U.S. patent application number 16/944348 was filed with the patent office on 2020-11-19 for adverse event mitigation systems, methods, and devices.
The applicant listed for this patent is Hill-Rom Services, Inc.. Invention is credited to Eric D. Agdeppa, Aziz A. Bhai, Pierre Deguignet, Laetitia Gazagnes, Michael Scott Hood, Charles A. Howell, Jason A. Penninger, David L. Ribble, Varad N. Srivastava, Neal Wiggermann.
Application Number | 20200360207 16/944348 |
Document ID | / |
Family ID | 1000004989763 |
Filed Date | 2020-11-19 |
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United States Patent
Application |
20200360207 |
Kind Code |
A1 |
Hood; Michael Scott ; et
al. |
November 19, 2020 |
ADVERSE EVENT MITIGATION SYSTEMS, METHODS, AND DEVICES
Abstract
A sleep apparatus, such as a mattress, comprises a head support
surface sized to support a person's head, and a torso support
surface sized to support a person's torso. The head support surface
is generally laterally sloped moving from a first side toward a
second side of the mattress, and the torso support surface is
generally laterally sloped moving from the first side toward the
second side. In some embodiments, the lateral slope of the head
support surface is at least about 15.degree., the lateral slope of
the head support surface is greater than the lateral slope of the
torso support surface, and/or, the sleep apparatus slopes in the
longitudinal direction as well.
Inventors: |
Hood; Michael Scott;
(Batesville, IN) ; Ribble; David L.;
(Indianapolis, IN) ; Gazagnes; Laetitia;
(Montpellier, FR) ; Deguignet; Pierre; (Clapiers,
FR) ; Bhai; Aziz A.; (Fishers, IN) ; Agdeppa;
Eric D.; (Cincinnati, OH) ; Wiggermann; Neal;
(Batesville, IN) ; Howell; Charles A.;
(Batesville, IN) ; Srivastava; Varad N.;
(Skaneateles, NY) ; Penninger; Jason A.;
(Charlotte, NC) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Hill-Rom Services, Inc. |
Batesville |
IN |
US |
|
|
Family ID: |
1000004989763 |
Appl. No.: |
16/944348 |
Filed: |
July 31, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14815010 |
Jul 31, 2015 |
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16944348 |
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14454961 |
Aug 8, 2014 |
10660807 |
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14815010 |
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PCT/US2013/042313 |
May 22, 2013 |
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14454961 |
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PCT/US2014/018033 |
Feb 24, 2014 |
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14454961 |
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61650022 |
May 22, 2012 |
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61729868 |
Nov 26, 2012 |
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61792911 |
Mar 15, 2013 |
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61792911 |
Mar 15, 2013 |
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61896358 |
Oct 28, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61G 7/05776 20130101;
A61B 5/4818 20130101; A61G 7/05707 20130101; A61G 2203/34 20130101;
A61G 7/018 20130101; A61B 2562/046 20130101; A61G 7/05715 20130101;
G16H 50/30 20180101; A61G 2203/42 20130101; G16H 20/00 20180101;
A61G 7/0509 20161101; A61G 7/0525 20130101; A61B 5/1116 20130101;
A61B 5/6831 20130101; A61B 2562/0252 20130101; A61B 5/7282
20130101; A61G 7/05723 20130101; A61B 5/6891 20130101; A61G 2203/40
20130101; A61B 5/4812 20130101; A61G 7/015 20130101; A61G 7/012
20130101; A61B 5/6892 20130101; A61B 5/1126 20130101; A61B
2562/0247 20130101; A61B 5/747 20130101; A61G 7/001 20130101; A61B
5/0816 20130101; A61G 2203/32 20130101; A61B 5/024 20130101; A61B
5/1113 20130101; A61B 5/002 20130101 |
International
Class: |
A61G 7/015 20060101
A61G007/015; A61G 7/018 20060101 A61G007/018; A61B 5/00 20060101
A61B005/00; A61G 7/057 20060101 A61G007/057; A61G 7/00 20060101
A61G007/00; A61B 5/11 20060101 A61B005/11; A61G 7/05 20060101
A61G007/05; G16H 50/30 20060101 G16H050/30; G16H 20/00 20060101
G16H020/00 |
Claims
1. A support system configured to support and laterally rotate at
least a portion of a user with respect to a longitudinal axis of
the support system, said support system being embodied as a
mattress and comprising: at least one support piece configured to
form a laterally angled sleep surface having a lateral dimension
defined between a first side of the mattress and an opposing second
side of the mattress spaced from the first side with the first and
second sides extending substantially parallel with the longitudinal
axis such that the laterally angled sleep surface extends fully all
the way across the support system in its entirety from the first
side to the second side, wherein the laterally angled sleep surface
comprises a flat, planar surface from the first side to the second
side when the user is absent from the support system, wherein the
at least one support piece is included as one of a plurality of
support pieces that are in abutment at respective vertical planes
that extend laterally between the first and second sides and that
are perpendicular to the longitudinal axis, wherein the laterally
angled sleep surface of the at least one support piece and an
adjacent laterally angled sleep surface of a next adjacent support
piece of the plurality of support piece slope laterally slope
downwardly in a same direction from the first side to the second
side but at different angles that are each greater than zero
degrees.
2. The support system of claim 1, wherein the laterally angled
sleep surface is situated in a head end region of the mattress and
is spaced from a foot end region of the mattress.
3. The support system of claim 1, wherein the at least one support
piece forms a continuously sloped sleep surface.
4. The support system of claim 1, wherein the at least one support
piece is rotatable about the longitudinal axis.
5. The support system of claim 1, wherein the plurality of support
pieces are each configured to define its respective laterally
angled sleep surface, a first support piece of the plurality of
support pieces forming a first support plane along the longitudinal
axis having a first angle of rotation with respect to a base
surface of the support system, and a second support piece of the
plurality of support pieces forming a second support plane along
the longitudinal axis having a second angle of rotation with
respect to the base surface different than the first angle of
rotation.
6. The support system of claim 5, wherein the plurality of support
pieces have progressively greater angles of rotation along the
longitudinal axis to facilitate a relatively greater rotation of an
upper respiratory tract of the user and a relatively lesser
rotation in a lower body of the user.
7. The support system of claim 5, wherein the second angle of
rotation is greater than the first angle of rotation to facilitate
greater rotation of an upper respiratory tract of the user
supported on the second support plane than a lower body of the user
at least partially supported on the first support plane.
8. The support system of claim 5, wherein each support piece of the
plurality of support pieces is independently rotatable about an
axis extending parallel with the longitudinal axis of the support
system.
9. The support system of claim 5, wherein the first support plane
is positioned at a first lateral angle of rotation of 20.degree. to
30.degree. with respect to a base surface of the first support
piece, the second support plane is positioned at a second lateral
angle of rotation of 10.degree. to 20.degree. with respect to a
base surface of the second support piece, and a third support piece
defines a third support surface positioned at a third lateral angle
of rotation of 5.degree. to 15.degree. with respect to a base
surface of the third support piece.
10. The support system of claim 5, further comprising a
transitional piece positioned between adjacent support pieces of
the plurality of support pieces to facilitate providing a gradual
continuous transition between support planes of the adjacent
support pieces.
11. The support system of claim 5, further comprising a
transitional piece positioned at a transitional line where the
first support piece meets with the second support piece to provide
support for the user.
12. The support system of claim 1, further comprising a system
control having a display configured to display information about
the support system.
13. The support system of claim 12, wherein the system control
comprises a processor configured to adjust angles of rotation of
the support planes based at least in part on data inputted at the
system control and/or data signals received from one or more
sensors of the support system.
14. A bolster in combination with the support system of claim 1,
wherein the bolster comprises an element separate from the support
system, the bolster being positioned along a lateral side of the
support system to limit lateral migration of the user.
15. The support system of claim 14, wherein at least a portion of
the bolster includes a textured surface to facilitate retaining the
user positioned on the sleep surface.
16. The support system of claim 14, wherein the bolster is formed
of a formable material to provide envelopment throughout the sleep
surface.
17. The support system of claim 14, further comprising a strap
operatively coupled to the bolster to facilitate maintaining the
user positioned on the sleep surface.
18. The support system, of claim 5, wherein each support piece of
the plurality of support pieces is rotatable about the longitudinal
axis between a first orientation having a right side slope and a
second orientation having a left side slope.
19. The support system of claim 18, further comprising a section
positioned within the first support piece and coaxially aligned
with the longitudinal axis to facilitate rotation of the first
support piece about the longitudinal axis independently of the
second support piece.
20. The support system of claim 1, further comprising at least one
spacer configured to adjust the length of the support system.
21. The support system of claim 1, wherein the support system has a
first length defined between a head end and a foot end of the
support system, and further comprising a spacer added to the
support system between the head end and the foot end to increase an
overall length of the support system from the first length to a
second length.
22. The support system of claim 21, wherein adjacent support pieces
of the at least one support piece and the spacer are coupled
together using a coupling mechanism.
23. The support system of claim 1, wherein the at least one support
piece comprises an inflatable fluid bladder configured to contain a
fluid.
24. The support system of claim 23, wherein an amount of fluid
within the fluid bladder is controlled electronically.
25. The support system of claim. 24, further comprising a coupler
configured to at least one of to maintain an amount of fluid within
the fluid bladder and provide support to the respective support
plane.
26. The support system of claim 1, wherein a first support piece of
the at least one support piece comprises a plurality of independent
support wedges forming a gradation in a longitudinal slope of the
sleep surface.
27. The support system of claim 26, wherein each of the plurality
of independent support wedges comprises one of a formable material
a semi-rigid material, a foam material, and a fluid bladder.
28. The support system of claim 27, wherein a first support wedge
of the plurality of independent support wedges defines a first
support plane positioned at a first lateral angle of rotation and a
second support wedge of the plurality of independent support wedges
defines a second support plane at a second lateral angle of
rotation different that the first lateral angle of rotation.
29. The support system of claim 1, wherein the at least one support
piece comprises a continuous support piece having a gradual density
transition along the length of the sleep surface.
30. The support system of claim 1, wherein the plurality of support
pieces are configured to collectively define the laterally angled
sleep surface, a first support piece of the plurality of support
pieces having a first density and a second support piece of the
plurality of support pieces having a second density different than
the first density.
31. The support system of claim 30, wherein each support piece of
the plurality of support pieces defines a support plane positioned
at a substantially similar, initial lateral rotational angle.
Description
CROSS REFERENCES TO RELATED APPLICATIONS
[0001] The present application is a continuation of U.S.
application Ser. No. 14/815,010, filed Jul. 31, 2015, which is a
continuation-in-part of, and claims priority to U.S. application
Ser. No. 14/454,961 filed Aug. 8, 2014, now U.S. Pat. No.
10,660,807, which is a continuation-in-part of, and claims priority
to, PCT/US2013/042313, filed May 22, 2013, and U.S. application
Ser. No. 14/454,961 is a continuation-in-part of, and claims
priority to, PCT/US2014/018033 filed Feb. 24, 2014, the entire
disclosures of which are hereby incorporated herein by reference.
PCT/US2013/042313 claims priority to: U.S. Provisional Application
Ser. No. 61/650,022, filed on May 22, 2012; U.S. Provisional
Application Ser. No. 61/729,868, filed on Nov. 26, 2012; and U.S.
Provisional Application Ser. No. 61/792,911, filed on Mar. 15,
2013; the entire disclosures of each are hereby incorporated herein
by reference. PCT/US14/018,033 claims priority to U.S. Provisional
Application Nos. 61/792,911 filed Mar. 15, 2013 and 61/896,358
filed Oct. 28, 2013, the entire disclosures of which are hereby
incorporated by reference herein.
BACKGROUND
[0002] This disclosure relates generally to systems, methods, and
devices for the treatment of sleep disorders. More particularly,
but not exclusively, the present disclosure relates to mattresses
having features and functions that aid in the treatment of sleep
disorders. While various systems have been developed, there is
still room for improvement. Thus, a need persists for further
contributions in this area of technology
SUMMARY
[0003] A system, method or apparatus according to this disclosure
may comprise one or more of the features recited in the appended
claims and/or the following features which, alone or in any
combination, may comprise patentable subject matter:
[0004] According to an aspect of the present disclosure, a mattress
may have a longitudinal length defined by a longitudinal axis
(e.g., a longitudinal central axis) of the mattress when the
mattress is in its most horizontal position and a lateral width
defined by a lateral axis (e.g., a lateral central axis) of the
mattress when the mattress is in its most horizontal position. The
mattress may include a head section having a head support surface
to support at least a portion of a person's head. At least a
portion of the head support surface is generally sloped in the
lateral direction at a first angle relative the lateral axis. The
first angle may be from about 15 (or alternatively, about 10
degrees) to about 30 degrees. The mattress may further comprise a
torso section having a torso support surface to support at least a
portion of a person's torso. At least a portion of the torso
support surface may be generally sloped in the lateral direction at
a second angle relative to the lateral axis. The second angle may
be from about 1 to about 25 degrees less than the first angle.
[0005] In some embodiments, the second angle may be from about 5 to
about 15 degrees less than the first angle. Alternatively or
additionally, the first angle may be from about 15 to about 30
degrees and the second angle may from about 0 to about 20 degrees.
Further alternatively or additionally, the first angle may be from
about 20 to about 30 degrees and the second angle may be from about
5 to about 15 degrees less than the first angle.
[0006] In some embodiments, the mattress may further include a leg
section having a leg support surface to support at least a portion
of a person's legs. The leg support surface may be generally sloped
in the lateral direction at a third angle relative to the lateral
axis. If desired, the third angle may be from about 0 to about 15
degrees. In some embodiments, the mattress includes a bolster that
may be positioned adjacent a bottom side of the sloped torso
support surface and that may rise above at least a portion of the
torso support surface.
[0007] In some embodiments, the head section may be from about 5
inches to about 30 inches in length, the torso section may be from
about 15 inches to about 50 inches in length, and the leg section
may be from about 25 inches to about 50 inches in length. It is
contemplated by this disclosure that the mattress may have a lower
leg support surface and a thigh support surface that may be
pivotable in the longitudinal direction relative to one another, so
as to form an angle between the two surfaces of from about 185 to
about 270 degrees. Thus, the mattress may be made at least
partially of a flexible material to allow for the pivoting of the
lower leg support surface and the thigh support surface. In some
embodiments, at least one of the head section and torso section may
have an air bladder configured to inflate to create at least one of
the first and second angles.
[0008] In accordance with another embodiment, a person support
apparatus is provided and may have a longitudinal length from its
head end to its foot end and a lateral width from side to side. The
person support apparatus may include a head section having a head
support surface to support at least a portion of a person's head.
At least a portion of the head support surface may be generally
sloped downward in a lateral direction. The person support
apparatus may further comprise a torso section having a torso
support surface to support a least a portion of the person's torso.
At least a portion of the torso support surface may be generally
sloped downward in the lateral direction and the slope of the torso
support surface may be different from the slope of the head support
surface. The person support apparatus may further have a bolster
extending along a side of the person support apparatus and
extending above the side. Alternatively or additionally, the person
support apparatus may have a bolster extending along an end of the
person support apparatus and extending above the end of the person
support apparatus.
[0009] In some embodiments, the bolster may not extend along at
least a portion of a side of the head section. The bolster may
extend along at least a portion of the leg section. The bolster may
extend above the foot end of the person support apparatus. The
person support apparatus may further include a leg section having a
leg support surface to support at least a portion of a person's
leg. The leg support surface may be flat (e.g., horizontal) or may
have a slope in the lateral direction. The slope of the leg support
surface may be about equal to or less than the slope of the torso
support surface.
[0010] In some embodiments, the head support surface may be sloped
at an angle of from about 10 to about 30 degrees and the torso
support surface may be sloped at an angle of from about 1 to about
20 degrees. At least one of the head section and torso section may
have an air bladder configured to inflate to create at least a
portion of the slope of the respective section. The person support
apparatus may further include a leg section having a leg support
surface to support at least a portion of a person's leg. The leg
support surface may be flat (e.g., horizontal) or may be generally
downwardly sloped in the lateral direction at an angle relative to
a plane that is less than the angle of the head support surface.
The leg section may be pivotable between a thigh section and a
lower leg section. The person support apparatus may have a
transition surface sloping between the head section and the torso
section.
[0011] Furthermore, a sleeping apparatus may be provided and may
have a longitudinal centerline. The apparatus may have at least one
bottom surface that may be generally horizontal when the person
support apparatus is in a generally horizontal position for
sleeping. The apparatus may have a support section sized to support
a person's head or torso. The support section may have a top
surface extending from a first side of the longitudinal centerline
to a second side of the longitudinal centerline. The top surface
may slope generally laterally downwardly relative to horizontal, at
an angle of at least approximately 10 degrees and may slope
generally longitudinally downwardly relative to horizontal, when
the person support apparatus is in a horizontal position.
[0012] According to another aspect of this disclosure, a sleep
apparatus may have a longitudinal dimension moving from a head end
to a foot end, and a lateral dimension moving from a first side to
a second side when in a generally horizontal position for sleeping.
The sleeping apparatus may include a head support section sized to
support a person's head. The head support section may be generally
laterally sloped moving from the first side toward the second side.
The head support section may has a height when the sleeping
apparatus is in the generally horizontal position. The sleeping
apparatus may also have a torso support section sized to support a
person's torso. The torso support section may be generally
laterally sloped moving from the first side toward the second side.
The torso support section has a height when the sleeping apparatus
is in the generally horizontal position. The height of the head
support section may be greater than the height of the torso support
section.
[0013] In some embodiments, the height of the head section may be
the average of the maximum heights of lateral cross sections of the
head section and the height of the torso section may be the average
of the maximum heights of lateral cross sections of the torso
section. The head support section may slope generally laterally
downwardly relative to horizontal at an angle of at least about 20
degrees and the torso support section may slope generally laterally
downwardly relative to horizontal an angle of at least about 10
degrees. The angle of the head support section may be the average
angle of slope of tangents to horizontal cross sections of the head
support section and the angle of the torso support section may be
the average angle of slope of tangents to horizontal cross sections
of the torso support section.
[0014] In some embodiments, the sleep apparatus may further have a
leg support section sized to support a person's legs. The leg
support section may be generally laterally sloped moving from the
first side toward the second side. The leg support section may have
a height when the sleeping apparatus is in the generally horizontal
position. The height of the torso support section may be greater
than the height of the leg support section.
[0015] According to another aspect of the present disclosure, a
sleep support apparatus may be provided having a longitudinal axis
when in a horizontal position. The sleep support apparatus may
comprise a body part support section. The body support section may
have at least one surface configured to support at least a portion
of a person's body during sleep. The body support section may
permit the person's head to turn sideways substantially in at least
one direction, but at the same time may urge a longitudinal center
plane of the person's face to rest at a first angle during sleep
relative to a vertical plane extending upwardly against the
direction of gravity and along the longitudinal axis of the sleep
support apparatus. The first angle may be equal to or greater than
about +/-35 degrees from the upwardly extending vertical plane, and
up to about +130 degrees, whether the patient is supported
generally on the patient's back/rear, on the patient's side, or on
the patient's front side and/or stomach.
[0016] Thus, according to an aspect of the present disclosure, a
sleep apparatus may have a body part support section, the support
section may have at least one surface configured to support at
least a portion of a person's body during sleep, and the support
section may allow the person's head to turn substantially in at
least one direction. The support section may urge the longitudinal
center plane of the person's face to rest at a first angle during
sleep relative to the vertical plane extending generally upwardly
and along the longitudinal axis of the sleep apparatus. The first
angle may be equal to or greater than about 35 degrees from the
upwardly extending vertical plane.
[0017] In some embodiments, the body part support section may
include a head support section or torso support section sloping
generally laterally downwardly. The body part support section may
further include a head support section sloping generally laterally
downwardly at a first angle and a torso support section sloping
generally laterally downwardly at a second angle that is different
from the first angle. The sleep apparatus may comprise a bed or
mattress or a device to be placed under or on a bed or mattress or
person support apparatus.
[0018] According to the present disclosure, a sleep apparatus may
be provided having a longitudinal dimension moving from a head end
to a foot end and a lateral dimension moving from a first side to a
second side when in a generally horizontal position for sleeping.
The apparatus may include a head support section sized to support a
person's head. The head support section may be generally laterally
sloped moving from the first side toward the second side. The
apparatus may further include a torso support section sized to
support a person's torso. The torso support section may be
generally laterally sloped moving from the first side toward the
second side. The sleep apparatus may also be generally
longitudinally sloped moving from the head end to the foot end.
[0019] In some embodiments, the slopes are achieved by linear
surfaces, non-linear surfaces, or stepped surfaces. In some
embodiments, the sleep apparatus may further include a leg support
section sized to support a person's legs and the leg support
section may be generally laterally sloped moving from the first
side toward the second side.
[0020] According to an aspect of this disclosure, a sleep apnea
prevention apparatus for use with a mattress is provide and may
include a mattress overlay that may be placeable on the mattress to
cover at least a top surface of the mattress. A plurality of
lateral tilt bladders may be coupled to the overlay and may be
situated above the top surface of the mattress when the overlay is
placed on the mattress. The apparatus may further include a control
unit that may be configured to control inflation and deflation of
the lateral tilt bladders individually. The control unit may have
user inputs that may permit a user to individually select an amount
of tilt of each lateral tilt bladder of the plurality of lateral
tilt bladders so that an upper surface of the overlay may have
regions with different lateral tilt angles from a first side of the
overlay to a second side of the overlay.
[0021] In some embodiments, the sleep apnea prevention apparatus
may further include a sleep monitor that may be coupled to the
control unit and that may be configured for attachment to a person
to send signals to the control unit which may be used by the
control unit to detect and record sleeping events. The control unit
may be configured to store and display trends in sleep data and
progress in sleeping based on the signals from the sleep monitor.
The control unit may be configured to provide suggested position
changes that may be based on the trends in sleep data. The signals
from the sleep monitor may be used by the control unit to detect
and record apnea events.
[0022] In some embodiments, the plurality of lateral tilt bladders
may include at least one head tilt bladder that may be located so
as to underlie a person's head when the person is lying on the
mattress overlay, at least one torso tilt bladder that may be
located to underlie the person's torso when the person is lying on
the mattress overlay, and at least one leg tilt bladder that may be
located so as to underlie the person's legs when the person is
lying on the mattress overlay. The at least one head tilt bladder
may include a first head tilt bladder and a second head tilt
bladder. The first head tilt bladder may be configured to tilt the
person's head toward a right side of the mattress when the first
head tilt bladder is inflated and the second head tilt bladder is
deflated. The second head tilt bladder may be configured to tilt
the person's head toward a left side of the mattress when the
second head tilt bladder is inflated and the first head tilt
bladder is deflated.
[0023] In some embodiments, the at least one torso tilt bladder may
include a first torso tilt bladder and a second torso tilt bladder.
The first torso tilt bladder may be configured to tilt the person's
torso toward a right side of the mattress when the first torso tilt
bladder is inflated and the second torso tilt bladder is deflated,
and the second torso tilt bladder may be configured to tilt the
person's torso toward a left side of the mattress when the second
torso tilt bladder is inflated and the first torso tilt bladder is
deflated. In some embodiments, the at least one leg tilt bladder
may include a first leg tilt bladder and a second leg tilt bladder.
The first leg tilt bladder may be configured to tilt the person's
legs toward a right side of the mattress when the first leg tilt
bladder is inflated and the second leg tilt bladder is deflated,
and the second leg tilt bladder may be configured to tilt the
person's legs toward a left side of the mattress when the second
leg tilt bladder is inflated and the first leg tilt bladder is
deflated.
[0024] In some embodiments, the sleep apnea prevention apparatus
may further have a knee gatch bladder that may be situated between
the at least one torso tilt bladder and the at least one leg tilt
bladder. The control unit may be configured to control inflation
and deflation of the knee gatch bladder. Alternatively or
additionally, the sleep apnea prevention apparatus may further
include at least one side bolster bladder that may extend parallel
with a long dimension of the overlay and that may be situated
adjacent a first side of the overlay. The control unit may have
user inputs to control inflation and deflation of the side bolster
bladder.
[0025] According to this disclosure, the mattress overlay may be
included as part of a mattress ticking that may include material
extending downwardly from the overlay to cover sides and ends of
the mattress. Optionally, the ticking may further include
additional material that may cover a bottom of the mattress.
Alternatively or additionally, the sleep apnea prevention apparatus
may further include straps coupled to the overlay and configured to
secure the overlay on the mattress.
[0026] According to the present disclosure, a person support
apparatus may include a mattress foundation that may have a top and
bottom surface. The top surface may have a predetermined sloped
shape. The person support apparatus may further have at least one
foam filled bladder that may be configured to lie on top of, and
fill in, the sloped shape surface of the mattress foundation to
create a flat sleeping surface. An opening may be provided in the
at least one foam filled bladder that, after a person lies on the
foam filled bladder, may provide a controlled release of air over
time from the at least one foam filled bladder so that foam within
the foam filled bladder may compress to permit the flat sleeping
surface to transition into a shape that may conform generally with
the predetermined sloped shape of the mattress foundation.
[0027] In some embodiments, the mattress foundation may include a
head end, a foot end, a right side, and a left side, and the
predetermined sloped shape may comprise an angle from the left side
to the right side. For example, the predetermined sloped shape may
include a predetermined angle sufficient to prevent sleep apnea. In
some embodiments, the opening in the foam filled bladder may
comprise a check valve that may be configured to release air over a
predetermined period of time in response to the weight of the
person on the at least one foam filled bladder.
[0028] In some embodiments, the person support apparatus may
further include a controller that may include a timer. The
controller may control the transition based on the timer. The
person support apparatus may further include a plug that may block
the opening and the controller may be configured to send a signal
to move the plug to open the opening after a period of time has
elapsed after the person lies on the foam filled bladder. The plug
may be included as a component of a controllable valve, for
example. In some embodiments, the mattress foundation may include
first foam of a first compressibility and the foam filled bladder
may include second foam of a second compressibility that may be
less than the first compressibility.
[0029] According to a further aspect of this disclosure, a
controller for controlling a person support apparatus may be
provided. The controller may include a processor, and a memory with
instructions that, when executed, may cause the processor to:
receive signals from one or more sensors of the person support
apparatus; detect movement of a person on the person support
apparatus based on the signals received; determine whether the
movement of the person may be indicative of an intention to shift
on the person support apparatus to a new sleep position; predict
the new sleep position of the person on the patient support
apparatus; and adjust a sleep surface of the patient support
apparatus to accommodate the new sleep position within a predefined
set of therapeutic sleep surface adjustment ranges.
[0030] In some embodiments, the predefined set of therapeutic sleep
surface adjustment ranges may correspond to therapeutic sleep
surface angle ranges for prevention of sleep apnea. The processor
may be configured to receive at least one of video, acoustic, and
accelerometer signals relating to the person. The processor may
further be configured to identify whether the movement of the
person may be indicative of increased agitation or actual
movement.
[0031] According to yet another aspect of the present disclosure, a
control system for a therapeutic patient support apparatus may be
provided. The control system may include a controller that may
include a processor and a memory with instructions that, when
executed, may cause the processor to: receive physiological
measurements of a person that may be relevant to sleep position;
compare the received physiological measurements to stored
physiological measurements; identify optimum person support angles
of a sleep surface of the person support apparatus corresponding to
the comparison of the physiological measurements; and adjust the
sleep surface of the patient support apparatus to the identified
optimum person support angles.
[0032] In some embodiments, the control system may further include
sensors for sensing the physiological measurements and sending the
physiological measurements to the controller. The sensors may
include at least one video sensor, for example. The controller may
include one or more inputs for a user to enter physiological
measurements. The physiological measurements may include at least
one, two, three, or each of neck circumference, torso range of
motion, body mass index, or stop-bang index.
[0033] According to still a further aspect of the present
disclosure, a modular system for adjusting the position of a person
on a person support apparatus having a mattress foundation and a
mattress supported by the mattress foundation may be provided. The
modular system may include a plurality of tilting units. Each
tilting unit may include a substrate and a plurality of air
bladders that may be mounted to the substrate. Each tilting unit
may be positionable between a portion of the mattress and the
mattress foundation. An electronics module may be connected to the
tilting unit and may be configure to introduce air to, and remove
air from, the plurality of air bladders of the plurality of tilting
units. A handheld controller pendant may be in communication with
the electronics module and may have user inputs that may be used to
control the position of the person on the person support apparatus
by introducing or removing air from the plurality of air bladders
of the plurality of tilting units. Each tilting unit may be
individually controllable so that different portions of the
mattress are tiltable in a lateral dimension of the mattress by
different amounts.
[0034] In some embodiments, the substrate of at least some of the
tilting units may include couplers that couple to the mattress
foundation. For example, the couplers may comprise straps or
hook-and-loop fastener material or both. The electronics module may
include a compressor and valves. The handheld controller pendant or
the electronics module may include a timer. The electronics module
may introduce air to the air bladders after a predetermined period
of time has elapsed as measured by the timer. In some embodiments,
the substrate of each tilting unit may include three plates that
may be hinged together in a Z-shaped formation. Optionally, the
plurality of tilting units may be coupled together so as to form a
unitary layer that is placeable on the mattress foundation.
[0035] According to yet still a further aspect of this disclosure,
a controller for controlling a person support apparatus may be
provided and may include a processor and a memory with instructions
that, when executed, may cause the processor to: receive signals
from one or more sensors; determine a head orientation of a person
positioned on the person support apparatus based on the received
signals; determine if the head orientation angle from vertical is
below a threshold; and in response to a determination that the head
orientation angle is below a threshold, determine the user to be at
risk of an apnea event.
[0036] In some embodiments, the instructions may further cause the
processor to alert a caregiver upon determination that the user may
be at risk of an apnea event. For example, the processor may alert
the caregiver by sending a notification to one or more of the
following: a local audio alert unit, a local visual alert unit, a
nurse call computer, a handheld device of a caregiver, and an
electronic status board.
[0037] In some embodiments, the instructions may further cause the
processor to activate a portion of the patient support apparatus to
tilt a portion of the patient and change the head orientation. The
processor may be configured to receive signals after the patient
support apparatus has been activated to tilt the portion of the
person to determine if a resulting head orientation angle is
greater than or equal to the threshold.
[0038] Alternatively or additionally, the instructions may further
cause the processor to determine if the head orientation angle from
vertical may be greater than or equal to the threshold. In response
to a determination that the head orientation angle is greater than
or equal to a threshold, the processor may determine that the user
may not be at risk of an apnea event. In some embodiments, the
threshold may be about 45.degree.. The one or more sensors may
comprise a machine vision acquisition unit. Alternatively or
additionally, the one or more sensors may comprise an accelerometer
worn by the person, such as by being worn on the person's forehead,
ear, throat or chest.
[0039] According to another aspect of the present disclosure, a
controller for controlling the position of a person support
apparatus may be provided and may include a processor and a memory
with instructions that, when executed, may cause the processor to:
receive input from a user of the patient support apparatus; recall
stored therapeutic support positions for a plurality of adjustable
support sections based on the user input; and move the plurality of
adjustable support sections to the therapeutic support positions to
change an amount of lateral tilt of an upper surface of a mattress
to support a person in a position that may reduce a possibility of
occurrence of sleep apnea.
[0040] In some embodiments, the processor may be configured to
receive input when the user presses a single button that may be
communicatively coupled to the processor. For example, the single
button may be coupled to a siderail of the patient support
apparatus. In some embodiments, the input may include
identification of the user and the recalled stored therapeutic
support position may be a user-specific therapeutic support
position stored in the memory.
[0041] In some embodiments, the plurality of adjustable support
sections may include head, torso, and leg sections of the mattress
and an amount of the lateral tilt of each of the head, torso and
leg sections when in the respective therapeutic support positions
each may comprise an angle in a range of about 1.degree. to about
20.degree.. The plurality of adjustable support sections may
include a head section of a mattress support deck and the
therapeutic position of the head section may be a position inclined
with respect to horizontal by about 10.degree.. The plurality of
adjustable support sections may include an upper frame of the
patient support apparatus and the therapeutic position of the upper
frame may be a reverse Trendelenburg angle of about 2.degree.. The
processor may be configured to enable an exit alarm after the
adjustable support sections have reached the therapeutic support
positions. The exit alarm may become activated if the person exits
the patient support.
[0042] According to yet a further aspect of the present disclosure,
a controller for controlling a person support apparatus may be
provided and may include a processor and a memory with instructions
that, when executed, may cause the processor to: receive signals
from one or more sensors of the person support apparatus;
determine, based on the signals, whether a head of a person that
may be supported on a laterally tilted surface, may be angled
toward an uphill side of the laterally tilted surface or a downhill
side of the laterally tilted surface; and adjust an amount of
lateral tilt of the laterally tilted surface if the head of the
patient may be angled toward the uphill side of the laterally
sloped surface.
[0043] In some embodiments, the amount of lateral tilt of the
laterally tilted surface may be decreased or the laterally tilted
surface may be adjusted to tilt in an opposite direction by the
processor if the head of the patient is angled toward the uphill
side of the laterally sloped surface. The signals from the one or
more sensors may be used by the processor to identify a sleep apnea
event. The one or more sensors may comprise first and second
acoustic sensors that may be situated near opposite sides of the
patient support apparatus. The signals from the one or more sensors
may be used by the processor to identify at least one physiological
parameter of a person that may be positioned on the patient support
apparatus. The physiological parameter may include a sleep stage,
for example. Alternatively or additionally, the physiological
parameter may include a supine position of a user. The signals from
the one or more sensors may comprise video signals. The one or more
sensors may comprise an accelerometer that may be coupled to the
person's head.
[0044] According to yet a further aspect of the present disclosure,
a person support apparatus having a longitudinal length from a head
end to a foot end, and having a lateral width from side to side may
be provided. The person support apparatus may include a head
section that may have a head support surface to support at least a
portion of a person's head. At least a portion of the head support
surface may be tilted in a lateral direction. The person support
apparatus also may have a torso section that may have a torso
support surface to support at least a portion of the person's
torso. At least a portion of the torso support surface may be
adjustable to be sloped in the lateral direction. The person
support apparatus may further have a head under-rotation and/or
head over-rotation component to adjust a head orientation of the
person on the support while maintaining an amount of tilt of at
least a sub-portion of the portion of the head support surface.
[0045] In some embodiments, the head over-rotation component may
include a wedge-shaped shelf that may be adapted to be placed on
the head support surface and shaped to keep the person's head from
rotating beyond 90.degree. from a vertical plane. Alternatively or
additionally, the head over-rotation component may comprise a
blocking component that may be situated adjacent the person's
shoulder or hip to keep the person's head from rotating beyond 90
degrees from a vertical plane. For example, the blocking component
may include an upstanding cylindrically shaped projection.
Alternatively or additionally, the blocking component may include
an upstanding projection that may be generally triangular in
horizontal cross section.
[0046] In some embodiments, the head under-rotation component may
comprise a region of reduced density and/or firmness on an uphill
side of the downward lateral slope of the head section.
Alternatively or additionally, the head under-rotation component
may include a region of decreased slope on an uphill side of the
head support surface.
[0047] In some embodiments, the head section may include first
material of a first firmness on a downhill side of the head support
surface and second material of a second firmness, less than the
first firmness, on an uphill side of the head support surface. The
second material may serve as the head under-rotation component. In
some embodiments, the head support surface may have an apex in a
central region of the head section and may slope downwardly in
opposite directions from the apex toward opposite sides of the head
section.
[0048] In some embodiments, the head under-rotation and/or head
over-rotation component may include an inflatable and deflatable
bladder in the head section. An amount of inflation of the bladder
may be determined based on one or more signals from one or more
sensors. The one or more sensors may comprise one or more of the
following: a sound sensor, an infrared sensor, a thermal sensor, a
video camera, an accelerometer, a weight sensor, an angle sensor,
or a pressure sensor.
[0049] Additional features and embodiments, that alone or in
combination with any other features of any other embodiments,
including those listed above and those listed in the claims, and
those described in detail below, may comprise patentable subject
matter. Other features and embodiments will become apparent to
those skilled in the art upon consideration of the following
detailed description of illustrative embodiments. Any feature or
aspect disclosed herein, or any embodiment disclosed herein, can be
combined with any other feature or aspect or embodiment disclosed
herein. One or more features of any embodiment disclosed herein can
be combined with one or more features of any other embodiment
disclosed herein, and other features can be removed or added to
create still further embodiments. Accordingly, many other features,
aspects, and embodiments are possible without departing from the
spirit, scope, and principles of the present disclosure.
BRIEF DESCRIPTION OF THE DRAWINGS
[0050] Referring now to the illustrative examples in the drawings,
wherein like numerals represent the same or similar elements
throughout:
[0051] FIG. 1 is a partial diagrammatic view of an adverse event
mitigation system according to one embodiment of the current
disclosure;
[0052] FIG. 2 is a side perspective view of a person support
apparatus and person support surface of FIG. 1;
[0053] FIG. 3 is a cross-sectional side view of the deck of the
upper frame and the person support surface of FIG. 2;
[0054] FIG. 4 is a cross-sectional view of a portion of the person
support surface of FIG. 2 showing the layers of the person support
surface;
[0055] FIG. 5 is a side view of the person support surface of FIG.
2 according to another embodiment showing supports configured to
support the cervical vertebrae and scapula;
[0056] FIG. 6 is a block diagram of a proactive procedure according
to one embodiment;
[0057] FIG. 7 is a block diagram of a reactive procedure according
to one embodiment;
[0058] FIG. 8 is a block diagram of a predictive procedure
according to one embodiment;
[0059] FIG. 9 is a partial diagrammatic view of a garment
configured to rotate a person;
[0060] FIGS. 10A-10C are partial diagrammatic views of a person
support apparatus configured to rotate a person in accordance with
one or more embodiments disclosed herein;
[0061] FIG. 11 is a perspective view of an exemplary support system
supporting a user on a sleep surface defined by the support
system;
[0062] FIG. 12 is a perspective side view of the support system
shown in FIG. 11;
[0063] FIG. 13 is a side elevational view of the support system
shown in FIG. 11;
[0064] FIG. 14 is a front elevational view of the support system
shown in FIG. 11;
[0065] FIG. 15 is a schematic view of an exemplary support
system;
[0066] FIG. 16 is a partial front view of the support system shown
in FIG. 15 illustrating a lateral rotation of planes;
[0067] FIG. 17 is a partial side view of the support system shown
in FIG. 15 illustrating a longitudinal rotation of planes;
[0068] FIG. 18 shows an exemplary control system operatively
coupled to the support system shown in FIG. 15;
[0069] FIG. 19 is a side view of an exemplary support system
including a plurality of independently rotatable support
pieces;
[0070] FIG. 20A is a cross-sectional view of the support system
shown in FIG. 19 taken along sectional line 20A in FIG. 19;
[0071] FIG. 20B is a cross-sectional view of the support system
shown in FIG. 19 taken along sectional line 20A in FIG. 19 and
rotated 180.degree. about a longitudinal axis of the support
system;
[0072] FIG. 21 is side view of an exemplary support system
including a plurality of support pieces;
[0073] FIG. 22 is a side view of the support system shown in FIG.
21 including a spacer positioned between adjacent support
pieces;
[0074] FIG. 23 is a side view of an exemplary support system
including a plurality of support pieces;
[0075] FIG. 24 is a side view of the support system shown in FIG.
23 including a spacer replacing one of the support pieces;
[0076] FIG. 25 is a perspective view of an exemplary support system
showing a greater number of support wedges to allow more gradual
changes in edge angle along a length of a sleep surface;
[0077] FIG. 26 is a top plan view of an exemplary support system
supporting a user on a sleep surface defined by the support
system;
[0078] FIG. 27 is a side view of the support system shown in FIG.
26 illustrating a continuous support piece exhibiting a gradual
density transition along a longitudinal length of the sleep
surface;
[0079] FIG. 28 is a top plan view of an exemplary dynamic support
system;
[0080] FIG. 29 is a front view of an exemplary dynamic support
system;
[0081] FIG. 30 is a top view of the dynamic support system shown in
FIG. 29;
[0082] FIG. 31 is an end view of the dynamic support system shown
in FIG. 29 illustrating a lateral rotation of planes;
[0083] FIGS. 32-35 illustrate various configurations of fluid
bladders forming at least a portion of the dynamic support system
shown in FIG. 29;
[0084] FIG. 36 is a schematic view of an exemplary dynamic support
system;
[0085] FIG. 37 illustrates an exemplary method for monitoring sleep
activities of a user positioned on a dynamic support system, such
as the support system shown in FIG. 36;
[0086] FIGS. 38-41 illustrate an exemplary heuristic control of an
apnea therapy surface function;
[0087] FIG. 42 is a perspective view of an exemplary continuous
lateral rotation therapy (CLRT) system;
[0088] FIG. 43 is a front view of a control system configured to
control the CLRT system shown in FIG. 42;
[0089] FIG. 44 is a cross-sectional view of the support system
shown in FIG. 42;
[0090] FIG. 45 is a cross-sectional view of a portion of the
support system shown in FIG. 42;
[0091] FIG. 46 is a cross-sectional view of an exemplary support
system with fixed-length bands to restrict fluid bladder
inflation;
[0092] FIG. 47 is a front perspective view of a front portion of an
exemplary posture shirt;
[0093] FIG. 48 is a rear view of a back portion of the posture
shirt shown in FIG. 47;
[0094] FIG. 49 is a top view of an exemplary chest constriction
device;
[0095] FIG. 50 is a top view of a constriction device of the chest
constriction device shown in FIG. 49;
[0096] FIG. 51 is a top view of a portion of the constriction
device shown in FIG. 50 with the lever in a relaxed position;
[0097] FIG. 52 is a top view of a portion of the constriction
device shown in FIG. 50 with the lever in a constricted
position;
[0098] FIG. 53 is a simplified plan view of at least one embodiment
of a person support apparatus including a number of support
sections configured to position a support surface of the support
section at a lateral tilt angle, shown with a top portion of the
cover removed, and a simplified schematic view of an air control
system in communication with the support sections of the person
support apparatus;
[0099] FIG. 54 is a simplified sectional view 54-54 of a support
section of the person support apparatus of FIG. 53, where the
support section is configured to position a support surface of the
support section at a lateral tilt angle;
[0100] FIG. 55 is a simplified perspective view of at least one
embodiment of a support section for the person support apparatus of
FIGS. 53-54;
[0101] FIG. 56 is a simplified sectional view 56-56 of the support
section of FIG. 55;
[0102] FIG. 57 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0103] FIG. 58 is a simplified perspective view of the embodiment
of FIG. 57, shown in a substantially flat position;
[0104] FIGS. 59-60 are simplified end views of at least one
embodiment of a support section for the person support apparatus of
FIGS. 53-54, showing different lateral tilt angles of a support
surface of the support section;
[0105] FIG. 61 is a simplified top plan view of at least one
embodiment of an arrangement of support sections and fluid
communication channels for the person support apparatus of FIGS.
53-54, showing the fluid communication channels coupling the
support sections to the air control system;
[0106] FIG. 62 is a simplified top plan view of at least one
embodiment of a side support member for the person support
apparatus of FIGS. 53-54;
[0107] FIG. 63 is a simplified side view of the side support member
of FIG. 62, taken while the side support member is inflated;
[0108] FIG. 64 is a simplified perspective view of at least one
embodiment of a cover for the person support apparatus of FIG.
53;
[0109] FIG. 65 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0110] FIG. 66 is a simplified perspective view of the embodiment
of FIG. 65, shown in a substantially flat position;
[0111] FIG. 67 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0112] FIG. 68 is a simplified perspective view of the embodiment
of FIG. 67, shown in a flat position;
[0113] FIG. 69 is a simplified perspective view of at least one
embodiment of a support section for the person support apparatus of
FIG. 53;
[0114] FIG. 70 is a simplified side view of the support section of
FIG. 69;
[0115] FIGS. 71-74 are simplified sectional views of various
embodiments of a support section similar in some respects to the
support section of FIG. 55, where the sectional views are similar
to the view of FIG. 56;
[0116] FIG. 75 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in
communication with a weighing system;
[0117] FIGS. 76-77 are simplified side views of at least one
embodiment of a support section for the person support apparatus of
FIG. 53, showing a lateral tilt position and a substantially flat
position, respectively;
[0118] FIG. 78 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0119] FIGS. 79-80 are simplified end views of the support section
of FIG. 78, showing a lateral tilt position and a substantially
flat position, respectively;
[0120] FIG. 81 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0121] FIG. 82 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0122] FIGS. 83-85 are simplified side views of the support section
of FIG. 82, showing a lateral tilt position, another lateral tilt
position, and a substantially flat position, respectively;
[0123] FIG. 86 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position, and including at least one side
member;
[0124] FIG. 87 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position, and including a side member;
[0125] FIG. 88 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position, and including at least one side
member;
[0126] FIG. 89 is a simplified perspective view of the person
support apparatus of FIG. 88, shown in a substantially flat
position;
[0127] FIG. 90 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0128] FIG. 91 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position;
[0129] FIGS. 92-93 are simplified side views of the support section
of FIG. 91, showing a lateral tilt position and a substantially
flat position, respectively;
[0130] FIG. 94 is a simplified perspective view of at least one
embodiment of the person support apparatus of FIG. 53, shown in a
progressive lateral tilt position, and including at least two side
members;
[0131] FIG. 95 is a simplified flow diagram of a method for
controlling lateral angles of a person support apparatus;
[0132] FIG. 96a is a perspective view of a mattress according to
another illustrative embodiment of the present disclosure;
[0133] FIG. 96b is a top view of the illustrative embodiment of
FIG. 96a looking in the direction labeled 96b in FIG. 96a;
[0134] FIG. 96c is a longitudinal side view (viewed along the
longer side) of the illustrative embodiment of FIG. 96a, looking in
the direction labeled 96c in FIG. 96b;
[0135] FIG. 96d is a lateral side view (viewed along the shorter
side, or end) of the illustrative embodiment of FIG. 96a, looking
in the direction labeled 96d in FIG. 96c;
[0136] FIG. 97a is a perspective view of the base, having a side
bolster on top of it, of the illustrative embodiment of FIG.
96;
[0137] FIG. 97b is a top view of the base and bolster of FIG. 97a,
looking in the direction labeled 97b in FIG. 97a;
[0138] FIG. 97c is a left side view of the base and bolster of FIG.
97a, looking in the direction labeled 97c in FIG. 97b;
[0139] FIG. 97d is a head end view of the base and bolster of FIG.
97a, looking in the direction labeled 97d in FIG. 97c;
[0140] FIG. 98a is a perspective view of the head section of the
illustrative embodiment of FIG. 96;
[0141] FIG. 98b is a top view of the head section of FIG. 98a,
looking in the direction labeled 98b in FIG. 98a;
[0142] FIG. 98c is an end view of the head section of FIG. 98a,
looking in the direction labeled 98c in FIG. 98b;
[0143] FIG. 98d is an end view of the head section of FIG. 97a,
looking in the direction labeled 98d in FIG. 98c;
[0144] FIG. 99a is a perspective view of the torso section of the
illustrative embodiment of FIG. 96;
[0145] FIG. 99b is a top view of the torso section of FIG. 99a,
looking in the direction labeled 99b in FIG. 99a;
[0146] FIG. 99c is a side view of the torso section of FIG. 99a,
looking in the direction labeled 99c in FIG. 99b;
[0147] FIG. 99d is a side view of the torso section of FIG. 99a,
looking in the direction labeled 99d in FIG. 99c;
[0148] FIG. 100a is a perspective view of the leg section of the
illustrative embodiment of FIG. 96;
[0149] FIG. 100b is a top view of the leg section of FIG. 100a,
looking in the direction labeled 100b in FIG. 100a;
[0150] FIG. 100c is an end view of the leg section of FIG. 100a,
looking in the direction labeled 100c in FIG. 100b;
[0151] FIG. 100d is a side view of the leg section of FIG. 100a,
looking in the direction labeled 100d in FIG. 100c;
[0152] FIG. 101 is a perspective view of mattress according to
another illustrative embodiment of the present disclosure, where
the mattress includes transitions sections between the head section
and torso section and between the torso section and leg
section;
[0153] FIG. 102a is a perspective view of the first transition
section of the illustrative embodiment of FIG. 101;
[0154] FIG. 102b is a top view of the first transition section of
FIG. 101, looking in the direction labeled 102b in FIG. 102a;
[0155] FIG. 102c is a side view of the first transition section of
FIG. 101, looking in the direction labeled 102c in FIG. 102b;
[0156] FIG. 102d is a side view of the first transition section of
FIG. 101, looking in the direction labeled 102d in FIG. 102c;
[0157] FIG. 103a is a perspective view of the second transition
section of the illustrative embodiment of FIG. 101;
[0158] FIG. 103b is a top view of the second transition section of
FIG. 101, looking in the direction labeled 103b in FIG. 103a;
[0159] FIG. 103c is a side view of the second transition section of
FIG. 101, looking in the direction labeled 103c in FIG. 103b;
[0160] FIG. 103d is a side view of the second transition section of
FIG. 101, looking in the direction labeled 103d in FIG. 103b;
[0161] FIG. 104 is a perspective view of a person support apparatus
according to another illustrative embodiment of the present
disclosure, that includes a leg section that articulates near the
knee of the person supported;
[0162] FIG. 105a is a perspective view of a mattress according to
another illustrative embodiment of the present disclosure;
[0163] FIG. 105b is a top view of the illustrative embodiment of
FIG. 105a looking in the direction labeled 105b in FIG. 105a;
[0164] FIG. 105c is a longitudinal side view (viewed along the
longer side) of the illustrative embodiment of FIG. 105a, looking
in the direction labeled 105c in FIG. 105b;
[0165] FIG. 105d is a lateral side view (viewed along the shorter
side, or end) of the illustrative embodiment of FIG. 105a, looking
in the direction labeled 105d in FIG. 105c;
[0166] FIG. 106a is a perspective view of a mattress according to
another illustrative embodiment of the present disclosure, where
the mattress includes an articulating leg section;
[0167] FIG. 106b is a top view of the illustrative embodiment of
FIG. 106a looking in the direction labeled 106b in FIG. 106a;
[0168] FIG. 106c is a longitudinal side view (viewed along the
longer side) of the illustrative embodiment of FIG. 106a, looking
in the direction labeled 106c in FIG. 106b, but showing the leg
section articulated;
[0169] FIG. 107 is a top, foot end, perspective view of a mattress
design according to another embodiment;
[0170] FIG. 108 is a top plan view of the mattress of FIG. 107;
[0171] FIG. 109 is a back plan view of the mattress of FIG.
107;
[0172] FIG. 110 is a first side elevation view of the mattress of
FIG. 107;
[0173] FIG. 111 is a second side elevation view of the mattress of
FIG. 107;
[0174] FIG. 112 is a head end elevation view of the mattress of
FIG. 107;
[0175] FIG. 113 is a foot end elevation view of the mattress of
FIG. 107;
[0176] FIG. 114 is a top, foot end, perspective view of a mattress
design according to another embodiment;
[0177] FIG. 115 is a top plan view of the mattress of FIG. 114;
[0178] FIG. 116 is a back plan view of the mattress of FIG.
114;
[0179] FIG. 117 is a first side elevation view of the mattress of
FIG. 114;
[0180] FIG. 118 is a second side elevation view of the mattress of
FIG. 114;
[0181] FIG. 119 is a head end elevation view of the mattress of
FIG. 114;
[0182] FIG. 120 is a foot end elevation view of the mattress of
FIG. 114;
[0183] FIG. 121 is a top, foot end, perspective view of a mattress
according to another embodiment of an illustrative design;
[0184] FIG. 122 is a top plan view of the mattress of FIG. 121;
[0185] FIG. 123 is a back plan view of the mattress of FIG.
121;
[0186] FIG. 124 is a first side elevation view of the mattress of
FIG. 121;
[0187] FIG. 125 is a second side elevation view of the mattress of
FIG. 121;
[0188] FIG. 126 is a head end elevation view of the mattress of
FIG. 121;
[0189] FIG. 127 is a foot end elevation view of the mattress of
FIG. 121;
[0190] FIG. 128 is a top, foot end perspective view of a sleep
apparatus according to another embodiment;
[0191] FIG. 129 is a side, foot end perspective view of a tilting
insert device used in the apparatus of FIG. 128;
[0192] FIG. 130 is a head end elevation view of the device of FIG.
129;
[0193] FIG. 131 is a foot end elevation view of the device of FIG.
129;
[0194] FIG. 132 is a left side elevation view of the device of FIG.
129;
[0195] FIG. 133 is a right side elevation view of the device of
FIG. 129;
[0196] FIG. 134A is a block diagram of an exemplary dynamic support
system;
[0197] FIG. 134B is a perspective exploded view showing a mattress
overlay situated above a mattress, the mattress overlay having
bladders that are inflated to create a contoured sleeping surface
that slopes laterally in head, torso and leg support sections of
the overlay, and an apnea control box having a graphical user
interface with user inputs that allow a user to adjust a lateral
angle for each of the head, torso, and leg sections;
[0198] FIGS. 135A-135B are head end views of an exemplary support
system including a plurality of support pieces at a first and
second time;
[0199] FIG. 136 is a block diagram of a predictive process
according to one embodiment;
[0200] FIG. 137 is a block diagram of personalized support
adjustment process according to one embodiment;
[0201] FIG. 138A is a perspective view of a bed frame and mattress
according to another illustrative embodiment of the present
disclosure, showing a set of tilting units (in phantom) situated
between the mattress and the bed frame;
[0202] FIG. 138B is a cross sectional view of one of the tilting
units of FIG. 138A showing the tilting unit having three plates
hinged together in a Z-shaped formation, an upper bladder in an
inflated state, and a lower bladder in a deflated state so that an
upper plate of the three plates slopes in a first lateral
direction;
[0203] FIG. 138C is a cross sectional view of the tilting unit of
FIG. 138B showing the lower bladder in an inflated state and the
upper bladder in a deflated state so that the upper plate of the
three plates slopes in a second lateral direction that is opposite
to the first lateral direction;
[0204] FIG. 139 is a simplified block diagram of a process of
adjusting a patient support based on head orientation;
[0205] FIG. 140 is a block diagram of a process of adjusting head
end tilt parameters according to another embodiment;
[0206] FIG. 141 is a block diagram of a process of adjusting bed
tilt parameters using a single initiating step;
[0207] FIGS. 142A-142B illustrate head end views before and after a
patient positioner is used;
[0208] FIG. 143 is a top view of an embodiment of a patient
positioner;
[0209] FIG. 144 is a top view of another embodiment of a patient
positioner;
[0210] FIGS. 145A-145B are head end views of another embodiment
where 145A illustrates a sub optimal patient position and 145B
illustrates a corrective measure taken; and
[0211] FIGS. 146A-146B are head end views of another embodiment
where 146A illustrates a sub-optimal patient position and 146B
illustrates a corrective measure taken.
DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
[0212] While the present disclosure can take many different forms,
for the purpose of promoting an understanding of the principles of
the disclosure, reference will now be made to the embodiments
illustrated in the drawings, and specific language will be used to
describe the same. No limitation of the scope of the disclosure is
thereby intended. Various alterations, further modifications of the
described embodiments, and any further applications of the
principles of the disclosure, as described herein, are
contemplated.
[0213] An adverse event mitigation system 10 according to one
contemplated embodiment is shown in FIGS. 1-8. The adverse event
mitigation system 10 is configured to help reduce the likelihood of
an adverse event occurring and/or stop an adverse event in
progress. In some contemplated embodiments, the adverse event
mitigation system 10 may help reduce the likelihood of obstructive
sleep apnea occurring and/or may help stop an obstructive apnea
event in progress. In other contemplated embodiments, the adverse
event mitigation system 10 may help reduce the likelihood of other
adverse events occurring and/or stop other adverse events in
progress.
[0214] The adverse event mitigation system 10 includes a person
support apparatus 12, a person support surface 14 supported on the
person support apparatus 12, and a control system 16 as shown in
FIG. 1. In some contemplated embodiments, the person support
apparatus 12 is a hospital bed frame and the person support surface
14 is supported thereon as shown in FIG. 2. In other contemplated
embodiments, the person support apparatus 12 can be a stretcher, an
operating room table, or other person supporting structure. The
person support apparatus 12 includes a lower frame 17, supports 18
or lift mechanisms 18 coupled to the lower frame 17, and an upper
frame 20 movably supported above the lower frame 17 by the supports
18 as shown in FIG. 1. The lift mechanisms 18 are configured to
raise and lower the upper frame 20 with respect to the lower frame
17 and move the upper frame 20 between various orientations, such
as, Trendelenburg and reverse Trendelenburg.
[0215] The upper frame 20 includes an upper frame base 24, a deck
26 coupled to the upper frame base 24, and a plurality of actuators
27 coupled to the upper frame base 24 and the deck 26 as shown in
FIG. 2. The plurality of actuators 27 are configured to move at
least a portion of the deck 26 along at least one of a longitudinal
axis, which extends along the length of the upper frame 20, and a
lateral axis, which extends across the width of the upper frame 20,
between various articulated configurations with respect to the
upper frame base 24. The deck 26 includes a calf section 28, a
thigh section 30, a seat section 32, and a head and torso section
34 as shown in FIG. 3. The calf section 28 and the thigh section 30
define a lower limb support section LL1. The head and torso section
34 define an upper body support section U1. The seat section 32
defines the seat section S1. The calf section 28, the thigh section
30, and the seat section 32 define a lower body support section
LB1. At least the calf section 28, the thigh section 30, and the
head and torso section 34 are movable with respect to one another
and/or the upper frame base 24. In some contemplated embodiments,
the calf section 28, the thigh section 30, the seat section 32, and
the head and torso section 34 cooperate to move the person support
apparatus 12 between an substantially planar or lying down
configuration and a chair configuration. In some contemplated
embodiments, the calf section 28, the thigh section 30, the seat
section 32, and the head and torso section 34 cooperate to move the
person support apparatus 12 between a substantially planar or lying
down configuration and an angled or reclined configuration. In some
contemplated embodiments, the head and torso section 34 is moved
such that it is at an angle of at least about 30.degree. with
respect to a reference plane RP1 passing through the upper frame
20.
[0216] The person support surface 14 is configured to support a
person thereon and move with the deck 20 between the various
configurations. In some contemplated embodiments, the person
support surface 14 is a hospital bed mattress as shown in FIG. 2-4.
In some contemplated embodiments, the person support surface 14 is
a consumer mattress. In some contemplated embodiments, the person
support surface 14 includes a heat and moisture regulating topper
positioned on the person support surface 14. In some contemplated
embodiments, the person support surface 14 can include a pressure
mapping topper positioned on the person support surface 14. The
person support surface 14 includes a calf portion 36, a thigh
portion 38, a seat portion 40, and a head and torso portion 42 as
shown in FIG. 3, which is supported on corresponding sections of
the deck 26. In one illustrative embodiment, the deck sections help
move and/or maintain the various portions of the person support
surface 14 at angles .alpha., .beta. and .gamma. with respect to
the reference plane RP1. In some contemplated embodiments, the
person support surface 14 is a non-powered (static) surface. In
some contemplated embodiments, the person support surface 14 is a
powered (dynamic) surface configured to receive fluid from a fluid
supply FS1 as shown in FIG. 5.
[0217] The person support surface 14 includes a mattress cover 44
and a mattress core 46 as shown in FIGS. 3 and 4. In some
contemplated embodiments, the person support surface 14 includes a
temperature and moisture regulating topper (not shown) coupled to
the mattress cover 44. The mattress cover 44 encloses the mattress
core 46 and includes a fire barrier 48, a bottom ticking 50 or
durable layer 50, and a top ticking 52. In some contemplated
embodiments, the fire barrier 48 is the innermost layer of the
cover 44, the top ticking 52 is the outermost layer, and the bottom
ticking 50 is positioned between the fire barrier 48 and the top
ticking 52 and is not coupled to the top ticking 52. The bottom
ticking 50 and the top ticking 52 are vapor and air impermeable. In
some contemplated embodiments, the top ticking 52 and the bottom
ticking 50 are composed of polyurethane coated nylon and the bottom
ticking 50 is configured to facilitate movement of the top ticking
52 with respect to the fire barrier 48. In other contemplated
embodiments, the top ticking 52 and/or the bottom ticking 50 can be
air and/or moisture permeable.
[0218] The mattress core 46 can be composed of a single type of
material or a combination of materials and/or devices. In the case
of a powered surface, the mattress core 46 includes at least one
fluid bladder 54 therein that receives fluid from a fluid supply
(not shown) to maintain the fluid pressure within the fluid bladder
54 at a predetermined level. In some contemplated embodiments, the
powered surface can include non-powered components, such as, a foam
frame that at least one fluid bladder 54 is positioned between. In
some contemplated embodiments, a fluid bladder 54 can be positioned
proximate to the thigh section and inflated or the calf portion 36,
thigh portion 38, and/or seat portion 40 (including their
corresponding deck sections) can be articulated to help prevent the
occupant from sliding down the person support surface 14 as, for
example, the inclination of the head and torso section 34 increases
with respect to the reference plane RP1. In some contemplated
embodiments, wedge shaped bladders are mirrored laterally about the
centerline of the person support surface 14 and are configured to
be inflated consecutively to laterally tilt the occupant, thereby
relieving pressure on various portions of the occupant's body to
help reduce the occurrences of pressure ulcers.
[0219] In some contemplated embodiments, the mattress core 46
includes inflatable fluid bladders 54a and 54b, which are
configured to protrude from the patient facing surface of the
person support surface 14 by at least about 70 mm (adjusted for
pillow height) and about 20 mm to about 30 mm to support the
cervical vertebrae and scapula, respectively. In some contemplated
embodiments, the inflatable fluid bladders 54a and 54b are replaced
foam bolsters or static air bladders or a combination thereof. In
some contemplated embodiments, the distance the fluid bladders 54a
and 54b protrude from the patient facing surface of the person
support surface 14 can vary depending on any number of factors,
including, but not limited to, a person's body type and the angle
at which the surface is at with respect to the reference plane RP1.
In some contemplated embodiments, the fluid bladders 54a and 54b
can also be configured to laterally tilt the head and/or torso of
the occupant. In some contemplated embodiments, wedge shaped fluid
bladders (not shown) are positioned in the head and torso portion
42 and are configured to increase the angle of the occupant
contacting surface of the head and torso portion 42 with respect to
the seat portion 40 when inflated.
[0220] In some contemplated embodiments, the head and torso of the
occupant can be tilted at different angles. For example, the person
support apparatus 12 and/or the person support surface 14 can
laterally rotate the occupant so that the torso is at an angle of
about 10.degree. with respect to the reference plane RP1 and the
head is at an angle of about 180.degree. with respect to the
reference plane RP1. Rotation of the occupant's torso can help an
occupant maintain their head at an angle of about 180.degree. with
respect to the reference plane RP1. In some contemplated
embodiments, the person support surface 14 is configured to allow
the occupant's body to be immersed into the surface to improve
comfort with lateral positioning. In some contemplated embodiments,
support blocks (not shown) can be placed on the surface 14 adjacent
to the occupant to help maintain the position of the occupant. In
some contemplated embodiments, the person support apparatus 12
and/or person support surface 14 can laterally rotate the occupant
so that the torso is at an angle of about 10.degree. with respect
to the reference plane RP1 and fluid bladders 54a and 54b can
rotate the occupant's head so that it is at an angle of at least
about 180.degree.. In some contemplated embodiments, the occupant
can be wearing a garment G1 with fluid bladders G2 configured to be
inflated to help laterally rotate the occupant so that the torso is
at an angle of at least 10% with respect to the reference plane RP1
as shown in FIG. 9. In some contemplated embodiments, the garment
G1 is configured to provide therapy, including, for example,
percussion, vibration, and compression therapies. In some
contemplated embodiments, the garment G1 is an airway clearance
vest, such as the Vest.RTM. Airway Clearance System sold by
Hill-Rom. In other contemplated embodiments, the garment G1 can be
other therapy garments, including sequential compression devices
(SCD). In some contemplated embodiments, fluid can be supplied to
the garment G1 via the fluid supply FS1 configured to supply fluid
to the fluid bladders 54a and 54b. In some contemplated
embodiments, fluid is supplied to the garment G1 and/or fluid
bladders G2 by a dedicated fluid supply (not shown). The angle of
the occupant's head with respect to the reference plane RP1 may
vary depending on the occupant's preferences, their risk of the
adverse condition, or other factors.
[0221] In the case of a non-powered surface, the mattress core 46
is composed of a cellular engineered material, such as, single
density foam. In some contemplated embodiments, the mattress core
46 includes at least one bladder 54, such as, a static air bladder
or a static air bladder with foam contained there within, a metal
spring and/or other non-powered support elements or combinations
thereof. In some contemplated embodiments, the mattress core 46
includes multiple zones with different support characteristics
configured to enhance pressure redistribution as a function of the
proportional differences of a person's body. Also, in some
embodiments, the mattress core 46 includes various layers and/or
sections of foam having different impression load deflection (ILD)
characteristics, such as, in the NP100 Prevention Surface, AccuMax
Quantum.TM. VPC Therapy Surface, and NP200 Wound Surfaces sold by
Hill-Rom Company, Inc.
[0222] The control system 16 is configured to change at least one
characteristic of the person support apparatus 12 and/or person
support surface 14 to help reduce the likelihood of an adverse
event occurring and/or stop an adverse event in progress. The
control system 16 includes a processor 100, an input 102, and
memory 104. In some contemplated embodiments, the input 102
includes a sensor 106, such as, a position sensor, a pressure
sensor, a temperature sensor, an acoustic sensor, and/or a moisture
sensor, configured to provide an input signal to the processor 100
indicative of a physiological characteristic of the occupant, such
as, the occupant's heart rate, respiration rate, respiration
amplitude, skin temperature, weight, and position. In some
contemplated embodiments, the sensors 106 are incorporated into the
person support surface 14 or topper positioned on the person
support surface, for example, as disclosed in U.S. Pat. No.
7,515,059 to Price et al. and U.S. Patent Publication No.
2011/0068928 to Riley et al. In some contemplated embodiments, the
sensors 106 include, for example, RFID tags, accelerometers,
proximity sensors, level sensors, or other physical tracking
sensors that may be integrated into or coupled to, for example, ear
plugs, ear phones, adhesive sensors, earlobe clips, eye covers,
hats, nose strips or other devices that are attached to the
patient's head or worn by the patient so that the
position/orientation of the patient's head can be tracked.
Information captured by monitoring the lateral position of the
user's upper respiratory tract has several benefits, including one
or more of the following: providing more accurate measurements of
the upper respiratory angle for diagnosis of positional obstructive
sleep apnea (in one example, sleep labs can use the information to
more accurately diagnose POSA); providing biofeedback to help the
user to train to maintain a posture that prevents POSA; tracking
performance of the system to determine if the system is achieving a
sufficient upper respiratory angle to prevent apnea; monitoring
compliance to determine if the system is being used; monitoring the
upper respiratory angle and recording the angle when a sleep apnea
event occurs; and controlling a surface capable of providing
lateral rotation as a function of the inputs from the sensors 106,
tracking whether optimal lateral position has been achieved, and
controlling the system to achieve a desired head lateral position
and/or upper respiratory angle. In some contemplated embodiments,
the sensors 106 are tracked by reading devices (i.e., an RFID
reader) in a siderail, person support surface, deck, headboard, or
location on or in the person support apparatus 10 or person support
surface 14, or on or in a headwall in the room or other location in
the room. In some contemplated embodiments, the sensor 106 includes
a camera positioned at the foot of the bed or above the bed, as
disclosed in U.S. Patent Publication No. 2012/0029879 to Sing et
al., for example, to track the orientation of the person's
head.
[0223] In some contemplated embodiments, the input 102 includes a
user interface 108 configured to receive information from a
caregiver or other user. In other contemplated embodiments, the
input 102 is an Electronic Medical Record (EMR) system 110 in
communication with the processor 100 via a hospital network 112. In
some contemplated embodiments, the processor 100 can output
information, automatically or manually upon caregiver input, to the
EMR for charting, which can include therapy initiation and
termination, adverse event occurrence information, therapy protocol
used, caregiver ID, and any other information associated with the
occupant, caregiver, person support apparatus 12, person support
surface 14, and adverse event.
[0224] The memory 104 stores one or more instruction sets
configured to be executed by the processor 100. The instruction
sets define procedures 114 that, when executed by the processor,
cause the processor 100 to implement one or more protocols that
modify the configuration of the person support apparatus 12 and/or
the person support surface 14. In one illustrative embodiment, the
instruction set defines a proactive procedure 114 that causes the
processor 100 to configure the person support apparatus 12 and/or
the person support surface 14 in response to an input specifying
that the occupant is at risk for sleep apnea. Procedure 114 begins
with step 116 in which the processor 100 receives an input signal
from the input 102 indicative of the level of risk for an apnea
event occurring. In some contemplated embodiments, the level of
risk is input from a field in the occupant's EMR. In some
contemplated embodiments, the level of risk is input by a caregiver
through the user interface 108, which may arise from a doctor's
order or be based on a patient scoring system. In some contemplated
embodiments, the level of risk is determined based on a risk score
that is calculated by the processor 100 based on a number of
factors, including, but not limited to, those listed in the table
below:
TABLE-US-00001 Predisposing BMI in the 95th percentile physical for
age and gender characteristics (i.e., physical 35 kg/m2) 17 inch
neck circumference for men (16 inches for women) craniofacial
abnormalities that affect the airway anatomical nasal obstructions
tonsils that nearly touch or do touch in the medline History of
apparent loud or frequent snoring airway obstruction observed
pauses in breathing during sleep while asleep awakening from sleep
with a choking sensation frequent arousal from sleep during sleep
Somnolence frequent somnolence or fatigue despite getting an
adequate amount of sleep falling asleep easily in a nonstimulating
place despite adequate sleep Sleep study results Invasiveness of
superficial under local or surgery and peripheral nerve block
anesthesia without sedation superficial with moderate sedation or
general anesthesia peripheral with spinal or epidural anesthesia
and no more than moderate sedation peripheral with general
anesthesia airway surgery with moderate sedation major surgery with
general anesthesia airway surgery with general anesthesia
Requirement of none postoperative low-dose oral opioids opioids
high-dose oral opioids or neuraxial or parenteral opioids
Estimation of perioperative risk Sex and age of Estimated sleep
disordered occupant breathing is 9% in women and 24% in men with
the prevalence for obstructive sleep apnea being 2% in women and 4%
in men. The percentages likely increase for older and more obese
people
[0225] In circumstances where an occupant is known to snore
frequently, has a high BMI, has had major surgery, and/or requires
postoperative opioids, the occupant may have an elevated risk. In
circumstances where an occupant has a low BMI, is not known to
snore, had superficial surgery, and/or does not require
postoperative opioids, the occupant may have a reduced risk. An
example of a scoring system is shown in the table below, where a
score of 4 can indicate an increased risk, and a score of greater
than 4 can indicate a significantly increased risk.
TABLE-US-00002 I. Severity of apnea Based on sleep study 0-3 points
Based on predisposing 0 points physical characteristics, 1 point
history of apparent 2 points airway obstruction 3 points during
sleep, and somnolence None Mild Moderate Severe II. Surgery and
Invasiveness 0-3 points Anesthesia Type Superficial under 0 points
local or peripheral 1 point nerve block without 1 point sedation
Superficial with moderate sedation or general anesthesia Peripheral
with spinal or epidural anesthesia and no more than moderate
sedation Peripheral with 2 points general anesthesia 2 points
Airway surgery with 3 points moderate sedation 3 points Major
surgery with general anesthesia Airway surgery with general
anesthesia III. Postoperative Requirement 0-3 points opioids Dosage
0 points None 1 point Low-dose oral 3 points High dose oral,
parenteral or neuraxial Risk = Score from I + Score from the
greater of II and III (0-6 points)
[0226] In step 118, the processor 100 determines which protocol
should be implemented based on the level of risk. One type of the
protocol is a default protocol set according to the hospital's
standard operating procedures/guidelines for patients with specific
risk profiles. Another type of protocol is a variable protocol that
modifies the default protocol based on the occupant's preferences
(i.e., prefers to sleep on their left side), the caregiver's
observations, and/or information about the occupant's medical
condition (i.e., pressure ulcer susceptibility, BMI, type of
surgery, etc.) from the occupant's EMR, sensors 106, and/or other
input 102. In some contemplated embodiments, the protocol can be
modified to exclude or limit a therapy or movement. For example,
the protocol can be prevented from increasing the head of bed angle
(the angle between the reference plane RP1 and the head and torso
section 34 or head and torso portion 42) above a predetermined
threshold where the occupant is recovering from abdominal surgery.
In some contemplated embodiments, the protocol can caution the
caregiver against implementing the configurations based on
information obtained from the occupant's EMR or other sources.
[0227] In step 120, once the protocol is selected, the
configuration settings are communicated to the caregiver, for
example, on a graphical user interface or other display device, and
the caregiver is prompted to accept/modify the settings. In some
contemplated embodiments, the configuration settings can be
communicated to a hand held device. In one example, the protocol
may require the head of bed angle to be greater than about
35.degree. and the lateral tilt angle to be greater than 15.degree.
with respect to the reference plane RP1 for an occupant with an
elevated risk score. In another example, the protocol may require
the head of bed angle to be about 10.degree. to about 15.degree.
and the lateral tilt angle to be about 10.degree. to about
15.degree. with respect to the reference plane RP1 for an occupant
with a reduced risk score. In some contemplated embodiments, the
upper frame 20 can also be moved to a Trendelenburg or reverse
Trendelenburg orientation. In some contemplated embodiments, the
protocol can require additional therapies to be active, such as,
continuous lateral rotation where, for example, the lateral tilt
angle changes every 30-120 minutes depending on the occupant's risk
of developing pressure ulcers. In some contemplated embodiments,
the sleep stage of the occupant can be taken into account so that
the occupant is moved only when they are in a sleep state that
would allow them to be moved without waking up. In some
contemplated embodiments, the person support apparatus 12 and/or
the person support surface 14 are returned to the configuration
they were in prior to the implementation of the protocol before the
occupant wakes up. In some contemplated embodiments, a manual stop
button can be included so that the caregiver, occupant, or other
person can terminate the protocol in the event of an emergency. In
some contemplated embodiments, the protocol can automatically be
terminated when an emergency condition occurs, such as, when the
CPR handle (not shown) is pulled by a caregiver or the occupant is
coding. In some contemplated embodiments, the procedure 114 can be
terminated remotely by a caregiver, such as, via the hospital
network or over a nurse call system.
[0228] In some contemplated embodiments, the position and/or the
orientation of the occupant with respect to patient facing surface
of the person support surface 14 is detected and can influence how
the person support surface 14 and/or the person support apparatus
12 are configured to move the occupant to the desired position. For
example, if the occupant is positioned along the left edge of the
patient facing surface of the person support surface 14, the
protocol will not rotate them to the left. In some contemplated
embodiments, the protocol is terminated because the occupant is in
the correct position. In some contemplated embodiments, the
protocol helps to maintain the occupant in the position. The
position of the occupant on the person support surface 14 can be
determined a number of ways, including sensing the force
distribution on the upper frame 20 utilizing one or more load cells
(not shown) coupled to the upper frame 20, calculating the
occupant's center of gravity using the one or more load cells,
sensing pressures within the fluid bladders 54, using a camera (not
shown) or 3D sensor (not shown), or using other methods.
[0229] In step 122, if the caregiver accepts the configuration or
changes the configuration and accepts the new configuration, the
processor 100 implements the configuration for a predetermined
time. In some contemplated embodiments, the processor 100 can
implement the configuration the moment the caregiver approves it
and stop or change the configuration when the caregiver deactivates
it. In some contemplated embodiments, the processor 100 will wait
to implement the configuration until the occupant is in a
predetermined sleep stage and will return to the initial
configuration when the occupant begins to wake up. In some
contemplated embodiments, procedure 114 does not require the
caregiver to confirm or accept the settings, and instead
automatically initiates the configuration. For example, the
configuration can be automatically initiated a predetermined time
after the occupant departed from the surgical room, which can be
determined based on the occupant's EMR. In some contemplated
embodiments, the configuration will not be implemented if the bed
is unoccupied.
[0230] Procedure 114 can be used for a number of other adverse
conditions. In some contemplated embodiments, procedure 114 can be
used to determine if a person is at risk for or has
gastroesophageal reflux disease and select a protocol that assists
the occupant in maintaining a left lateral decubitus position or
semi-reclining position while sleeping. In some contemplated
embodiments, procedure 114 can be used to determine if a person is
at risk for or has chronic respiratory insufficiency and select a
protocol for the caregiver to approve that assists the occupant in
maintaining a left lateral decubitus position while sleeping. In
some contemplated embodiments, the procedure can be used to
determine if a person is at risk for of has allergies to, for
example, feather or down filled pillows, cushions or covers, and
can alert the caregiver so that they can remove the item. In other
contemplated embodiments, procedure 114 can be used to determine if
the person is at risk for or has one or more other conditions, such
as, for example, asthma, pregnancy, sleep paralysis or
hallucinations, snoring, stroke bruxism, coughing, hypoxaemia in
geriatric inpatients, stroke, or tuberculosis, that might be
affected negatively by sleeping in the supine position and select a
protocol and/or alert the caregiver so that the person support
apparatus 12 and/or the person support surface 14 can be configured
to maintain the occupant in a desirable position. In some
contemplated embodiments, the procedure 114 can be used to change
the sleeping position of occupants to help stimulate blood
oxygenation, which can undesirably decrease as the occupant remains
stationary.
[0231] In another illustrative embodiment, the instruction set
causes the processor 100 to carry out a responsive procedure 114
that configures the person support apparatus 12 and/or the person
support surface 14 in response to detection of an adverse event,
such as, an apnea event. Procedure 124 begins with step 126 where
the adverse event mitigation system is armed manually by the
caregiver or automatically based on information from the occupant's
EMR, the caregiver, or calculated by the processor 100.
[0232] In step 127, the processor 100 receives signals from the
sensors 106 indicative of the physiological characteristics of the
occupant, including, but not limited to, the occupant's heart rate
and the respiration characteristics, such as, amplitude and rate,
and/or the amount of movement of the occupant.
[0233] In step 128, the processor 100 compares the signals from the
sensors 106 to predetermined thresholds to determine if an apnea
event is in progress. For example, if there is an interval of at
least about 10 seconds between breaths then the person is likely
having an apnea event. In another example, if the person is taking
less than about 25% of a normal breath for at least about 10
seconds, then the person is likely having an apnea event. In
another example, if there is a drop in oxygen saturation of at
least about 4%, then the person is likely having an apnea event. If
the person is taking between about 26% and about 69% of a normal
breath, the person is likely having a hypopnea event. In some
contemplated embodiments, the processor 100 determines that an
adverse event is in progress and alerts the caregiver that an
adverse event is occurring and that it is likely not an apnea event
based on the position of the occupant and/or the configuration of
the person support apparatus 12 and/or the person support surface
14, the occupant's risk score, and/or the occupant's physiological
characteristics, medical information from the occupant's EMR,
and/or other information. In some contemplated embodiments, the
caregiver can be alerted by a visual or audible alarm on the person
support apparatus 12, a visual or audible alarm located in the room
where the person support apparatus 12 is located, and/or a visual
or audible alarm located proximate to the room, such as, in the
hall way.
[0234] In some contemplated embodiments, the caregiver can be
notified remotely by a communication system (not shown). In some
contemplated embodiments, the communication system is a
patient/nurse call system that can include patient stations capable
of generating hospital calls and a remote master station which can
prioritize and store the calls. One example of such a system is
disclosed in U.S. Pat. No. 5,561,412 issued on Oct. 1, 1996 to
Novak et al., which is incorporated by reference herein in its
entirety. Another example of such a system is disclosed in U.S.
Pat. No. 4,967,195 issued on May 8, 2006 to Shipley, which is
incorporated by reference herein in its entirety.
[0235] In another contemplated embodiment, the communication system
is a system for transmitting voice and data in packets over a
network with any suitable number of intra-room networks that can
couple a number of data devices to an audio station, where the
audio station couples the respective intra-room network to a packet
based network. One example of such a system is disclosed in U.S.
Pat. No. 7,315,535 issued on Jan. 1, 2008 to Schuman, which is
incorporated by reference herein in its entirety. Another example
of such a system is disclosed in U.S. Patent Publication No.
2008/0095156 issued on Apr. 24, 2008 to Schuman, which is
incorporated by reference herein in its entirety.
[0236] In yet another contemplated embodiment, the communication
system is includes a patient/nurse call system, a nurse
call/locating badge, an electronic medical record (EMR) database,
and one or more computers programmed with work-flow process
software. One example of such a system is disclosed in U.S. Patent
Publication No. 2008/0094207 published on Apr. 24, 2008 to Collins,
Jr. et al., which is incorporated by reference herein in its
entirety. Another example of such a system is disclosed in U.S.
Patent Publication No. 2007/0210917 published on Sep. 13, 2007 to
Collins, Jr. et al., which is incorporated by reference herein in
its entirety. Yet another example of such a system is disclosed in
U.S. Pat. No. 7,319,386 published on Jan. 15, 2008 to Collins, Jr.
et al., which is incorporated by reference herein in its entirety.
It should be appreciated that the work-flow process software can be
the NaviCare.RTM. software available from Hill-Rom Company, Inc. It
should also be appreciated that the work-flow process software can
be the system disclosed in U.S. Pat. No. 7,443,303 issued on Oct.
28, 2008 to Spear et al., which is incorporated by reference herein
in its entirety. It should further be appreciated that the badge
can be of the type available as part of the ComLinx.TM. system from
Hill-Rom Company, Inc. It should also be appreciated that the badge
can also be of the type available from Vocera Communications,
Inc.
[0237] In still another contemplated embodiment, the communication
system is configured to organize, store, maintain and facilitate
retrieval of bed status information, along with the various non-bed
calls placed in a hospital wing or ward, and remotely identify and
monitor the status and location of the person support apparatus,
patients, and caregivers. One example of such a system is disclosed
in U.S. Pat. No. 7,242,308 issued on Jul. 10, 2007 to Ulrich et
al., which is incorporated by reference herein in its entirety. It
should be appreciated that the remote status and location
monitoring can be the system disclosed in U.S. Pat. No. 7,242,306
issued on Jul. 10, 2007 to Wildman et al., which is incorporated by
reference herein in its entirety. It should also be appreciated
that the remote status and location monitoring can be the system
disclosed in U.S. Patent Publication No. 2007/0247316 published on
Oct. 25, 2007 to Wildman et al., which is incorporated by reference
herein in its entirety.
[0238] In step 130, if the processor determines an apnea event is
in progress, the processor 100 configures the person support
surface 14 and/or the person support apparatus 12 to intervene and
help stop the apnea event. In one illustrative embodiment, the
processor 100 inflates a bladder 54 in the person support surface
14 to rotate the occupant onto their side such that they are at an
angle of about 10.degree. with respect to the reference plane RP1.
In some contemplated embodiments, the upper frame 20 can be rotated
along the longitudinal axis to laterally tilt the occupant. In
another illustrative embodiment, the processor 100 increases the
head of bed angle to about 15.degree. by moving the head and torso
section 34 of the person support apparatus 12 and/or inflating a
bladder 54 in the person support surface 14. In some contemplated
embodiments, the processor 100 increases the head of bed angle and
laterally rotates at least a portion of the occupant's body. In
some contemplated embodiments, the processor 100 implements
additional therapies, such as, for example, continuous lateral
rotation therapy (CLRT), percussion vibration therapy, heat and
moisture management therapy, rotation therapy, or other therapies
depending on the occupant's risk for developing additional adverse
conditions, such as, pressure ulcers.
[0239] In some contemplated embodiments, procedure 124 includes
step 132 and step 134 in which the processor 100, after
implementing the intervention, receives signals from the sensors
106 indicative of the occupant's physiological characteristics
and/or the amount of movement of the occupant, and compares them
with the predetermined thresholds to determine if the intervention
was successful and the apnea event has ceased. In one illustrative
embodiment, the processor 100 waits a predetermined amount of time,
such as, 5 seconds, after the intervention has been implemented
before it receives signals from the sensors 106. In some
contemplated embodiments, the processor 100 can receive signals
from the sensors 106 as the intervention is implemented and stop
intervening or maintain the current level of intervention when the
apnea event has ceased. For example, the processor 100 receives
signals from the sensors 106 as the head of bed angle and/or the
lateral tilt angle are gradually increased and stops increasing the
head of bed angle and/or the lateral tilt angle once the apnea
event has ceased. In some embodiments, the head of bed angle and/or
the lateral tilt angle are gradually increased and an alarm is
activated when the angle reaches a predetermined threshold. If the
processor 100 determines that the intervention was successful, the
processor 100 can cause the person support apparatus 12 and/or the
person support surface 14 to maintain the current configuration or
cause it to return to its initial position.
[0240] If the processor 100 determines that the apnea event is
still in progress, the processor 100 can increase the level of
intervention. In one illustrative embodiment, the head of bed angle
and/or the lateral tilt angle can be increased an additional
5.degree.. In other embodiments, the stimuli can include vibration,
sound, temperature, smells, lights (flashing and/or constant), or
other stimulus or combinations thereof that may or may not wake the
person. In some instances, the goal of the intervention is to stop
the apnea event without waking the occupant up, which can include
moving the person while the person is in a particular sleep stage
and/or causing the person to move from a deeper sleep stage to a
lighter sleep stage. In some contemplated embodiments, movement of
the occupant can cease if the processor 100 detects the person is
waking up (based on increased heart rate, respiration rate, and/or
movement) or is moving to a lighter sleep stage. If the increased
levels of intervention continue to be unsuccessful then the
processor 100 can initiate an alarm on or near the person support
apparatus 12 to wake the occupant and/or notify a caregiver via
nurse call or other means of communication that they need to
intervene. In some contemplated embodiments, if the processor 100
receives information that the occupant is sedated, the processor
100 can move the occupant to a position, such as, for example, a
sitting position or chair position.
[0241] In another illustrative embodiment, the instruction set
causes the processor 100 to carry out a proactive procedure 136
that configures the person support apparatus 12 and/or the person
support surface 14 when the processor 100 predicts the onset of an
adverse event. Procedure 136 begins with step 138 where the system
for mitigating adverse conditions is armed by the caregiver or the
bed or EMR based on the occupant's risk profile.
[0242] In step 139, the processor 100 receives signals from the
sensors 106 indicative of the physiological characteristics of the
occupant and/or the amount of movement of the occupant.
[0243] In step 140, the processor 100 stores the signal values in
the memory 104 and determines an amount and/or a magnitude of
change in the values for a predetermined time period. The processor
100 then compares the amount and/or the magnitude of change to a
predetermined threshold to determine if an adverse event is likely
to occur. In some contemplated embodiments, the processor 100
considers other factors, such as, the occupant's risk score, body
position or orientation, person support apparatus 12 and/or person
support surface 14 configurations, medical conditions, and/or other
information from the caregiver, occupant's EMR, sensors 106, and/or
person support apparatus 12 and/or person support surface 14 when
determining the likelihood of an adverse event occurring. For
example, if an occupant is at a high risk for apnea, is in the
supine position, and the occupant's respiration rate is decreasing,
then an apnea event may occur. In another example, if an occupant's
respiration amplitude decreases and the occupant's oxygen
saturation decreases then an apnea event may occur. In another
example, if an occupant's snoring is very loud and the occupant is
at a high risk for apnea, an apnea event may occur. In another
example, if an occupant is at high risk and the occupant is
receiving 90% normal breath, an apnea event may be unlikely.
[0244] In some contemplated embodiments, prediction of an apnea
event can be accomplished using a time-domain model of nonlinear
time-lagged interactions between heart rate, respiration, and
oxygen saturation to help determine when an apnea event is likely.
In some contemplated embodiments, prediction of an apnea event can
be accomplished using a Bayesian "belief network" model. In some
contemplated embodiments, prediction of an apnea event can be
accomplished using large memory storage and retrieval (LAMSTAR)
artificial neural networks to analyze signals indicative of heart
rate variability, nasal pressure, oronasal temperature, submental
EMG, and electrooculography. In some contemplated embodiments,
prediction of an apnea event can be accomplished by analyzing
tracheal breath sounds.
[0245] In step 142, the processor configures the person support
surface 14 and/or the person support apparatus 12 as previously
described above with respect to procedure 114 and procedure 124 to
intervene and help prevent the apnea event.
[0246] In another contemplated embodiment, referring to FIGS.
11-18, a support system includes one or more support pieces or
units that form a lateral support plane to prevent or restrict the
user from sleeping in a supine position, and, more specifically,
reduce a time duration that the user sleeps with his/her upper
respiratory tract oriented vertically or at an undesirable lateral
rotational angle with respect to a vertical plane substantially
perpendicular to a horizontal plane. In certain embodiments, the
lateral rotational angle of the user's head with respect to the
vertical plane is at least 30 degrees and, more specifically, at
least 45 degrees. In an alternative embodiment, the lateral
rotational angle of the user's head with respect to the vertical
plane may be less than 30 degrees. In one embodiment, the support
pieces provide multiple support planes for supporting the user's
body.
[0247] In one embodiment as shown in FIGS. 11-18, a support system
1100 suitable for supporting a user, such as a person, for example,
includes plurality of support pieces, namely a first or leg support
piece 1102 forming a first support plane 1104, a second or torso
support piece 1106 forming a second support plane 1108, and a third
or head support piece 1110 forming a third support plane 1112 that
collectively define a segmented, multi-plane, laterally angled
sleep surface 1114 having progressively greater angles of rotation
along a longitudinal axis 1115 of support system 1100, from a first
or bottom edge 1116 of sleep surface 1114 to an opposing second or
top edge 1118 of sleep surface 1114, resulting in relatively
greater rotation of the upper respiratory tract of the user (as
necessary for efficacy in preventing obstructive apnea) and
relatively lesser rotation in the lower body of the user (resulting
in greater comfort and perceived stability by avoiding rotation of
a majority of the user's body mass). In alternative embodiments,
sleep surface 1114 is formed using any suitable number of support
pieces defining corresponding support planes, for example, one
support piece forming a smooth contour over a length of sleep
surface 1114 from first edge 1116 to opposing second edge 1118 or a
plurality of support pieces, such as two support pieces, three
support pieces, or more than three support pieces forming a smooth
contour over the length of sleep surface 1114.
[0248] Unlike conventional positional therapies for the prevention
of obstructive sleep apnea, which attempt to manipulate the user's
sleep position and/or orientation using rotation of one plane, in
certain embodiments the system described herein uses multiple
support planes formed by one or more support pieces to laterally
rotate the user. For example, in one embodiment, two support pieces
provide two separate support planes, with a first support plane
defined by the first support piece configured to support the torso
and the legs of the user, and a second support plane defined by the
second support piece configured to support the neck and the head of
the user.
[0249] In an alternative embodiment, three support pieces provide
three separate support planes, with a first support plane defined
by the first support piece configured to support the legs of the
user, a second support plane defined by the second support piece
configured to support the torso of the user, and a third support
plane defined by the third support piece configured to support the
head of the user.
[0250] In a further alternative embodiment, more than three support
pieces, for example, numerous independent support pieces having a
length in a longitudinal direction of sleep surface 1114 of 2-18
inches or, more specifically, 4-12 inches, or, even more
specifically, 6 inches, provide a corresponding number of separate
support planes. Each support piece can be laterally rotated
independently of other support pieces to collectively form sleep
surface 1114. In a particular embodiment, the numerous support
pieces can be combined to form separate support pieces, for
example, creating a first support piece having a length of 18
inches in the longitudinal direction at the foot of the support
system 1100, an adjacent second support piece having a length of 12
inches in the longitudinal direction, and a third support piece
adjacent the second support piece having a length in the
longitudinal direction of 6 inches. In these embodiments, the
support pieces forming the support planes can be rotated as
necessary or desired to achieve an optimal configuration that is
clinically effective (i.e., prevents apnea) and demonstrates
acceptable tolerance (i.e., allows the user to sleep comfortably).
In an alternative embodiment, a continuously sloped sleep surface
is formed by a plurality of support pieces without step increases
in lateral rotational angle; this is illustrated as a sleep surface
with an infinite number of support pieces.
[0251] In the embodiments described herein, the length in the
longitudinal direction of each support piece and defined support
plane (and the resulting location of transitions between support
planes) is designed to achieve clinical efficacy and tolerability.
Therefore, a specific length can be defined in a number of
configurations, including without limitations: (a) generic plane
dimensions (e.g., based on average body geometry, a length of a
torso section of the user defined so that when an average user's
head is supported by a head support piece, a transition between the
torso support piece and the leg support piece occurs below the
user's S3 vertebrae); (b) customized plane dimensions (e.g., a
torso support plane has a suitable length in the longitudinal
direction appropriate to the user's leg length, torso length,
and/or a distance from the user's shoulder to his/her inseam); or
(c) dynamic plane dimensions (e.g., transitions selected on dynamic
surface appropriate to user, selection being either user-selected,
care-giver defined, or automatically calculated).
[0252] In certain embodiments, each support piece defining the
corresponding support planes is independently rotatable about an
axis extending parallel with a longitudinal axis of the support
system. The independent rotation of each support piece allows the
caregiver or the user the ability to focus on progressively
increasing an angle of rotation in one or more support pieces
having support planes positioned to support the torso of the user,
and the neck and/or the head of the user. In certain embodiments,
an angle of rotation (or lateral rotational angle) at which the one
or more support planes defined by the support pieces configured to
support the neck and/or the head of the user is positioned is
greater than a rotational angle of the one or more support planes
defined by the support pieces configured to support the torso of
the user, which is greater than a rotational angle at which the one
or more support planes defined by the support pieces configured to
support the legs of the user is positioned.
[0253] In a particular embodiment, the support plane defined by the
support piece configured to support the legs and the torso of the
user is positioned at a rotational angle of 10.degree. with respect
to a base surface of the support piece, while the support plane
defined by the support piece configured to support the head of the
user is positioned at a rotational angle of 20.degree. with respect
to a base surface of the support piece. In an alternative
embodiment, a first support plane defined by the support piece
configured to support the legs of the user is positioned at a
rotational angle of 10.degree. with respect to a base surface of
the first support piece, a second support plane defined by a second
support piece configured to support the torso of the user is
positioned at a rotational angle of 15.degree. with respect to a
base surface of the second support piece, and a third support plane
defined by the third support piece configured to support the head
of the user is positioned at a rotational angle of 20.degree. with
respect to a base surface of the third support piece. In
alternative embodiments, the support planes can be positioned at
any suitable rotational angle including any suitable lateral
rotational angle and/or any suitable longitudinal rotational
angle.
[0254] Referring further to FIGS. 14 and 15, in a particular
embodiment, first support piece 1102 defines support plane 1104
positioned at a lateral rotational angle .alpha. of 20.degree. to
30.degree., or more specifically, 20.degree. to 25.degree., or,
even more specifically, 25.degree. with respect to a base surface
1122 of first support piece 1102. Second support piece 1106 defines
support plane 1108 positioned at a lateral rotational angle 13 of
10.degree. to 20.degree., or more specifically, 10.degree. to
15.degree., or, even more specifically, 15.degree., with respect to
a base surface 1124 of second support piece 1106. Third support
piece 1110 defines support plane 1112 positioned at a lateral
rotational angle .gamma. of 5.degree. to 15.degree., or more
specifically, 10.degree., with respect to a base surface 1126 of
third support piece 1106. Other lateral rotational angles and step
increases in lateral rotational angles between each support piece
may also be used to achieve a progressive lateral rotational
angle.
[0255] In one embodiment as shown in FIG. 15, one or more contoured
transitional pieces, such as a first transitional piece 1130 and a
second transitional piece 1132, are positionable between adjacent
support pieces or at or near a transition line between the adjacent
support pieces to provide a gradual continuous transition between
support planes. As shown in FIG. 15, in one embodiment, a first
transitional piece 1130 is positioned at a transitional line where
first support piece 1102 meets with adjacent second support piece
1106 to provide lumbar support for the user. Similarly, a second
transitional piece 1132 is positioned at a transitional line where
second support piece 1106 meets with adjacent third support piece
1110 to provide lumbar support for the user. In particular
embodiments, one or more additional transitional pieces can be
positioned on the support planes to provide additional support at
the neck region and/or the knee region of the user, for example. In
other embodiments, increasing the number of contoured transitional
pieces allows for more contouring and gradual changes in the angle
of support along the length of the support system 1100.
[0256] As shown in FIG. 17, each of first support piece 1102,
second support piece 1106, and third support piece 1110 has a
respective height in a direction perpendicular to longitudinal axis
1115 of support system 1100. In one embodiment, first support piece
1102 has a maximum height from base surface 1122 to support plane
1116 in a direction perpendicular to longitudinal axis 115 of 14 to
18 inches, or more specifically, 16 to 17 inches; second support
piece 1106 has a maximum height from base surface 1124 to support
plane 1108 in a direction perpendicular to longitudinal axis 1115
of 8 to 12 inches, or more specifically, 9 to 10 inches; and third
support piece 1110 has a maximum height from base surface 1126 to
support plane 1112 in a direction perpendicular to longitudinal
axis 1115 of 4 to 8 inches, or more specifically, 6 to 7 inches. As
a result, the support pieces can be designed with desired heights
and defining support planes positioned at desired rotational angles
such that support system 1100 provides a composite longitudinal
plane angle (e.g., reverse Trendelenburg angle) to facilitate the
prevention and/or treatment of sleep apnea as well as to improve
tolerability.
[0257] As described in greater detail below, in certain
embodiments, support system 1100 includes a system control, such as
a controller 1140 shown in FIG. 18, having a display configured to
display information about support system 1100 including, without
limitation, lateral plane angles of each support piece and/or
composite plane angles of each support piece. In one embodiment,
controller 1140 includes one or more processors configured to
adjust the rotational angles of the support planes based on data
input by the user or a caregiver and/or data signals received from
one or more sensors positioned at locations on or near support
system 1100.
[0258] Referring again to FIG. 15, in one embodiment, support
system 1100 includes a bolster 1142 or other suitable boarder
positioned along at least one lateral side of support system 1100
to limit or prevent lateral migration of the user. More
specifically, bolster 1142 extends along at least a portion of the
lateral side generally parallel with longitudinal axis 1115 to
prevent or limit lateral movement of the user positioned on sleep
surface 1114 to prevent the user from moving or sliding off sleep
surface 1114. Bolster 1142 is bolstered at lower edge 1116 of sleep
surface 1114 to define an envelopment zone. In one embodiment,
bolster 1142 extends from lower edge 1116 partially along a length
of support system 1100 to a torso region of the user, but, in this
embodiment, terminates below a head portion of the user. In a
particular embodiment, at least a portion of bolster 1142 includes
a suitable material to provide a textured surface to facilitate
retaining the user in the desired position on the support system
1100. Additionally or alternatively, bolster 1142 may include a
formable material, such as a suitable foam material, having one or
more different densities along a length of bolster 1142 to provide
an increased envelopment throughout sleep surface 1114. A belt
and/or an adjustable strap (not shown in FIG. 15) or a body may be
operatively coupled to bolster 1142 to facilitate maintaining the
user properly positioned on sleep surface 1114.
[0259] In one embodiment, each of support pieces 1102, 1106, 1110
are rotatable about longitudinal axis 1115 to provide sleep surface
1114 having a right side slope or, alternatively, a left side slope
to allow the user to sleep on his/her right side or left side,
respectively. In one embodiment, one or more cylindrical or tubular
sections are positioned within at least a portion of first support
piece 1102, second support piece 1106, and third support piece 1110
and coaxially aligned with longitudinal axis 1115 to allow each
support piece 1102, 1106, 1110 to rotate about longitudinal axis
1115 independently of the other support pieces 1102, 1106,
1110.
[0260] As shown in FIG. 19, a first cylindrical section 1144 is
positioned within a bore 1146 defined within a portion of first
support piece 1102 and second support piece 1106 along longitudinal
axis 1115 to allow first support piece 1102 and second support
piece 1106 to rotate about longitudinal axis 1115 and with respect
to each other. Similarly, a second cylindrical section 1148 is
positioned within a bore 1150 defined within a portion of second
support piece 1106 and third support piece 1110 along longitudinal
axis 1115 to allow second support piece 1106 and third support
piece 1110 to rotate about longitudinal axis 1115 and with respect
to each other. In an alternative embodiment not shown, a single
cylindrical section extends through a bore defined through second
support piece 1106 and into at least a portion of first support
piece 1102 and into at least a portion of third support piece 1110
to allow each of first support piece 1102, second support piece
1106, and third support piece 1110 to rotate about longitudinal
axis 1115 and with respect to each other. In this embodiment, each
support piece 1102, 1106, 1110 is rotatable between a first
orientation having a right side slope, as shown in FIG. 20A, and a
second orientation having a left side slope, as shown in FIG. 20B.
Axial rotation allows each support piece 1104, 1106, 1110 to lie
flat with a right side slope or a left side slope as shown in FIGS.
20A and 20B.
[0261] In certain embodiments, support pieces 1102, 1106, 1110 are
formed of more than one material, for example, two or more
materials, such as two foam materials, having different densities,
with the less dense material covering the denser material. In this
embodiment, the less dense material is laid on the denser material
at the respective base surface and the respective support plane of
the support piece to allow sleep surface 1114 to function properly,
whether with a right side slope or a left side slope. With the
denser material sandwiched between the less dense material, the
user will be positioned on the less dense material in either the
first or the second orientation.
[0262] In this embodiment, support system 1100 allows the user to
sleep on either his/her right side or left side, based on the
user's sleeping preference. This sleeping preference may not be
static. For example, if the user has an injury, an ache, or a
desire to change his/her sleeping preference, the orientation of
sleep surface 1114 can be changed at any time to accommodate the
user's sleeping preference. The orientation can be changed from day
to day or during the night. Moreover, from a manufacturing
standpoint, a versatile support system 1100 prevents having to
manufacture and distribute a sleep surface 1114 having a right side
slope and a separate sleep surface 1114 having a left side slope,
which would increase production and distribution costs. Finally, a
potential purchaser would not have to commit to a sleep side before
purchasing the product, which might be a deterrent to purchasing
the product.
[0263] In one embodiment, support system 1100 includes one or more
spacers 1152 that allow a length of support system 1100 to be
adjusted and customized to a height of the user supported by
support system 1100. For example, the length of sleep surface 1114
can be adjusted by adding one or more suitable spacers 1152 or
replacing one or more support pieces 1102, 1106, 1110 with a
suitable spacer 1152 of a different length, so that transitional
lines between lateral angles of support planes defined by adjacent
support pieces 1102, 1106, 1110 will desirably occur at a neck
region and a hip region of the user. In one embodiment, spacer 1152
has a same or similar lateral rotational angle and/or a same or
similar longitudinal rotational angle as the respective lateral
rotational angle and the respective longitudinal rotational angle
of an adjacent support piece or the support piece that spacer 1152
replaces. In an alternative embodiment, spacer 1152 has a different
lateral rotational angle and/or a different longitudinal rotational
angle as the respective lateral rotational angle and the respective
longitudinal rotational angle of an adjacent support piece or the
support piece that spacer 1152 replaces. As shown in FIGS. 21 and
22, spacer 1152 is positioned between first support piece 1102 and
second support piece 1106 to adjust the length of sleep surface
1114. As shown in FIGS. 23 and 24, first support piece 1102 is
replaced with spacer 1152 to adjust the length of sleep surface
1114.
[0264] Assuming the user positions his/her neck at the appropriate
location on sleep surface 1114, and an overall length of sleep
surface 1114 is adjustable, in one embodiment only second support
piece 1106 of support system 1100 has an adjustable length. In
alternative embodiments having a support system 1100 with a fixed
length, both first support piece 1102 and second support piece 1106
have adjustable lengths. In this embodiment, a length of first
support piece 1102 increases as a length of second support piece
1106 decreases and, conversely, the length of first support piece
1102 decreases as the length of second support piece 1106
increases.
[0265] In one embodiment, adjacent support pieces 1102, 1106, 1110
and spacers 1152 can be coupled together using a suitable coupling
mechanism including, without limitation, one or more of the
following: snaps, straps, buttons, and hook-and-loop fasteners. In
certain embodiments, the length of sleep surface 1114 is adjustable
by any combination of inserting one or more spacers 1152, replacing
one or more support pieces 1102, 1106, 1100 with a longer or
shorter spacer 1152, cutting or trimming one or more support pieces
1102, 1106, 1110 to a desired length, and removing one or more
support pieces 1102, 1106, 1110. In alternative embodiments, the
length of sleep surface 1114 is not adjustable but one or more of a
leg region, a torso region, and a head region of sleep surface 1114
is adjustable by any combination of inserting one or more spacers
1152, replacing one or more support pieces 1102, 1106, 1100 with a
longer or shorter spacer 1152, cutting or trimming one or more
support pieces 1102, 1106, 1110 to a desired length, and removing
one or more support pieces 1102, 1106, 1110 without adjusting the
length of sleep surface 1114.
[0266] In a further alternative embodiment, each support piece
1102, 1106, 1110 includes one or more inflatable fluid bladders
configured to contain a fluid, such as air. In this embodiment, a
length of each support piece 1102, 1106, 1110 is adjustable by
adding fluid or removing fluid from one or more respective fluid
bladders. By adding fluid to one or more of the respective fluid
bladders, the length of the respective support piece 1102, 1106,
1110 is increased and the length of the respective support plane
1104, 1108, 1112 is also increased. Conversely, removing fluid from
one or more of the respective fluid bladders, the length of the
respective support piece 1102, 1106, 1110 is decreased and the
length of the respective support plane 1104, 1108, 1112 is also
decreased. The amount of fluid within the respective fluid bladders
can be monitored and controlled electronically or by the user or
caregiver using a suitable device including, without limitation, a
suitable pneumatic pump or nozzle. In certain embodiments, a
coupler, such as one or more snaps or straps, are utilized to
maintain the desired amount of fluid within the respective fluid
bladders and provide additional support to the respective support
plane(s), for example, when the fluid bladders are not
inflated.
[0267] As described herein, sleep surface 1114 is customizable to
anthropometric dimensions of the individual user to facilitate
support system 1100 performance that optimizes or matches the
design intent--the body position of the user will prevent or limit
undesirable sleep apnea episodes and provide improved comfort.
[0268] In certain embodiments, support system 1100 includes a
plurality of support pieces, such as two support pieces, three
support pieces, or more than 3 support pieces, and more
specifically, at least 6 support pieces, and even more
specifically, 8-20 support pieces. For example, referring to FIG.
25, in one embodiment each of a leg region 1160 corresponding to
first support piece 1102, a torso region 1162 corresponding to
second support piece 1106, and a head region 1164 corresponding to
third support piece 1110 of support system 1100 includes a
plurality of independent support wedges forming a finer gradation
in the longitudinal slope of sleep surface 1114 to increase user
compliance and the effectiveness of support system 1100 in
preventing or limiting sleep apnea episodes and providing more
comfort for the user supported on sleep surface 1114. The support
wedges may be formed of one or more suitable materials including,
without limitation, a formable material, a semi-rigid material, a
foam material or one or more fluid bladders.
[0269] In the embodiment shown in FIG. 25, first support piece 1102
includes two independent support wedges defining respective support
planes positioned at different lateral rotational angles, second
support piece 1106 includes three independent support wedges
defining respective support planes positioned at different lateral
rotational angles, and third support piece 1110 includes four
independent support wedges defining respective support planes
positioned at different lateral rotational angles. In alternative
embodiments, each support piece 1102, 1106, 1110 includes any
suitable number of independent support wedges. Generally, an
increasing number of independent support wedges within a selected
support piece allows for more detailed and specific contouring of
sleep surface 1114 and more gradual changes in rotational angles of
adjacent support wedges and support pieces along the length of
sleep surface 1114.
[0270] For example, a support system including a series of support
wedges may twist or urge the user's body to rotate and tilt the
user's head in a more gradual trend than a support system including
only three larger support pieces with respective support planes of
different lateral rotational angles. The additional support wedges
allow for more comfortable transitions between and within the lower
body, the torso, and the upper body of the patient. The increased
number of support wedges allow for more specific positioning of the
patient's body, and a more effective therapy.
[0271] Referring to FIGS. 26 and 27, in one embodiment, each
support piece 1102, 1106, 1110 defines a support plane positioned
at the same or similar lateral rotational angle; however, each
support piece 1102, 1106, 1110 is made of a material having a
different density than the material used to make the other support
pieces. The base material of each support piece 1102, 1106, 1110
may be the same or different than the base material of the other
support pieces, but with a different density. In a particular
embodiment, support system 1100 utilizes varied foam density to
achieve a variation in the lateral rotation of the user's body
across different body segments. In one particular embodiment,
support piece 1102 is composed of the least dense material, support
piece 1106 is composed of the medium density material, and support
piece 1110 is composed of the most dense material.
[0272] In this embodiment, sleep surface 1114 is formed of support
pieces cut to form support planes at the same lateral rotational
angle but with different densities. To achieve a greater relative
rotation at the head portion of the user, third support piece 1110
is denser than second support piece 1106, while first support piece
is less dense than second support piece 1106 and third support
piece 1110 to achieve a lesser or limited relative rotation at the
leg region of the user. In a particular embodiment, rather than
having a plurality of discrete support pieces, sleep surface 1114
is one continuous support piece exhibiting a gradual density
transition along a longitudinal length of sleep surface 1114 such
that the leg portion of sleep surface 1114 is less dense than the
opposite head portion of the sleep surface 1114. This feature may
result in a support system that appears less intimidating to the
user and more aesthetically pleasing. Moreover, sleep surface 1114
is rotatable about longitudinal axis 1115, shown in FIG. 26, so
that sleep surface 1114 is oriented in one of a lateral right side
slope or a lateral left side slope shown in FIG. 27.
[0273] Referring to FIGS. 28-35, in an alternative embodiment,
sleep surface 1114 is formed of a closed air system 1160 that
induces the user's body to rotate laterally when sleeping to
facilitate preventing or limiting the incidence of sleep apnea. In
certain embodiments, closed air system 1160 does not require
electrical power or control, and allows the user to quietly move
sleep orientations between the lateral left side slope and the
lateral right side slope during sleep.
[0274] In one embodiment, closed air system 1160 includes one or
more pairs of fluid bladders communicatively coupled to each other.
For example, as shown in FIGS. 28 and 30, a first pair of fluid
bladders 1162 is positioned within the leg region 1164 of closed
air system 1160, a second pair of fluid bladders 1166 is positioned
within a torso region 1168 of closed air system 1160, and a third
pair of fluid bladders 1170 is positioned within a head region 1172
of closed air system 1160. In a particular embodiment, a sleep
sensor is positioned in a pillow or on the bladder 1166. In a
particular embodiment, the fluid bladders are plumbed together
using a suitably sized tube or hose, shown schematically by
reference number 1174 in FIGS. 28 and 30, or any suitable coupling
mechanism providing communication between the interior cavities of
the fluid bladders to allow fluid to move at a desired rate between
the coupled bladders. Fluid, such as air, can be added manually or
using a suitable pump to each pair of fluid bladders, for example,
through one or more nozzles to adjust the firmness and lateral
rotational angle of the respective pair of fluid bladders. In this
embodiment, the user can adjust the side upon which he/she sleeps
(even during sleep) and an amount of fluid contained within the
fluid bladders to adjust the firmness of sleep surface 1114 and/or
the lateral rotational angle of each support plane forming sleep
surface 1114. In this embodiment, each pair of fluid bladders is
separated along longitudinal axis 1115 of support system 1100. In a
particular embodiment, fluid can be added to the bladders 1166
based on the sleep state of the person.
[0275] In a particular embodiment, closed air system 1160 includes
one or more bolsters 1176, as shown in FIGS. 29-31, positioned
along at least a portion of the opposing lateral sides of support
system 1100 to prevent or limit lateral migration of the user
during sleep. In one embodiment, bolsters 1176 are the same or
similar to bolster 1142 described above with reference to FIG. 15.
Referring further to FIG. 29, each air bladder rests on and is
supported by a suitable bottom layer, such as a foam material layer
1178 and/or a mattress, and can also be covered by another suitable
top layer, such as a foam material layer 1180. Materials other than
foam materials known to those having ordinary skill in the art can
be utilize to form the bottom layer and/or the top layer. In a
certain embodiment, material layer 1180 at least partially encloses
or envelops one or more of the fluid bladders to retain the fluid
bladders properly positioned within support system 1100. One or
more of the fluid bladders in one or more of the pairs of fluid
bladders are inflatable to rotate the user onto his/her right side
or left side based at least in part on his/her sleep state.
[0276] In one embodiment, one or more pairs of fluid bladders 1162,
1166, 1170 include two wedge-shaped fluid bladders that are
removably coupled to material layer 1178 and/or material layer 1180
using a suitable coupler, such as a hook and loop fastener system.
For example, third pair of fluid bladders 1170 are positioned with
respect to the user's upper body or head region and are removably
coupled to material layer 1180 using a hook and loop fastener
system such that sleep surface 1114 is adjustable based at least in
part on the size and weight of the user. These fluid bladders are
inflatable based on the user's sleep state to urge the upper body
of the user to rotate. Additionally, first pair of fluid bladders
1162 and/or second pair of fluid bladders 1166 are also inflatable
to urge the user's legs and/or the user's torso, respectively, to
rotate.
[0277] Referring further to FIGS. 32-35, each fluid bladder of each
pair of fluid bladders 1162, 1166, 1170 is inflatable to form a
support piece having a desired or selected shape. Select fluid
bladders may remain substantially deflated, as shown in FIG. 32, or
both fluid bladders or only one fluid bladder of one or more pairs
of fluid bladders may be inflated to form a desired sleep surface
1114, as shown in FIGS. 33 and 34 respectively. In an alternative
embodiment, as shown in FIG. 35 a single fluid bladder 1182 may be
utilized in one or more of leg region 1164, torso region 1168, and
head region 1172 of closed air system 1160 positioned along
longitudinal axis 1115 of support system 1100 that, when inflated,
urges the user to roll towards either the lateral right side or the
lateral left side after the user is in a predetermined sleep state.
In this embodiment, fluid bladder 1182 can be deflated occasionally
to allow the user to reposition himself/herself. A pillow can be
positioned on third pair of fluid bladders, for example, such that
the pillow is inclined when one or more of the fluid bladders are
inflated.
[0278] The fluid bladders are inflatable with air or another
suitable fluid (which can be drained as desired from within the
cavities of the fluid bladders into a reservoir). A fluid supply
1188, shown in FIG. 30, is positioned at or near support system
1100, such as on the floor, beneath the bed, or coupled to the bed.
The fluid supply is in independent fluid communication with each
pair of fluid bladders 1162, 1166, 1170 to supply a desired amount
of fluid to each fluid bladder based on a signal from a control,
for example.
[0279] In one embodiment as shown in FIG. 30, support system 1100
includes a suitable computer-implemented control system 1190
operatively coupled to closed air system 1160, such as in
operational control communication with closed air system 1160. The
computer-implemented control system includes a computer 1192 having
one or more processors 1194 and one or more sleep sensors 1196,
such as one or more pressure sensors, coupled in signal
communication with processors 1194. Sleep sensors 1196 are
configured to monitor the user's sleep patterns and transmit
signals indicative of the sensed sleep patterns to processors 1194
for manipulation and evaluation of the data. Based at least in part
on the one or more signals received from one or more sleep sensors
1196, control system 1190 is configured to inflate or deflate
select fluid bladders to reposition the user during sleep to
prevent or limit the occurrence of a sleep apnea episode, for
example.
[0280] Additionally, in certain embodiments, closed air system 1160
is configured to rest on a conventional mattress or may be
configured or reinforced to rest directly on a support structure,
such as a bed frame or a floor. With the fluid substantially
removed from each of the fluid bladders, closed air system 1160 can
be folded or rolled into a compact configuration to facilitate
storing and transporting closed air system 1150. In certain
embodiments, closed air system is less expensive than a
conventional mattress and more compact to facilitate portability of
support system 1100. Additionally, closed air system 1160 as
configured prevents or limits disturbance to the user's partner
sleeping next to the user.
[0281] In certain embodiments as described herein, support system
1100 is a dynamic support system, rather than a static support
system, that is configured to control the configuration of sleep
surface 1114 based at least in part on data entered into control
system 1190 using computer 1192, or another control operatively
coupled to computer 1192, and/or sensed by one or more sleep
sensors 1196, for example, to improve the performance of sleep
surface 1114 in terms of clinical efficacy and user
tolerability.
[0282] As described herein and shown schematically, for example, in
FIGS. 36 and 37, dynamic support system 1100 includes, in addition
to other components, a plurality of sleep sensors 1196 configured
to sense and monitor various activities including without
limitation, the user's body position, a location of the user with
respect to sleep surface 1114, an orientation, for example, a left
side orientation or a rights side sleep orientation, of the user,
the user's vital signs including his/her sleep state, and
additional relevant user activity during sleep. Each sleep sensor
1196 is in signal communication with one or more processors 1194
contained within computer 1192 and configured to gather relevant
data and generate and transmit to processors 1194 signals
indicative of the data gathered. Sleep sensors 1196 are also
configured to receive operation control signals from processors
1194.
[0283] Within computer 1192, data received from sleep sensors 1196
is analyzed and operational control signals are transmitted to
sleep sensors 1196 as well as to other components of support system
1100, such as to fluid supply 1188 to activate fluid supply 1188 to
provide air to one or more fluid bladders and/or remove air from
one or more fluid bladders to adjust sleep surface 1114 based on
signals generated by sleep sensors 1196 and analyzed within
computer 1192. In one embodiment, computer 1192 includes suitable
memory 1198 to store data sensed and/or generated by control system
1190.
[0284] An exemplary method 1200 utilizing control system 1190 for
monitoring the sleep activities of a user positioned on support
system 1100 is illustrated in FIG. 37. As described above, control
system 1190 includes one or more processors 1194 configured to
perform the steps as described herein.
[0285] Control system 1190 is activated 1202 either manually or
automatically to monitor the user's sleep activities and patterns
as user begins to sleep. In one embodiment, control system 1190
detects when the user begins to fall asleep 1204 and activates
support system 1100 (or a dynamic sleep surface) on a delay 1206 to
rotate the user at a suitable time after sleep is detected, such as
after the user has been asleep for 30 minutes. In an alternative
embodiment, control system 1190 is programmed to activate support
system 1100 at a preset time, for example, at a 30 minute delay,
without relying on monitoring the user's sleep activity. In a
particular embodiment, control system 1190 delays inter-sleep
rotation of the user until the user is in a deep sleep. Further,
when control system 1190 detects that the user is waking, control
system 1190 will activate support system 1100 to move sleep surface
1114 to an initial configuration such that the user can exit from
support system 1100. In a further embodiment, control system 1190
prevents activation of support system 1100 if control system 1190
detects the user is sleeping in a lateral decubitus position.
[0286] Prior to sleep, the user is able to input 1208 to control
system 1190 sleep data 1210 including without limitation, preferred
sleeping sides and positions, the user's measurements including,
for example, the user's height, weight, and inseam and torso
measurements, preferred lateral rotational angles and/or
longitudinal rotational angles of one or more support planes
defining sleep surface 1114. Based at least in part on the user's
input data, control system 1190 is configured to activate support
system 1100 to adjust a direction and/or a level of rotation of one
or more support planes defining sleep surface 1114. For example, if
the user prefers a left side slope to sleep surface 1144, control
system 1114 activates fluid bladders within support system 1100 to
form the desired lateral left side slope, or if the user's partner
is sleeping on the left side of the user, a left angle may be
created. In one embodiment, minimal adjustments are made to sleep
surface 1114 to maintain the user's AHI under 5 and/or prevent
snoring because apneas events and snoring may or may not be
equivalent, depending on the user. Additionally, control system
1190 is configured to collected and record data obtained as the
user sleeps to diagnose any undesirable or abnormal sleep
activities or conditions, including the user's apnea-hypopnea index
(AHI), for example.
