Abstract: A system includes one or more sensors and a processor. Each of the sensors generates a signal as a function of at least one physiological parameter of a patient that may discernibly change when the patient is asleep. The processor monitors the physiological parameters, and determines whether the patient is asleep based on the parameters. In some embodiments, the processor determines plurality of sleep metric values, each of which indicates a probability of the patient being asleep, based on each of a plurality of physiological parameters. The processor may average or otherwise combine the plurality of sleep metric values to provide an overall sleep metric value that is compared to a threshold value in order to determine whether the patient is asleep. In addition, an electroencephalogram signal may be used to identify sleep states of the patient.

Abstract: Techniques for controlling delivery of a therapy to a patient by a medical device, such as an implantable medical device (IMD), involve a sensitivity analysis of a performance metric. The performance metric may relate to efficacy or side effects of the therapy. For example, the performance metric may comprise a sleep quality metric, an activity level metric, a movement disorder metric for patients with Parkinson's disease, epilepsy, or the like. The sensitivity analysis identifies values of therapy parameters that defines a substantially maximum or minimum value of the performance metric. The identified therapy parameters are a baseline therapy parameter set, and a medical device may control delivery of the therapy based on the baseline therapy parameter set.

Abstract: A device, such as an implantable medical device (IMD), programming device, or other computing device determines when a patient is attempting to sleep. When the device determines that the patient is attempting to sleep, the device determines values for one or more metrics that indicate the quality of a patient's sleep based on at least one physiological parameter of the patient. When the device determines that the patient is not attempting to sleep, the device periodically determines activity levels of the patient. Activity metric values may be determined based on the determined activity levels. A clinician may use sleep quality information and patient activity information presented by a programming device to, for example, evaluate the effectiveness of therapy delivered to the patient by a medical device.

Abstract: A medical device, such as an implantable medical device (IMD), determines values for one or more metrics that indicate the quality of a patient's sleep, and controls delivery of a therapy based on the sleep quality metric values. For example, the medical device may compare a sleep quality metric value with one or more threshold values, and adjust the therapy based on the comparison. In some embodiments, the medical device adjusts the intensity of therapy based on the comparison, e.g., increases the therapy intensity when the comparison indicates that the patient's sleep quality is poor. In some embodiments, the medical device automatically selects one of a plurality of therapy parameter set available for use in delivering therapy based on a comparison sleep quality metric values associated with respective therapy parameter sets within the plurality of available therapy parameter sets.

Abstract: Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination.

Abstract: Apparatus and method detect a detection cluster that is associated with a neurological event, such as a seizure, of a nervous system disorder and update therapy parameters that are associated with a treatment therapy. The occurrence of the detection cluster is detected when the maximal ratio exceeds an intensity threshold. If the maximal ratio drops below the intensity threshold for a time interval that is less than a time threshold and subsequently rises above the intensity threshold, the subsequent time duration is considered as being associated with the detection cluster rather than being associated with a different detection cluster. Consequently, treatment of the nervous system disorder during the corresponding time period is in accordance with one detection cluster. Treatment therapy may be provided by providing electrical stimulation, drug infusion or a combination.

Abstract: A medical device system includes a housing, the housing at least partially supporting a therapy module and a processor, and a respiratory monitoring element coupled to the processor. The processor is configured to activate the therapy module upon detection of a respiratory event in a respiratory signal. In some embodiments, the system may further comprise a brain monitoring element, and the processor may be configured to monitor a brain signal and change the therapeutic output based upon the brain signal.

Abstract: At least one of a medical device, such as an implantable medical device, a monitor, and a computing device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

Abstract: A medical device system that includes a brain stimulating element, cardiac monitoring element and a processor. The processor is configured to receive a brain stimulation signal from the brain stimulating element and a cardiac signal from the cardiac monitoring element. The processor is further configured to determine at least one reference point for a stimulation event time period by evaluation of the brain stimulation signal. The processor further identifies a first portion of the cardiac signal based on the at least one reference point of the stimulation event time period.

Abstract: A system for regulating or modulating cardiac therapy using brain state information. The modulation may include suppressing standard, prescribed cardiac therapy for a period of time or it may involve modulating the type of cardiac therapy delivered In another embodiment, a system is provided for determining whether a cardiac event is categorized as neurologically matched, and, if so, modulating the therapeutic output to the heart.

Abstract: A method of treating a neurological disorder in a patient. In some embodiments, the method includes obtaining a neurological event detection signal, obtaining a cardiac event detection signal, analyzing the timing relationships between the detected neurological and cardiac events to identify matched events, using the matched events to determine whether the cardiac event detection signal facilitates detection of neurological events, delivering a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events, and changing the therapy delivered based on sensed brain signals from the patient.

Abstract: A medical device system and method for monitoring cardiac signal activity in patients with nervous system disorders. In some embodiments, a brain signal and a cardiac signal are received by a processor, brain events are identified in the brain signal, and the brain events are used to identify portions of the cardiac signal. In some embodiments, Event portions of the cardiac signal are identified corresponding to brain event time periods, and Inter-event portions are identified corresponding to time periods between brain events. An Inter-event heart-rate variability (HRV) calculation is performed using Inter-event portions of the cardiac signal, and an output of the medical device system is modified based upon the calculated Inter-event HRV according to certain embodiments of the invention. An Event HRV may also be calculated according to certain embodiments, and an output modified based on comparisons of the Event HRV to the Inter-event HRV, for example.

Abstract: A system for regulating or modulating cardiac therapy using brain state information. The modulation may include suppressing standard, prescribed cardiac therapy for a period of time or it may involve modulating the type of cardiac therapy delivered In another embodiment, a system is provided for determining whether a cardiac event is categorized as neurologically matched, and, if so, modulating the therapeutic output to the heart.

Abstract: Implantable medical device adapted to be implanted in a patient having a plurality of neurological disorders. First and second therapy modules are adapted to provide first and second outputs to the patient for the treatment of first and second of the plurality of disorders, respectively. Also, a method for the treatment of a plurality of neurological disorders in a patient. A first output is provided to the patient for the treatment of a first one of the plurality of neurological disorders and a second output is provided to the patient for the treatment of a second one of the plurality of neurological disorders.

Abstract: An implantable neurostimulator device for implantation in a head of a patient includes a housing adapted to be implanted beneath a patient's scalp, and a cardiac monitoring element, a brain monitoring element, and a processor. The processor is configured to receive a cardiac signal from the cardiac monitoring element, identify cardiac events in the cardiac signal, receive a brain signal from the brain monitoring element, identify neurological events in the brain signal, and indicate a relationship between the neurological events and the cardiac events.

Abstract: A medical device system includes a housing, a therapy module and a processor at least partially supported by the housing, and a cardiac monitoring element coupled to the processor, the cardiac monitoring element comprising a stub sensor. The processor is configured to activate the therapy module upon detection of a cardiac event in a cardiac signal. In some embodiments, the system may further comprise a brain monitoring element coupled to the processor. In some embodiments, the processor may be configured to monitor a brain signal and change the therapeutic output based upon the brain signal.

Abstract: A method of comparing cardiac and neurological event detection signals to indicate whether the cardiac event detection signal may facilitate detection of neurological events. The method includes obtaining a signal indicating detected neurological events, obtaining a signal indicating detected cardiac events, analyzing the timing relationships between the detected neurological and cardiac events to identify matched events, and using the matched events to indicate whether the cardiac event detection signal facilitates detection of neurological events.

Abstract: An implantable neurostimulator device for implantation in a head of a patient includes a housing adapted to be implanted beneath a patient's scalp, a cardiac monitoring element, a therapy module, and a processor. The processor is configured to activate the therapy module to deliver a therapeutic output to treat a neurological event upon detection of a cardiac event in a cardiac signal. In some embodiments, the device may comprise a brain monitoring element. In some embodiments, the processor may be configured to receive and monitor a brain signal from the brain monitoring element and change the therapeutic output based upon the brain signal.

Abstract: A device determines values for one or more metrics that indicate the quality of a patient's sleep based on sensed physiological parameter values. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. The sleep quality metric values may be used, for example, to evaluate the effectiveness of a therapy delivered to the patient by a medical device. In some embodiments, determined sleep quality metric values are automatically associated with the therapy parameter sets according to which the medical device delivered the therapy when the physiological parameter values were sensed, and used to evaluate the effectiveness of the various therapy parameter sets. The medical device may deliver the therapy to treat a non-respiratory neurological disorder, such as epilepsy, a movement disorder, or a psychological disorder. The therapy may be, for example, deep brain stimulation (DBS) therapy.

Abstract: Methods for receiving a patient mark in an implanted device. A patient may experience symptoms that indicative of a neurological event or are common precursors to more severe clinical symptoms. The patient may activate a patient activator. Activation of the patient activator can cause the patient activator to transmit the patient mark to an implanted device. The implanted device may adjust physiological data being stored in response to the patient mark, including data before and after the patient mark. The patient mark may be used to fine tune the detection algorithms and otherwise tune the detection capability of the implanted device and may also be used as an aid in statistical analysis of the stored physiological data.