U.S. patent application number 12/476872 was filed with the patent office on 2010-12-02 for method and apparatus for treating sleep apnea.
This patent application is currently assigned to Airway Metrics LLC. Invention is credited to Robert L. Horchover.
Application Number | 20100300457 12/476872 |
Document ID | / |
Family ID | 43218809 |
Filed Date | 2010-12-02 |
United States Patent
Application |
20100300457 |
Kind Code |
A1 |
Horchover; Robert L. |
December 2, 2010 |
METHOD AND APPARATUS FOR TREATING SLEEP APNEA
Abstract
A method and apparatus for diagnosing sleep apnea and for
comfortably fitting an oral device to treat the condition. The
patient is screened to reduce snoring using a device which changes
the airway, and then using an airway dilation simulator having
sequentially sized elements to determine the mandibular position
maximizing the upper airway dimension. An oral device is then
fabricated to retain the maximum position during sleep.
Inventors: |
Horchover; Robert L.;
(Seatle, WA) |
Correspondence
Address: |
JENSEN + PUNTIGAM, P.S.
2033 6th Ave, Suite 1020
SEATTLE
WA
98121
US
|
Assignee: |
Airway Metrics LLC
Seatle
WA
|
Family ID: |
43218809 |
Appl. No.: |
12/476872 |
Filed: |
June 2, 2009 |
Current U.S.
Class: |
128/848 ;
128/898 |
Current CPC
Class: |
A61F 5/56 20130101 |
Class at
Publication: |
128/848 ;
128/898 |
International
Class: |
A61F 5/56 20060101
A61F005/56 |
Claims
1. A method of modifying the air passage of a person with sleep
apnea, comprising the steps of: reviewing the health history of the
person; making an objective evaluation of the person's snore
factor; displacing the lower jaw relative to the upper jaw
vertically and horizontally by successive predetermined increments
to maximize the air flow and minimize the discomfort; and fabricate
an appliance to secure the jaw in the optimal position while
sleeping.
2. A method as in claim 1, wherein the jaw displacement could
extend over more than one appointment.
3. A method as in claim 1, wherein the jaw displacement is
accomplished with sequential use of discrete calibrated elements of
a defined set of elements.
4. A method as in claim 3, and further including the step of
temporarily securing a fork to the calibrated element to facilitate
securing an impression of the teeth with the jaw in the selected
optimal position.
5. A method of treating sleep disorders, comprising: conduct a
snore screening operation utilizing a screening instrument which
allows precise and measurable manipulation of the lower jaw to
maximize airflow; precisely locate the lower jaw utilizing a series
of jaw locator devices having fixed sequential horizontal and
vertical tooth receiving and positioning notches until a
comfortable position is found for the patient which maximizes the
air flow.
6. A method as in claim 1, wherein the appliance for retaining the
lower jaw position is molded in place at the comfortable
position.
7. A set of tools for diagnosing and treating breathing disorders
such as sleep apnea including a presorted set of discrete
mandibular positioning elements including positioning means for
upper and lower incisors controlling the relative vertical and
horizontal position enabling comparative airway measurements.
8. A kit for determining and simulating the optimal airway dilation
for a person having obstructive sleep apnea, comprising a plurality
of similar rectangular elements having ends and sides, wherein each
element includes opposing slots extending inwardly from the ends,
each element contains a groove mid-point on one side and at least
two grooves on the opposite side, said grooves determining the
relative horizontal jaw position when the incisors are placed in
the grooves, said elements further having predetermined end
dimensions to control the relative vertical jaw position.
Description
TECHNICAL FIELD
[0001] This invention relates to sleep apnea, and more
particularly, to an apparatus for diagnosing and treating sleep
apnea, including the method of measuring the airway with the
mandible in precisely displaced positions until the airway allows a
maximum airflow within the comfort zone of the patient, and then
fabricating an appliance to maintain the mandibular position during
sleep.
BACKGROUND OF THE INVENTION
[0002] Although sleep apnea has been recognized as a critical
life-endangering problem, there are still a limited number of
doctors or dentists trained to treat this disorder and a limited
number of treatments. The traditional options for treating
obstructive sleep apnea, which is a medical condition where there
is a blockage of the airway usually caused by the soft tissue in
the rear of the throat, which collapses and closes during sleep,
are with the nasal continuous positive air pressure (nCPAP), an
oral airway dilator or with surgery. The treatments using positive
air pressure and the oral airway dilators (OAD) are not cures, but
reversible management tools.
[0003] Some of the common design features in the first generation
(OADs) airway dilator resulted in minimal success and gave them a
negative image in sleep medicine. The current designs of the OADs
have increased their successes, and they are now more widely
accepted for managing sleep apnea and are far more user-friendly
and socially acceptable.
[0004] The current CPAPs on the market are expensive, difficult to
adjust and largely uncomfortable, and therefore disagreeable to the
patient during the diagnosis and fitting process. Further, a
percentage of these devices are non-compliant.
[0005] Current publications which are not necessarily directly
related to sleep apnea but may be considered prior art to the
current invention include:
[0006] U.S. Pat. No. 1,800,714 granted to Clapp Apr. 14, 1931,
which discloses a stepped device for determining the particular
bite when artificial dentures are needed, and the device includes a
scale intended to measure the angle of a line drawn from the crest
of the upper edentulous ridge to the crest of the lower edentulous
ridge.
[0007] U.S. Pat. No. Re 23,442 granted to George Nov. 20, 1990,
teaches the use of an appliance designed to prevent the occlusion
of the oro-pharngeal airway, which includes a front beak.
[0008] U.S. Pat. No. 4,997,368 granted to Mayer et al Mar. 5, 1991,
discloses an oral measuring device for determining the size of the
mouth opening and the range of motion to determine the success or
nature of the operation performed following facial or oral
surgery.
[0009] U.S. Pat. No. 5,154,609 granted to George Oct. 15, 1992,
discloses an instrument including calibrations and extensions for
registration of the dental bite of a patient, and includes as a
combination a bite fork.
DISCLOSURE OF THE INVENTION
[0010] With the above-noted prior art and inadequacies in mind, it
is the goal of the present invention to provide a simple,
straightforward diagnostic tool for obstructive sleep apnea, as
well as a simple, accurate tool for determining the optimal
position of the mandibular to maximize the air flow while not
compromising the comfort of the patient. The diagnostic tool allows
the dental personnel to quickly measure the position of the
patient's lower jaw when maximizing the air flow to determine the
suitability of the possible use of an oral airway dilator.
[0011] The airway dilution simulator comprises a plurality of
sequentially sized elements for positioning the mandible as guided
by the patients' subjective feedback on their airway changes and
comfort. The utilization of the present invention also quickly
interfaces with acoustic reflection pharyngometry that measures the
upper airway dimension in any of the mandibular positions with this
invention, thus permitting the dental personnel to determine the
position for maximum air flow.
[0012] Following the determination of maximum airway dimension, the
dental personnel can fabricate an oral device to retain the
mandible in the optimal position during sleep. The process of
achieving the optimal position of the mandible may take more than
one measurement and more than one adjustment, spread out over a
period of time, to allow the patient to comfortably adjust to the
proscribed changes.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] FIG. 1 is an elevational view of the snoring/airway
screener.
[0014] FIG. 2 is a side elevational view of one of a series of
airway dilation simulators.
[0015] FIG. 3 is a plan view of the bite fork.
[0016] FIG. 4 is an illustration of the portion of a set of a
series of the airway dilation simulator as seen in FIG. 2.
BEST MODE FOR CARRYING OUT THE INVENTION
[0017] As seen in FIG. 1, the snoring/airway screener which
empirically utilizes the snoring sound generated by the patient and
is relatively low tech, but empirically shows a high correlation
with the airway size in the airway segment that obstructive sleep
apnea airway dilators falter. Therefore, it is an effective
screening tool. The screener serves as a quick way to narrow the
more definitive analysis zone for optimum airway flow. The system
enables repeatability in any position.
[0018] Historically, after the standard muscle joint and range of
motion screening, there were no devices or accepted techniques for
predicting success with an oral airway dilator. Sonar technology
has been adapted to measure the upper airway by sending an echo
through the mouth and into the airway while the patient holds a
snorkel-like mouthpiece between their teeth and breathes naturally.
This process is actually comfortable, cost-effective and also
produces data and graphical output for analysis. This modality is
called acoustic reflective phargynometry, where the instrument
effectively measures the status quo of the patient but nothing
exists to show the pharyngometry to simulate jaw positions to
determine whether they are a candidate for the oral airway dilator
treatment and which device would be more effective.
[0019] The snoring/airway screener as shown in FIG. 1, as noted
hereinabove, is an effective screening tool for detecting airway
dilator candidacy, having a high correlation with a pharyngometer.
The device itself is a relatively thin piece of material which is
sterilizable, having a bottom surface 2 calibrated, a rear surface
4 likewise calibrated, and a front surface 6 of a stair-step
design, such that in use, the patient places his upper incisor on
the desired step (as designated by the calibration) and moves the
lower jaw to the position wherein the snore noise is least, giving
the clinician the quick determination and accurate location
indicating that this type of correction could and would be useful
as a reference for further treatment and perhaps installation of an
oral airway dilator.
[0020] As seen in FIG. 2, one of the airway dilation simulators is
shown. It comprises a relatively thin piece of material which is
sterilizable and, as explained hereinafter, is shown as only one of
a series of simulators that are used to allow the pharyngometer
testing of the jaw and airway dimension in simulated positions. The
simulator is a rectangular piece of material having a bottom 8,
including an indentation 10 for the lower incisor, a top 12 having
one or more indentations 14 for the placement of the upper incisor
to selectively find the maximum air flow position through the
sequential use of the set until the clinician determines which
relative position maximizes the flow and least comprises comfort.
The mandibular positioning simulator includes inscribed information
telling the clinician precisely the relative location, vertical and
horizontal, of the incisors to reduce the chance of error and
permitting an accurate repetition of positions. The simulator
includes two end portions 16 and 18, each including a slot 20-22
for reasons to be explained hereinafter.
[0021] Reference is now had to FIG. 3, wherein an instrument,
generally known as a bite fork, is shown, which includes a
horseshoe-shaped main body portion 24 having a plurality of spaced
openings, and a rearwardly projecting mounting member 26 having an
inwardly projecting slot 28.
[0022] As seen in FIG. 4, the simulator as shown in FIG. 2 is shown
in conjunction with the fork of FIG. 3, such that when the optimal
relative jaw position both vertical and horizontal is determined
using the simulator and the pharyngometer, then the fork is
attached to the simulator. This provides the correct jaw position
and a fitting substance is spread evenly on the fork so that the
impression of the patient's teeth can be reproduced in the oral
airway dilator, which is fabricated using the information achieved
through the combination of the pharyngometer and the sequential use
of the simulators.
[0023] Reference is now had to FIG. 5, wherein there is shown a
portion of a kit, including a plurality of the simulators 15 in a
case. It is important to note that the simulators vary in height
from 4 mm to 12 mm and the horizontal displacement of the lower
mandible varies from 2 mm to 7 mm, allowing the clinician to place
a series of the simulator in the mouth of the patient with or
without the pharyngometer to determine the maximum and minimum
discomfort as plotted on a graph. It is to be understood that the
simulators are constructed such that they can be reversed as
desired, thereby providing over 50 selected jaw positions.
[0024] Thus, as can be seen, the present invention provides a quick
and simple, straightforward method and apparatus for a
snoring/airway screener and a kit which allows the clinician to use
the pharyngometer to determine airway dimensions, predicting air
flow while noting the precise position, horizontally and
vertically, of the mandibles.
[0025] Mandibular positioning system for optimum airway includes
fifteen simulators which provide 40 horizontal and vertical
combinations that enable bite registration in the selected
position. Simulators, easily placed by patient, create simple,
effective, repeatable, and predictable position for device
effectiveness and quickly interface with pharyngometry. Accessories
enable screening and device tuning.
[0026] Although a preferred embodiment of the invention has been
disclosed for purposes of illustration, it should be understood
that various changes, modifications and substitutions may be
incorporated in the embodiment without departing from the spirit of
the invention, which is defined by the claims which follow.
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