) 2013-06-17 2022-04-12 Nyxoah SA Control housing for disposable patch
US10512782B2 (en) 2013-06-17 2019-12-24 Nyxoah SA Remote monitoring and updating of a medical device control unit
US11642534B2 (en) 2013-06-17 2023-05-09 Nyxoah SA Programmable external control unit
US9643022B2 (en) 2013-06-17 2017-05-09 Nyxoah SA Flexible control housing for disposable patch
US10898709B2 (en) 2015-03-19 2021-01-26 Inspire Medical Systems, Inc. Stimulation for treating sleep disordered breathing
US11806526B2 (en) 2015-03-19 2023-11-07 Inspire Medical Systems, Inc. Stimulation for treating sleep disordered breathing
US11850424B2 (en) 2015-03-19 2023-12-26 Inspire Medical Systems, Inc. Stimulation for treating sleep disordered breathing
US11298540B2 (en) 2017-08-11 2022-04-12 Inspire Medical Systems, Inc. Cuff electrode

Also Published As

Publication number Publication date
EP2197535A1 (en) 2010-06-23
CA2697826A1 (en) 2009-04-16
US9884191B2 (en) 2018-02-06
US10646714B2 (en) 2020-05-12
CA2697822A1 (en) 2009-04-16
US20130165996A1 (en) 2013-06-27
US20100241195A1 (en) 2010-09-23
CN101883606A (en) 2010-11-10
US9849288B2 (en) 2017-12-26
BRPI0818654A2 (en) 2015-04-07
WO2009048580A1 (en) 2009-04-16
US20200338339A1 (en) 2020-10-29
AU2008311312A1 (en) 2009-04-16
EP2197535A4 (en) 2013-08-21
US20180133474A1 (en) 2018-05-17
JP2011500144A (en) 2011-01-06
CN101939043A (en) 2011-01-05
JP2011500143A (en) 2011-01-06
WO2009048581A1 (en) 2009-04-16
US20150328455A1 (en) 2015-11-19
AU2008311313A1 (en) 2009-04-16
BRPI0817852A2 (en) 2015-04-07
US11351364B2 (en) 2022-06-07
EP2197536A1 (en) 2010-06-23

Similar Documents

Publication Publication Date Title
US20100198103A1 (en) System and method for neural stimulation
US11654082B2 (en) Auricular peripheral nerve field stimulator and method of operating same
KR101395473B1 (en) Equine airway disorders
US20180200512A1 (en) Obstructive sleep apnea treatment devices, systems and methods
CA2410248C (en) Vestibular stimulation system and method
CA2368795C (en) Vestibular stimulation system and method
US7801601B2 (en) Controlling neuromodulation using stimulus modalities
JP2022531007A (en) Systems and methods for improving sleep-disordered breathing
CN105873508A (en) Implant unit delivery tool
AU2002301815B2 (en) Vesibular stimulation system and method

Legal Events

Date Code Title Description
AS Assignment

Owner name: IMTHERA MEDICAL, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MEADOWS, PAUL M;LIMA, MARCELO G;CRAIG, STANLEY R;SIGNING DATES FROM 20100216 TO 20100224;REEL/FRAME:023988/0335

AS Assignment

Owner name: IMTHERA MEDICAL, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MEADOWS, PAUL M.;LIMA, MARCELO G.;CRAIG, STANLEY R.;SIGNING DATES FROM 20100216 TO 20100224;REEL/FRAME:024191/0501

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION