Abstract: Methods and apparatus treat a respiratory disorder. For example, a pressure generator supplies a flow of air at positive pressure to a patient's airway through a patient interface. A sensor generates a signal representing respiratory flow rate of the patient. A controller controls the pressure generator to provide to the patient interface a ventilation therapy having a base pressure. The controller computes a measure of ventilation of the patient from the signal. The controller computes a measure of flow limitation from an inspiratory portion of the signal. The controller computes a ratio of the measure of ventilation and an expected normal ventilation. The controller adjusts a set point for the base pressure of the ventilation therapy based on the measure of flow limitation. The adjustment may further depend on a comparison between the ratio and a relative ventilation threshold that increases as the measure of flow limitation increases.

Abstract: A ventilator that delivers air at different pressures to a patient during inspiratory and expiratory cycles of breathing and that cycles from inspiratory to expiratory operation when the patient's respiratory flow passes a threshold level. The threshold generally increases from the beginning of inspiration to the end of inspiration. The increase can be linear over all or only a portion of the inspiratory cycle, and the threshold can be adjusted so that cycling is prevented during the initial portion of an inspiratory cycle. The minimum and maximum levels may both be functions of peak flow and the threshold may increase as a function of elapsed inspiratory time. The rate at which the threshold increases from a minimum level to a maximum level may be adjustable for individual patient needs and may be determined from previous breaths.

Abstract: A respiratory treatment apparatus and method in which a leak is determined by using an averaging window. The window starts at the present time and extends back in time to a point determined according to a current one of progressively detected phase measures of a first respiratory cycle and a corresponding phase measure attributable to a preceding second respiratory cycle. In another aspect, a jamming index indicates whether the leak is rapidly changing. To the extent that jamming is high, the leak estimate used progressively changes from that using sliding breath-window averaging to a more robust and faster responding low-pass filter method, and adjustment of ventilatory support based on measures employing estimated respiratory flow is slowed down or stopped.

Abstract: Systems slow breathing with positive pressure therapy. In embodiments, a current interim breathing rate target is set, and periodically magnitude of a variable pressure waveform scaled to the current interim breathing rate target is increased if breathing rate is greater than the interim rate target to lengthen breath duration. The magnitude of the pressure increase may be a function of the difference between the interim rate target and the breathing rate. The interim rate target may be reduced in response to slowing breathing rate. The waveform cycles, inhalation to exhalation, when airflow decreases to a cycle threshold. Different interim rate targets have different cycle threshold functions that allow easier cycling as the interim rate targets decrease. Similarly, the waveform triggers, exhalation to inhalation, when airflow increases to a trigger threshold. Different interim rate targets have different trigger threshold functions that allow easier triggering as the interim rate targets decrease.

Abstract: A respiratory flow limitation detection device, which can include an airway pressure treatment generator, determines a flow limitation measure 506 based one or more shape indices for detecting partial obstruction and a measure of a patient's ventilation or respiratory duty cycle. The shape indices may be based on function(s) that ascertain the likelihood of the presence of M-shaped breathing patterns and/or chair-shaped breathing patterns. The measure of ventilation may be based on analysis of current and prior tidal volumes to detect a less than normal patient ventilation. The duty cycle measure may be a ratio of current and prior measures of inspiratory time to respiratory cycle time to detect an increase in the patient's inspiratory cycle time relative to the respiratory cycle time. A pressure setting based on the flow limitation may then be used to adjust the treatment pressure to ameliorate the patient's detected flow limitation condition.

Abstract: A patient interface includes a shell with a central opening configured to receive the pressurized flow of air, a foam cushion, and an elastomeric support portion that is attached to the shell, supports the foam cushion, and forms at least part of a chamber together with the shell and the foam cushion. The elastomeric support portion includes a side wall that forms a continuous perimeter around the chamber and a resiliently flexible lip that supports the foam cushion and extends from the side wall toward an interior of the chamber. The resiliently flexible lip has an outer perimeter that is anchored to the side wall and an unsupported inner perimeter. The foam cushion overhangs the inner perimeter of the resiliently flexible lip, and the shell is more rigid than the elastomeric support portion. In addition, the foam cushion is configured to directly contact and engage a portion of the patient's skin in use.

Abstract: A method and apparatus for providing ventilatory assistance to a spontaneously breathing patient an error signal (56) is computed that is the difference between a function of respiratory airflow (54) over a period of time and a target value (52). Using a servo loop, air is delivered to the patient at a pressure that is a function of the error signal, the phase of the current breathing cycle, and a loop gain that varies depending on the magnitude of the error signal. The loop gain increases with the magnitude of the error signal, and the gain is greater for error signals below a ventilation target than for error signals above the ventilation target value. The target value (52) is an alveolar ventilation that takes into account the patient's physiologic dead space.