[0287] During sleep, control system 1190 assesses the user's
comfort level 1214 and, in a particular embodiment, compares the
current evaluation with previous evaluations. The user's body is
then mapped 1216 to map body region locations 1218, and user
activities and movements 1220 during sleep. The collected data is
then analyzed 1222 to determine: the location of joints including,
for example, the user's neck, hips, and knees; preferred surface
orientation (right side vs. left side orientation); and body
orientation (e.g., mapping pressures at various locations on sleep
surface 1114 as a result of the user's body orientation, for
example, a lateral sleep position indicated by a narrow pressure
mapping profile). In one embodiment, location of one or more
support planes are calculated and located based on transition
points. Under the pressure mapping, specific pressure points are
identified to increase or decrease pressure. For example, select
fluid bladders are inflated or deflated based on body location and
desired lateral rotational angles.
[0288] Control system 1190 then assesses 1224 the user's body
orientation including, for example a determination of head angle
1226 and chest angle 1228. During sleep, control systems also
actively monitors 1230 the user's vital signs, which includes
measuring and monitoring the user's respiratory rate and amplitude,
AHI, sleep state, snoring, and oxygen saturation (SpO.sub.2), for
example. If an adverse event is detected, control system 1190
activates 1234 one or more components of support system 1100 to
respond appropriately. For example, fluid supply 1188 may be
activated to inflate or deflate one or more fluid bladders. Control
system 1190 may activate fluid supply 1188 based on one or more of
the following events: detection of snoring, detection of an AHI
episode (apnea and/or hypopnea), and detection that the user is in
a supine position (e.g., supine torso, upper respiratory tract
(URT) within 45.degree. of vertical). Control system 1190 may also
activate support system 1100 to vibrate to wake the user should
control system 1190 detect an adverse event, such as an apnea
episode.
[0289] Referring to FIGS. 38-41, in one embodiment a sleep apnea
therapy system is a design based on how an average user responds to
the therapy tested on a sufficiently large population. The sleep
apnea therapy system will effectively and tolerably treat any
user's sleep apnea. As a result, the therapy can be modified to
decrease a level of therapy (specifically, an amount of rotation)
and still achieve clinical efficacy while optimizing user comfort
and increasing usage compliance. By learning how the user reacts to
variations in therapy, the sleep apnea therapy system is adjustable
to optimize the results of therapy. As shown in FIGS. 38-41, the
sleep apnea therapy system is design to include, in the embodiment
illustrated, an active control of surface (e.g., rotation planes,
rotation angles, rotation time/duration, fluid bladder pressure);
capabilities to sense and assess tolerability (e.g., sleep
state/stage, vitals, movement, user assessment); and sense and
assess clinical efficacy (e.g., AHI, respiratory rate, head
orientation). With these assessments, tolerability and user
compliance is maximized for a clinically effective treatment of
obstructive sleep apnea.
[0290] As shown in FIG. 38, the sleep apnea therapy system
incorporates sensing of key elements and evaluates connections
between those elements until the balance between the elements is
optimized, as shown in FIGS. 39 and 40. As a result, the system is
capable of maintaining balance between efficacy and tolerability in
spite of changes over time (e.g., the user has a cold or develops a
higher body mass index (BMI) illustrated in FIG. 41.
[0291] In one embodiment, apnea therapy can be integrated as an
option in a continuous lateral rotation therapy (CLRT) system. An
exemplary CLRT system is configured to deliver lateral rotation as
a therapy for the prevention of pressure ulcers, as well as for use
in the prevention of ventilator-associated pneumonia and muscular
wasting associated with prolonged immobility. The exemplary CLRT
system is suitable for use as a therapy for the prevention of sleep
apnea with the addition of the following components or elements. In
one embodiment, the CLRT system includes a restrained lateral
rotation to create or develop progressively greater rotation by
limiting rotation in a torso region and/or a head region of the
user. Additionally, an augmented lateral rotation increases
rotation in the torso region and/or the head region of the
user.
[0292] Referring to FIGS. 42-46, an exemplary CLRT system 1300
includes a control system 1302 configured with a rotation function
(augmented or restrained rotation). Referring to FIG. 42, control
system 1302 is operatively coupled to a support system 1304.
Control system 1302 includes an apnea setting configured to select
a number of support planes, dimensions of each support plane, and a
desired lateral rotational angle and/or a desired longitudinal
rotational angle at which one or more support planes are positioned
to define the sleep surface. Further, control system 1302 includes
a rotation function that allows constrained rotation at a torso
region and/or a head region of the sleep surface (e.g., by pressure
modification or by physical constraint), as well as supplemented
rotation via a cushion.
[0293] As shown in FIG. 43, control system 1302 includes an apnea
mode, wherein blowers are controlled to initiate and maintain
rotation of the support planes. Within the apnea mode, control
system 1302 allows the user or a caregiver to select and/or define
one or more therapy modes (e.g., an amount and/or a location of
rotation). In one embodiment, control system 1302 is configured or
programmed to suggest rotation protocol based on sensed or input
data including, without limitation, one or more of the following:
AHI score, BMI, sensed respiratory rate, and sensed SpO.sub.2
history. Control system 1302 is also configured or programmed to
select a left side slope or a right side slope based on user
preference or an alternating lateral rotation, select a reverse
trend or composite longitudinal angle, and manually cancel a
protocol and/or return the sleep surface immediately to a flat,
initial position. Alternating lateral rotation can be specified to
alternate after an elapsed time period, to rotate at a certain
speed to avoid waking the user, and to gradually increase lateral
rotational angles from a low initial lateral rotational angle at a
first rotation toward the maximum desired lateral rotational angle
after a specified number of rotations.
[0294] In one embodiment, support system 1304 includes a base
support 1306 including a plurality of inflatable fluid bladders
aligned generally parallel to a longitudinal axis of support system
1304 forming a single support plane 1308 having a lateral rotation
angle .theta. of 5.degree. to 15.degree., or more specifically,
10.degree., with respect to a base plane 1310 of base support 1306.
One or more supplemental support wedges 1312 are positioned on
support plane 1308 within one or more of the leg region, the torso
region, and the head region of support system 1304. In this
embodiment, supplemental support wedge 1312 is a wedge-shaped
inflatable fluid bladder. As shown in FIG. 44, supplemental support
wedge 1312 is positioned at the head region of support system 1304
and forms a supplemental support plane 1314 having a lateral
rotation angle .gamma. of 5.degree. to 15.degree., or more
specifically, 10.degree., with respect to a base plane 1316 of
supplemental support wedge 1312. As a result, in the embodiment
shown in FIG. 44 a supplemental support plane 1314 is positioned at
a total lateral rotational angle .tau. of 20.degree. with respect
to base plane 1310 of base support 1306 (the sum of angle .theta.
and angle .gamma.). In alternative embodiments, the total lateral
rotational angle may be any suitable angle, less than 20.degree. or
greater than 20.degree.. Further, one or more supplemental support
wedges 1312 can be positioned within one or more of the leg region,
the torso region, and the head region of support system 1304.
[0295] Referring to FIGS. 45 and 46, in one embodiment support
system 1304 includes laterally positioned side constraints 1320 to
limit inflation of individual fluid bladders forming base support
1306. Support system 1304 may include, with or without laterally
positioned side constraints 1320, a plurality of fixed length bands
1322 positioned with respect to individual fluid bladders, such as
between adjacent fluid bladders, to limit inflation of the
individual fluid bladders.
[0296] In one embodiment, a posture garment or shirt 1500 is worn
by a user suffering from sleep apnea to apply an appropriate force,
such as a tugging force, on the shoulders, arms, and/or head of the
user to urge or cause the desired or necessary head turn to open up
the user's upper respiratory tract to prevent or limit the
occurrence of sleep apnea or in the event of a sleep apnea episode.
Applying forces to cause the user to turn his/her entire body to
the lateral decubitus position is an alternative approach to
achieving this desired head angle; this may involve the use of
whole-body garments or a pant garment in combination with a shirt
garment.
[0297] As shown in FIGS. 47 and 48, posture shirt 1500 includes one
or more areas 1502 located on a front portion of posture shirt
1500, as shown in FIG. 47, and/or a back portion of posture shirt
1500, as shown in FIG. 48, including a material panel and/or
material weaves having a different elasticity than other areas of
posture shirt 1500. Because of the different material elasticity
within areas 1502, areas 1502 tend to pull or urge select parts of
the user's torso, extremities, head, and/or neck in a desired
direction to open the upper respiratory airway. In a particular
embodiment, sections or panels of posture shirt 1500 within areas
1502 are made of a different elastic material that work
cooperatively to properly position the user's body. Posture shirt
1500 may have long sleeves, short sleeves, or may not include
sleeves, and/or have a hood. Any suitable material known to those
having ordinary skill in the art may be used within areas 1502 and
include, without limitation, elastic materials based on composition
(one or more of nylon, polyester, polyester fleece, and/or cotton)
or weave (one or more of plain, basket, and twill weaves) that
impart preferential deformability and recovery inducing a change in
the user's posture.
[0298] In one embodiment, a compression posture shirt 1500 is worn
like a typical shirt and naturally twists the torso, neck and/or
head of the user. Unlike conventional posture shirts, there is no
need to insert bladders or tennis ball-like inserts to urge the
user to turn or rotate from a supine sleep position. Moreover,
compression posture shirt 1500 for sleep apnea does not require any
user training because posture shirt 1500 pulls and tugs on the user
without the need of intervention from the user.
[0299] In certain embodiments, electrical circuitry, such as one or
more processors and/or one or more circuit boards, is operatively
coupled to, such as in electrical or electronic communication with,
control system 1190 to monitor operation of one or more components
of support system 1100 or control system 1302 to monitor operation
of one or more components of support system 1304, collect, process,
and/or store information, such as operation data and motor usage
data, and transmit information, such as operation data and motor
usage data, to one or more of the following computer-implemented
machines or devices including, without limitation, a control and/or
display device within or operatively coupled to support system 1100
or support system 1304, and/or a control and/or display device on a
computer or network of computers at one or more nurse stations or
administrative stations, for example.
[0300] In one embodiment, electrical circuitry, such as one or more
processors and/or one or more circuit boards, is contained within
control system 1190 or control system 1302 and connected in
communication with support system 1100 or support system 1304,
respectively. In a particular embodiment, one or more sensors or
other suitable detection components are operatively coupled to
support system 1100 or support system 1304 and/or control system
1190 or control system 1302 to detect operation. The one or more
sensors are configured to generate and transmit electronic signals
representative of the detected operation to the circuit board,
which is configured to collect, process, and/or store such
information, and generate and transmit information to one or more
computer-implemented machines or devices in communication with the
circuit board, as described above.
[0301] In certain embodiments, the one or more computer-implemented
machines or devices in communication with the circuit board include
a controller in signal communication, either wired or wireless
signal communication, with the circuit board contained within
support system 1100 or support system 1304. The controller includes
a suitable display to display information received from the circuit
board and/or information generated by the controller based on the
information received from the circuit board. In a particular
embodiment, the controller is configured to generate command
signals and transmit the command signals to the circuit board
contained within support system 1100 or support system 1304 to
control operation of support system 1100 or support system 1304
and/or adjust parameters and/or limits, for example, programmed
into the circuit board.
[0302] In one embodiment, a chest constriction device 400 assists
in expiring air from the user's lungs. Referring to FIGS. 49-52, a
belt 402 or strap made of a suitable material, such as nylon, is
placed generally around the circumference of the user at the thorax
or chest region of the user and coupled using a suitable fastener,
such as a buckle 404, to retain belt 402 properly positioned about
the user. Any suitable material known to those having ordinary
skill in the art that is comfortable to the user and provides the
required strength and flexibility may be used to make belt 402. A
constrictor device 406 is operatively coupled to belt 402.
Constrictor device 406 is movable between an initial or relaxed
position, as shown in FIG. 39, and an activated or constricted
position, as shown in FIG. 49. More specifically, referring to
FIGS. 49-52, constructor device 406 is configured to selectively
shorten a length of belt 402, thereby applying a compressive force
on the thorax of the user.
[0303] In one embodiment, one or more physiological sensors 408 are
coupled to or integrated in belt 402 and configured to detect the
user's sleep state. Physiological sensor 408 may include one or
more of the following sensors: a position sensor, a pressure
sensor, a temperature sensor, an acoustic sensor, a moisture
sensor, an RFID tag, an accelerometer, a proximity sensor, a level
sensor, or another physical tracking sensor in signal communication
with a processor 410 positioned within or operatively coupled to
constriction device 406 and configured to provide an input signal
to processor 410. Upon receiving an input signal from physiological
sensor 408, processor 410 is configured to activate an actuator 412
in signal communication with processor 410 to rotate a lever 414
against a spring 416. As lever 414 rotates, a length of belt 402
shortens to apply pressure against the thorax region of the user.
Lever 414 is rotatable against spring 416 in an opposite rotational
direction to increase the length of belt 402 and release pressure
against the thorax region of the user. Constrictor device 406 is
programmed to perform a regime of constrictions and relaxations to
mitigate sleep apnea.
[0304] In one embodiment, constrictor device 406 may also be used
as a continuous positive airway pressure (CPAP) device and therapy
may be activated by a caregiver or the user. Although not shown,
the data may be communicated to an electronic medical records (EMR)
system, and the caregiver and the user may be provided with a
graphical user interface (GUI) to control chest constriction device
400.
[0305] Referring now to FIGS. 53-94, various illustrative
embodiments of a person support apparatus configurable to assume a
"progressive" lateral tilt position are shown. The person support
apparatus may have any of the features described in this document,
or any combination of such features and/or other features. The
person support apparatus or portions thereof may be embodied as a
mattress, a mattress overlay or topper, a cover for a mattress, a
cushion or a pad, for example. In a progressive lateral tilt
position, the person support apparatus assumes a ramp-like
configuration intended to tilt a person's body laterally, to one
side, such that different portions of the person's body are tilted
laterally in the same general direction (e.g., all tilted to the
same side), but at different lateral angles. As used herein,
"lateral tilt," "lateral angle," or "tilt" may be used to refer to,
among other things, an angle of a surface of the person support
apparatus relative to the horizontal and with reference to (e.g.,
defined by rotation about) a longitudinal axis of the person
support apparatus. In some cases, the different lateral tilt angles
are defined so that the maximum lateral tilt angle of a portion of
the person support apparatus supporting the person's head is
greater than the maximum lateral tilt angles of portions of the
person support apparatus supporting other portions of the person's
body. An example of the general construction of such an apparatus
is shown in FIGS. 53-54, and exemplary embodiments are shown in
FIGS. 55-94. In FIG. 53, a person support apparatus 5300 includes a
number of support sections 5316, 5318, 5320 enclosed in an interior
region defined by a cover 5314. Although only three support
sections 5316, 5318, and 5320 are shown, it should be understood
that the person support apparatus 5300 may contain any number of
such sections, depending on the requirements of a particular design
or for other reasons.
[0306] The support sections 5316, 5318, 5320 are positioned along a
length l of the person support apparatus 5300, with the support
section 5316 positioned adjacent a head end 5310 of the person
support apparatus 5300, the support section 5320 positioned
adjacent a foot end 5312 of the person support apparatus 5300, and
the support section 5318 positioned between the support sections
5316, 5320. Each of the support sections 5316, 5318, 5320 has a
support surface 5422 (FIG. 54), which is configured to bear a load,
e.g., to support at least a body portion of a person on the person
support apparatus 5300. Portions of the support surface 5422 may be
rigid, semi-rigid, or non-rigid, depending on the requirements
(e.g., patient comfort, stability, etc.) of a particular design
and/or configuration of the person support apparatus 5300.
Illustratively, the support section 5316 is configured to support a
person's head and/or neck region, the support section 5318 is
configured to support a person's torso, hip, and/or thigh region,
and the support section 5320 is configured to support a person's
legs and/or feet. In embodiments having a greater number of support
sections, each support section may be configured to support a
correspondingly smaller portion of the person's body, and vice
versa.
[0307] As explained in more detail below with respect to the
embodiments of FIGS. 55-94, each of the support sections 5316,
5318, 5320 includes an inflatable portion which, alone or in
combination with one or more other support portions (e.g.,
non-inflatable support portions, such as foam pieces or
three-dimensional fiber network layers), can cause the support
surface 5422 to assume a progressively greater maximum lateral tilt
angle along the length l from the foot end 5312 to the head end
5310, or vice versa, in order to provide a therapeutic effect to a
person positioned on the person support apparatus 5300 or for other
reasons. As used herein, "progressive lateral tilt angle" may refer
to, among other things, a maximum lateral tilt angle that begins
with a relatively small tilt angle in the foot section 5320 (e.g.,
in the range of about 0 to about 10 degrees), increases to a larger
maximum tilt angle in the seat section 5318 (e.g., in the range of
about 10 to about 20 degrees) and increases to still a larger
maximum tilt angle in the head section 5316 (e.g., in the range of
about 15 to about 35 degrees). As used herein, "maximum" may be
used to, among other things, convey the idea that each support
section 5316, 5318, 5320 may be configurable to assume smaller tilt
angles or the same tilt angle from time to time, but that the
largest tilt angle achievable by each of the support sections 5316,
5318, 5320 is different.
[0308] The support sections 5316, 5318, 5320 are also each
configurable to assume a substantially flat position, e.g., to
provide a more typical flat or horizontal rest surface during
periods in which the progressive lateral tilt angle is not required
or desired. As such, the person support apparatus 5300 is
selectively configurable by, for example, an air control system
5328, to assume a progressive lateral tilt position and at least
one other position (e.g., the flat position). The air control
system 5328 can selectively inflate and deflate the inflatable
portions of the support sections 5316, 5318, 5320 to achieve a
desired or required (e.g., flat or tilt) configuration of the
person support apparatus 5300, and can adjust such position
dynamically in response to various inputs as described in this
document.
[0309] In the simplified view of FIG. 53, each of the connections
5322, 5324, 5326 represents a number of different types of
couplings including an air conduits (e.g., plastic tubing) and
electronic signal paths (e.g., insulated wiring and/or wireless
connections), in order to electronically and pneumatically couple
the air control system 5326 to the each of the support sections
5316, 5318, 5320, respectively. For example, one or more sensors
(e.g., pressure sensors, force sensors, and/or angle sensors) may
be coupled to each of the support sections 5316, 5318, 5320, and
some of the connections 5322, 5324, 5326 may electronically
communicate data obtained from the sensors to the air control
system 5326. The sensor data may indicate, for example, the air
pressure inside the inflatable portions and/or the current lateral
tilt angle of the support surface 5422. Although not specifically
shown in FIG. 53, it should be understood that the air control
system 5328 may be communicatively coupled to other devices, e.g.,
via a direct wired or wireless connection or by an electronic
communication network. For example, the air control system 5328 may
communicate air pressure data and/or lateral tilt angle data for
the various support sections 5316, 5318, 5320 over a network to a
healthcare communication system, such as a facility's nurse call
system, an electronic medical records system, and/or other devices
and systems. Such a network may be embodied as, for example, a
healthcare facility's internal network, a "private cloud," a secure
portion of the Internet, and/or others, and may enable longer range
communications (e.g., via ETHERNET) and/or shorter range
communications (e.g., via WIFI, BLUETOOTH, WLAN, or Near Field
Communication (NFC)).