Abstract: Systems slow breathing with positive pressure therapy. In embodiments, a current interim breathing rate target is set, and periodically magnitude of a variable pressure waveform scaled to the current interim breathing rate target is increased if breathing rate is greater than the interim rate target to lengthen breath duration. The magnitude of the pressure increase may be a function of the difference between the interim rate target and the breathing rate. The interim rate target may be reduced in response to slowing breathing rate. The waveform cycles, inhalation to exhalation, when airflow decreases to a cycle threshold. Different interim rate targets have different cycle threshold functions that allow easier cycling as the interim rate targets decrease. Similarly, the waveform triggers, exhalation to inhalation, when airflow increases to a trigger threshold. Different interim rate targets have different trigger threshold functions that allow easier triggering as the interim rate targets decrease.

Abstract: Apparatus for treating a respiratory disorder in a patient comprises a pressure generator configured to deliver a flow of air at positive pressure to an airway of the patient through a patient interface, a sensor configured to generate a respiratory flow rate signal of the patient, and a controller. The controller may be configured to control the generator to deliver ventilation therapy having a base pressure and a pressure support through the patient interface, detect an apnea from the signal representative of respiratory flow rate of the patient, control the generator to deliver one or more probe breaths to the patient during the apnea, determine patency of the patient's airway from a waveform of the respiratory flow rate signal in response to one of the one or more probe breaths and adjust a set point for pressure of the ventilation therapy in response to the apnea.

Abstract: A patient interface includes a shell with a central opening configured to receive the pressurized flow of air, a foam cushion, and an elastomeric support portion that is attached to the shell, supports the foam cushion, and forms at least part of a chamber together with the shell and the foam cushion. The elastomeric support portion includes a side wall that forms a continuous perimeter around the chamber and a resiliently flexible lip that supports the foam cushion and extends from the side wall toward an interior of the chamber. The resiliently flexible lip has an outer perimeter that is anchored to the side wall and an unsupported inner perimeter. The foam cushion overhangs the inner perimeter of the resiliently flexible lip, and the shell is more rigid than the elastomeric support portion. In addition, the foam cushion is configured to directly contact and engage a portion of the patient's skin in use.

Abstract: Disclosed is an apparatus for treating a respiratory disorder in a patient. The apparatus comprises a pressure generator configured to deliver a flow of air at positive pressure to an airway of the patient through a patient interface, a sensor configured to generate a signal representative of respiratory flow rate of the patient, and a controller.

Abstract: A patient interface assembly includes a cushion and frame assembly with a cushion portion and a frame portion that together form a breathing chamber. The frame portion includes an anterior aperture configured to receive the flow of breathable gas. Headgear includes a back portion, a pair of upper headgear straps extending from the back portion, and a pair of lower headgear straps. The patient interface assembly also includes a shroud in the form of a contoured plate. The shroud is removably mounted on the frame portion by way of a snap-fit connection and includes a pair of lower headgear connectors. The patient interface assembly also includes a forehead support extending from the shroud and having a free end with an upper headgear connector. The forehead support has a first curvature that curves in a first direction around an axis that is offset from the patient interface assembly and extends along a length of the forehead support.

Abstract: Methods and apparatus for treating a respiratory disorder, m one aspect, include an apparatus that delivers backup breaths at a sustained timed backup rate that is a function of the patient's spontaneous respiratory rate. Other aspects include apparatus that delivers backup breaths at a rate that gradually increases from a spontaneous backup rate to a sustained timed backup rate or, alternatively, apparatus that oscillates a treatment pressure in antiphase with the patient's spontaneous respiratory efforts when a measure indicative of ventilation is greater than a threshold. Other aspects include apparatus configured to treat Cheyne-Stokes respiration by computing the treatment pressure so as to bring a measure indicative of ventilation of the patient towards a target ventilation that is dependent on the measure indicative of ventilation or, alternatively, by periodically elevating the treatment pressure to a high level for a short time.

Abstract: Methods and apparatus for treating a respiratory disorder, in one aspect, include an apparatus that delivers backup breaths at a sustained timed backup rate that is a function of the patient's spontaneous respiratory rate. Other aspects include apparatus that delivers backup breaths at a rate that gradually increases from a spontaneous backup rate to a sustained timed backup rate or, alternatively, apparatus that oscillates a treatment pressure in antiphase with the patient's spontaneous respiratory efforts when a measure indicative of ventilation is greater than a threshold. Other aspects include apparatus configured to treat Cheyne-Stokes respiration by computing the treatment pressure so as to bring a measure indicative of ventilation of the patient towards a target ventilation that is dependent on the measure indicative of ventilation or, alternatively, by periodically elevating the treatment pressure to a high level for a short time.

Abstract: A respiratory flow limitation detection device, which can include an airway pressure treatment generator, determines a flow limitation measure based one or more shape indices for detecting partial obstruction and a measure of a patient's ventilation or respiratory duty cycle. The shape indices may be based on function(s) that ascertain the likelihood of the presence of M-shaped breathing patterns and/or chair-shaped breathing patterns. The measure of ventilation may be based on analysis of current and prior tidal volumes to detect a less than normal patient ventilation. The duty cycle measure may be a ratio of current and prior measures of inspiratory time to respiratory cycle time to detect an increase in the patient's inspiratory cycle time relative to the respiratory cycle time. A pressure setting based on the flow limitation may then be used to adjust the treatment pressure to ameliorate the patient's detected flow limitation condition.

Abstract: A respiratory flow limitation detection device, which can include an airway pressure treatment generator, determines a flow limitation measure 506 based one or more shape indices for detecting partial obstruction and a measure of a patient's ventilation or respiratory duty cycle. The shape indices may be based on function(s) that ascertain the likelihood of the presence of M-shaped breathing patterns and/or chair-shaped breathing patterns. The measure of ventilation may be based on analysis of current and prior tidal volumes to detect a less than normal patient ventilation. The duty cycle measure may be a ratio of current and prior measures of inspiratory time to respiratory cycle time to detect an increase in the patient's inspiratory cycle time relative to the respiratory cycle time. A pressure setting based on the flow limitation may then be used to adjust the treatment pressure to ameliorate the patient's detected flow limitation condition.

Abstract: Devices and systems provide methods of detecting a severity change in respiratory insufficiency (RI) or chronic obstructive pulmonary disease (COPD) condition of a patient. In an example embodiment, a detection monitoring device determines one or more severity change indicators based on a measure of supplied pressure or other representative measure determined by the device. The supplied pressure may optionally be determined during pressure treatment that satisfies a target ventilation. The supplied pressure or representative data may be compared to one or more thresholds that are selected to represent a change in the condition of the RI or COPD patient such as an exacerbation of a prior condition. Results of the comparisons may trigger one or more warnings or messages to notify a patient or physician of a pending change to the patient's RI or COPD condition so that the patient may more immediately seek medical attention to treat the condition.

Abstract: Methods and apparatus treat a respiratory disorder. For example, a pressure generator supplies a flow of air at positive pressure to a patient's airway through a patient interface. A sensor generates a signal representing respiratory flow rate of the patient. A controller controls the pressure generator to provide to the patient interface a ventilation therapy having a base pressure. The controller computes a measure of ventilation of the patient from the signal. The controller computes a measure of flow limitation from an inspiratory portion of the signal. The controller computes a ratio of the measure of ventilation and an expected normal ventilation. The controller adjusts a set point for the base pressure of the ventilation therapy based on the measure of flow limitation. The adjustment may further depend on a comparison between the ratio and a relative ventilation threshold that increases as the measure of flow limitation increases.

Abstract: A respiratory treatment apparatus implements pressure delivery control settings by improved set-up procedures. In such an embodiment, a processor may automate setting of parameters for delivering a controlled flow of breathable gas. Data sets of pressure delivery parameter settings may be associated with one or more respiratory pathology indicators. The respiratory pathology indicators may each represent a different respiratory condition diagnosis. The processor may then prompt for an input of at least one of the respiratory pathology indicators. In response to the input, a particular set of pressure delivery parameter settings associated with the input respiratory pathology indicator may then serve as a basis for setting controls for delivering a controlled flow of breathable gas for respiratory treatment.

Abstract: A patient interface assembly includes a cushion and frame assembly with a cushion portion and a frame portion that together form a breathing chamber. The frame portion includes an anterior aperture configured to receive the flow of breathable gas. Headgear includes a back portion, a pair of upper headgear straps extending from the back portion, and a pair of lower headgear straps. The patient interface assembly also includes a shroud in the form of a contoured plate. The shroud is removably mounted on the frame portion by way of a snap-fit connection and includes a pair of lower headgear connectors. The patient interface assembly also includes a forehead support extending from the shroud and having a free end with an upper headgear connector. The forehead support has a first curvature that curves in a first direction around an axis that is offset from the patient interface assembly and extends along a length of the forehead support.