[0310] Referring to FIG. 54, an exemplary sectional view of the
support section 5316 is shown. It should be understood that each of
the other support sections 5318, 5320, may have the same or a
similar composition as the support section 5316, although not
specifically shown. Illustratively, the support section 5316
includes a number of support portions or pieces including an upper
layer 5412, a middle layer 5414 (which includes illustrative
support portions 5414A and 5414B), a lower layer 5416, a side
member 5418, and a side member 5420. The support portions 5412,
5414, 5416, 5418, 5420 are located in the interior region defined
by the cover 5314. In some embodiments, the cover 5314 may be
omitted or may enclose less than all of the support sections 5316,
5318, 5320 and/or the support portions 5412, 5414, 5416, 5418,
5420. Further, some embodiments of the person support apparatus
5300 may not include all of the support sections 5316, 538, 5320
and/or the support portions 5412, 5414, 5416, 5418, 5420. For
example, one or more of the support portions 5412, 5416, 5418,
and/or 5420 may be omitted from the support section 5316 and/or the
support sections 5318, 5320.
[0311] The support section 5316 has a width w, which in some
embodiments is sized to substantially coincide with a width of an
underlying mattress or other support structure (e.g., a frame or a
deck section of a bed). The side members 5418, 5420 are each
positioned adjacent to a side 5424, 5426 of the support section
5316, respectively. The support portions 5412, 5414, 5416 are
positioned between the side members 5418. At least one of the upper
layer 5412, the middle layer 5414, and the lower layer 5416
includes one or more inflatable portions as described herein. In
some embodiments, the upper layer 5412 may include a non-inflatable
material, such as foam and/or a three-dimensional woven or nonwoven
fiber network or other material (e.g., SPACENET or TYTEX). In some
embodiments, the lower layer 5416 may include a non-inflatable
material, such as a molded foam base. Illustratively, the middle
portions 5414A, 5414B alone or in combination with the upper layer
5412 and the lower layer 5410 are each configured to provide the
desired lateral tilt angle of the support surface 5422. In some
embodiments, each of other portions 5414A and 5414B include one or
more inflatable bladders that can be selectively inflated and
deflated to provide a desired lateral tilt position or a flat
position of the support surface 5422. For example, the portion
5414B may be embodied as a wedge-shaped inflatable (e.g., one or
more air bladders) or non-inflatable (e.g., foam) piece that is
configurable to provide a lateral tilt angle A, to tilt the person
situated on the person support apparatus 5300 in the direction of
the side 5424, when the middle portion 5414A is either absent or
deflated and the portion 5414B is present and/or inflated.
Similarly, the portion 5414A may be embodied as a wedge-shaped
inflatable or non-inflatable piece that is configurable to provide
a lateral tilt angle B to tilt the person situated on the person
support apparatus 5300 in the direction of the side 5426 when the
middle portion 5414B is either absent or deflated and the portion
5414A is present and/or inflated.
[0312] Referring now to FIGS. 55-56, an illustrative embodiment
5500 of a support portion, which may be used as a middle portion
5414A and/or a middle portion 5414B of a support section 5316,
5318, 5320, for example, is shown. The support portion 5500 is
embodied as a bellows-style bladder having a substantially
triangular cross section 56-56 when inflated (FIG. 56). The support
portion 5500 includes a lower surface 5510 and an upper surface
5512, each of which are defined by a pair of laterally spaced sides
(side 5514 and side 5516 of the upper surface 5512; side 5514 and
side 5518 of the lower surface 5510) and longitudinally spaced ends
(end 5520 and end 5522 of the upper surface 5512; end 5524 and
opposite end, obscured in FIG. 55, of the lower surface 5510). The
upper surface 5512 and the lower surface 5510 are joined together
(e.g., by radio frequency (RF) welding, adhesive, or other suitable
technique) along the side 5514 to form a hinge 5522. A bellows
bladder 5526 is coupled to and extends between the upper surface
5512 and the lower surface 5510 such that when inflated, the upper
surface 5512 is rotated about an axis 5554, which extends along the
hinge 5552. The upper surface 5512 can thereby be tilted at a
desired lateral tilt angle relative to the lower surface 5510,
where the desired lateral tilt angle may differ depending on, for
example, a characteristic of a person situated on the person
support apparatus 5300 (e.g., the person's height, weight, and/or
therapeutic needs) and/or the position of the support section 5316,
5318, 5320 in which the support portion 5500 is used relative to
the person support apparatus 5300 as a whole.
[0313] The bellows bladder 5526 has a pleat 5528, which extends
around the perimeter of the bladder 5526 and enables the bladder
5526 to fold in on itself when deflated. A number of baffles 5530,
5532, 5534, 5536 each having different lengths 11, 12, 13,14 are
positioned in an interior region defined by the bellows bladder
5526. Each of the baffles 5530, 5532, 5534, 5536 has a top end
5538, 5540, 5542, 5544, which is coupled to an underside of the
upper surface 5512, and a bottom end 5546, 5548, 5550, 5552, which
is coupled to an underside of the lower surface 5510. The
illustrative baffles 5530, 5532, 5534, 5536 each have substantially
the same width w/, although they may have different widths in other
embodiments. The baffles 5530, 5532, 5534, 5536 are spaced from one
another by distances d1, d2, d3, as shown in FIG. 56. The distances
d1, d2, d3 may be the same or different, depending on the
requirements of a particular design, or for other reasons. In
general, the dimensions of each of the baffles 5530, 5532, 5534,
5536 are defined to retain the support portion 5500 in a position
in which the upper surface 5512 is tilted at the desired maximum
lateral tilt angle. For example, if the upper surface 5512 is to be
tilted at a lateral tilt angle in the range of about 20 degrees
when the bellows bladder 5526 is inflated, the lengths l1, l2, l3,
l4 and the distances d1, d2, d3 are configured to retain the
support section 5500 in the proper position to achieve such
angle.
[0314] The illustrative support section 5500 is generally made of
one or more cloth materials, such as nylon sheets (e.g., twill
and/or taffeta). Portions of the support section 5500 that are
coupled together may be coupled by any suitable fastening
techniques, such as RF welding, stitching, snaps, rivets, and/or
others. One or more fluid ports, e.g., a fill port 5554 and a vent
port 5556, are coupled to the bellows bladder 5526 and, in use,
connected to a fluid supply (e.g. a blower), which may be
incorporated into or in communication with the air control system
5328.
[0315] Referring now to FIGS. 57-58, an embodiment 5700 of a person
support apparatus includes a number of support sections 5712, 5714,
5716, each of which incorporates least one of the support portions
5500, is shown. The support sections 5712, 5714, 5716 are supported
by a base 5710. The base 5710 may be constructed of foam and/or one
or more air bladders, for example. Each of the support sections
5712, 5714, 5716 has a bellows-type bladder that, when inflated,
tilts a person situated on the person support apparatus 5700 in a
direction toward a side member 5718. The side member 5718 may be
constructed of foam and/or one or more air bladders, for example,
and is sized to retain the person on the person support apparatus
5700 notwithstanding the lateral tilt angles provided by the
support sections 5712, 5714, 5716.
[0316] The bellows bladder 5526 of each of the support sections
5712, 5714, 5714 is constructed to provide the maximum lateral tilt
angle desired of the respective section 5712, 5714, 5716. To do
this, the pleat 5528 or the baffles 5530, 5532, 5534, 5536 may be
differently sized for each of the sections 5712, 5714, 5716 (e.g.,
by having different lengths). In other embodiments, the bellows
bladder 5526 of each of the support sections 5712, 5714, 5716 may
have the same or similar construction, and the desired maximum
lateral tilt angle may be achieved by varying the amount of air
pressure in the interior region of the bellows bladder 5526.
[0317] In the embodiment of FIGS. 57-58, each of the support
sections 5712, 5714, 5718 has a different maximum lateral tilt
angle x, y, and z. Further, the support sections 5712, 5714, 5718
have different lengths l.sub.x, l.sub.y, l.sub.z. In other
embodiments, one or more of the support sections 5712, 5714, 5718
may have the same maximum lateral tilt angle and/or the same
length.
[0318] In the person support apparatus 5700, the support section
5712 is positioned adjacent a head end 5720 of the person support
apparatus 5700, the support section 5716 is positioned adjacent a
foot end 5722, and the support section 5714 is positioned between
the head end 5720 and the foot end 5722. Further, in the
illustrative person support apparatus 5700, the maximum lateral
tilt angle x is greater than the maximum lateral tilt angle y, and
the maximum lateral tilt angle .gamma. is greater than the maximum
lateral tilt angle 5716. In FIG. 57, the bellows bladder 5526 of
each of the support sections 5712, 5714, 5716 is inflated, causing
the person support apparatus 5700 to assume a progressive lateral
tilt position as described herein. In FIG. 58, the bellows bladders
5526 of each of the sections 5712, 5714, 5716 are deflated, causing
the person support apparatus 5700 to assume a substantially flat
position. In the substantially flat position, the side member 5718
is also deflated. While only the progressive lateral tilt position
and the substantially flat position are shown in the drawings, it
should be understood that the bellows bladders 5526 of each of the
sections 5712, 5714, 5716 and the side member 5718 can be
selectively inflated (e.g., to different levels or angles), so that
the person support apparatus 5700 can assume a range of positions
between the progressive lateral tilt position and the substantially
flat position.
[0319] Referring now to FIGS. 59-60, an embodiment 5900 of a
support section, which may be used as a support section 5316, 5318,
5320, for example, is shown. The support section 5900 includes a
pair of complementary bellows-type bladders 5910, 5912, each of
which may be embodied as the support portion 5500, described above.
The bladders 5910, 5912 are supported by a lower layer 5914 and a
base 5916. The lower layer 5914 may be embodied as a number of
support cushions and may be similar in construction to the lower
layer 5416 described above. The base 5916 may be constructed of,
for example, one or more air bladders, foam, or a combination
thereof. Illustratively, the base 5916 is crib or tray shaped,
having side portions 5924, 5926 extending upwardly to form a
substantially u-shaped cross-section. Additionally, side members
5918, 5922 are supported by or integrated with the side portions
5924, 5926. The side members 5918, 5922 may be constructed of, for
example, one or more air bladders, foam, or a combination thereof.
The side members 5918, 5922 are, alone or in combination with the
base 5916, sized to extend upwardly above the height of the bellows
bladder vertices 5930, 5932.
[0320] In FIG. 59, the bellows bladder 5910 is inflated and the
bellows bladder 5912 is deflated, to tilt the upper surface 5512 at
an angle having a vertex at 5930 (and thereby tilt a body portion
of a person situated thereon toward the side member 5922. In FIG.
60, the bellows bladder 5910 is deflated and the bellows bladder
5912 is inflated, to tilt the upper surface 5512 at an angle having
a vertex at 5932 (and thereby tilt a body portion of a person
situated thereon toward the side member 5918.
[0321] Referring now to FIG. 61, a top view of an embodiment 6100
that is similar to the person support apparatus 5700 is shown. A
difference between the embodiment 5700 and the embodiment 6100 is
that the embodiment 6100 includes a side member 6128 that has a
length l.sub.s, which is less than the length of the person support
apparatus (e.g., the length l shown in FIG. 53). The side member
6128 and each of the support sections 5712, 5714, 5716 are coupled
to a base sheet by any suitable fastening technique, such as any of
the techniques mentioned herein. The side member 6128 and each of
the support sections 5712, 5714, 5716 are pneumatically coupled to
an air system 6124 by fill lines 6110, 6114, 6118, 6122 and vent
lines 6112, 6116, 6120, 6124, respectively. In general, the air
system 6126 includes a processor or controller that executes
control logic (which may be embodied as computer-executable
instructions or routines, etc.), to operate an air supply/vacuum
device (e.g., a blower, compressor, etc.) to selectively inflate
and deflate the inflatable portions of the support sections 5712,
5714, 5716 and the side member 6128. The air system 6126 or
portions thereof may be embodied as the air control system 5328,
described above.
[0322] FIGS. 62-63 illustrate additional details of the side member
6128. The illustrative side member 6128 is an elongated inflatable
bladder having a length that is greater than its width. As shown in
FIG. 63, the side member 6128 has perimeter welds or seams (e.g.,
RF welds) 6310, 6312, 6314. In the illustration, the welds 6310,
6312, 6314 are spaced substantially equidistantly from one another,
however this need not be the case. The welds 6310, 6312, 6314 may
be configured to provide vertical stability to the side member 6128
or for other reasons. Additionally, a tether 6316 may couple the
side member 6128 to the base sheet 6130.
[0323] Referring now to FIG. 64, a cover 6400 for the person
support apparatus 5300, or any of the embodiments thereof disclosed
herein, including the embodiment 5700, is shown. In general, the
cover 6400 is configured to slide over the components of the person
support apparatus 5300 such that all of the components (e.g.,
support portions 5712, 5714, 5716 and side member 5718) are
retained or enclosed in an interior region of the cover 6400.
Additionally, the cover 6400 has a number of expandable portions
6416, 6418, 6420, 6422 corresponding to the support portions 5712,
5714, 5716 and the side member 5718. The expandable portions 6416,
6418, 6420, 6422 are designed to allow the cover 6400 to
accommodate the support portions 5712, 5714, 5716 in the lateral
tilt positions, flat positions, and positions therebetween, as well
as the side member 5718 when it is inflated. Illustratively, the
portions 6416, 6418, 6420, 6422 are pleated, with each of the
portions 6416, 6418, 6420 having a different number of pleats as
needed to accommodate the different maximum lateral tilt angles of
each of the portions 5712, 5714, 5716. The expandable portions
6416, 6418, 6420, 6422 are coupled to a perimeter skirt 6410, which
may be elasticized to secure the cover 6400 around the person
support apparatus 5700. The expandable portions 6416, 6418, 6420,
6422 are also coupled to top surfaces 6412, 6414. The top surface
6414 is coupled to the top surface 6412 by a seam 6424, which
allows the top surface 6414 to move independently of the top
surface 6412. Together, the skirt 6410, the expandable portions
6416, 6418, 6420, 6422, and the top surfaces 6412, 6414 form a
hollow interior region that can receive a person support apparatus
such as the person support apparatus 5700. The various portions of
the cover 6400 may be constructed of a nylon material, for
example.
[0324] Referring now to FIGS. 65-66, an embodiment 6500 of a person
support apparatus is shown. The person support apparatus 6500
includes a number of non-inflatable support portions 6510, 6512,
6514, a number of inflatable support portions 6516, 6518, 6520
supported by the non-inflatable support portions 6510, 6512, 6514,
respectively, and a non-inflatable side member 6522. The
non-inflatable support portions 6510, 6512, 6514 and the side
member 6522 may be constructed of foam, for example. The inflatable
support portions 6516, 6518, 6520 may include one or more air
bladders, and may each be embodied as the support portion 5500,
described above.
[0325] The illustrative non-inflatable support portions 6510, 6512,
6514 are each embodied as a substantially triangular or
wedge-shaped support piece, each having a hypotenuse side 6524,
6526, 6528. The length of the side 6526 is greater than the length
of the side 6528, and the length of the side 6524 is greater than
the length of the side 6526, such that when the inflatable portions
6516, 6518, 6520 are deflated, the person support apparatus 6500
has progressively greater lateral tilt angles, with the lateral
tilt angle increasing from the foot end 6532 to the head end 6530
of the person support apparatus 6500. When the inflatable portions
6516, 6518, 6520 are inflated, the person support apparatus 6500
assumes a substantially flat position as shown in FIG. 66.
Intermediate positions are also provided. For example, one or more
of the inflatable portions 6516, 6518, 6520 may be deflated while
the other(s) are inflated, to allow a greater degree of variation
in the elevation of the support sections, or for other reasons. The
side member 6522 is positioned adjacent the vertex side of the
non-inflatable support portions 6510, 6512, 6514 (opposite the
hypotenuse sides 6510, 6512, 6514) and sized so that its vertical
height substantially corresponds to the vertical height of the
inflatable support portions 6516, 6518, 6520 when inflated. The
side member 6522 may be constructed of, for example, foam.
[0326] Referring now to FIGS. 67-68, an embodiment 6700 of a person
support apparatus includes a base 6710 and a number of support
sections 6740, 6742, 6744, which generally correspond to the
support sections 5316, 5318, 5320 of FIG. 53. The support sections
6740, 6742, 6744 are supported by the base 6710. Each of the
support sections 6740, 6742, 6744 includes an inflatable support
portion 6712, 6714, 6716, a stiffener plate 6730, 6732, 6734
supported by the inflatable support portion 6712, 6714, 6716, and a
non-inflatable support portion 6718, 6720, 6722 supported by the
stiffener plate 6730, 6732, 6734.
[0327] The base 6710 is substantially rectangular in shape and has
a width that is wider than the width of the support sections 6740,
6742, 6744. A non-inflatable support member 6724 is supported by
the base 6710 and positioned along an edge of the base 6710,
adjacent a hinge 6746, which extends along the length of the person
support apparatus 6700. An inflatable support member 6726 is
supported by the non-inflatable support member 6724. The inflatable
support member 6726 is sized to have a vertical height that extends
upwardly above a portion of the top surface of the support sections
6740, 6742, 6744 that is adjacent to the support member 6726.
[0328] When inflated, the inflatable support portions 6712, 6714,
6716 cause the top surfaces of the non-inflatable support portions
6718, 6720, 6722 to assume the desired progressive lateral tilt
angle as described above. When the inflatable support portions
6712, 6714, 6716 are deflated, the top surface of the
non-inflatable support portions 6718, 6720, 6722 is substantially
flat as shown in FIG. 68. Intermediate positions of the person
support apparatus 6700, in which less than all of the inflatable
support portions 6712, 6714, 6716 are inflated, are also provided,
as mentioned above.
[0329] The stiffener plates 6730, 6732, 6734 may be constructed of,
for example, a rigid or semi-rigid plastic, stainless steel, or
other suitable material. The stiffener plates 6730, 6732, 6734
provide additional support for the non-inflatable portions 6718,
6720, 6722 and may thereby facilitate pivoting of the
non-inflatable portions 6718, 6720, 6722 to the desired lateral
tilt angle. Additionally or alternatively, the stiffener plates
6730, 6732, 6734 may provide a substrate to which one or more
sensors may be mounted for the purpose of detecting and monitoring
the lateral tilt angle of each of the support sections 6740, 6742,
6744. For example, an angle sensor (e.g., an inclinometer or
accelerometer) may be mounted to each stiffener plate 6730, 6732,
6734 to measure the lateral tilt angle of its respective support
section 6740, 6742, 6744. The angle data obtained by such sensors
may be transmitted to and analyzed by a control system (e.g., by a
feedback loop of the control system 5238), in order for the control
system to make adjustments to the air pressure supplied to the
inflatable portions 6712, 6714, 6716, as may be needed to maintain
the desired lateral tilt angles for each of the sections 6740,
6742, 6744.
[0330] Referring now to FIGS. 69-70, an embodiment 6900 of an
inflatable support section, which may be used as a middle section
5414A and/or 5414B, for example, is shown. A number of fluidly
connected bladders 6912, 6914, 6916 are formed from a base sheet
6910. Each of the bladders 6912, 6914, 6916 has a vertical height
h.sub.1, h.sub.2, h.sub.3, respectively, which extends vertically
upwardly from the base sheet 6910 and also equally vertically
downwardly below the base sheet 6910. The vertical heights h.sub.1,
h.sub.2, h.sub.3 progressively increase, such that the height
h.sub.1 is smaller than the height h.sub.2 and the height h.sub.2
is smaller than the height h.sub.3. As such, when inflated, the
bladders 6912, 6914, 6916 can provide the desired lateral tilt
angle.
[0331] Channels 6920, 6922 fluidly couple the bladders 6912, 6914,
6916 to one another. The length of the channels 6920, 6922
generally defines the amount of space between the bladders 6912,
6914, 6916. The amount of space between the bladders 6912, 6914,
6916 may be the same or different, in accordance with the
requirements of a particular design. Fluid ports 6930, 6932 couple
the bladders 6912, 6914, 6916 to an air supply (e.g., via plastic
tubing). The ports 6930, 6932 may each include a valve, which may
be selectively opened and closed (e.g., by the control system 5328)
to retain air in or vent air from the bladders 6912, 6914, 6916 as
needed. While the support section 6900 is illustrated with three
inflatable bladders 6912, 6914, 6916, it should be understood that
any number of bladders may be used. For example, two bladders may
be used in some embodiments, and more than three bladders may be
used in other embodiments.
[0332] Referring now to FIGS. 71-74, a number of embodiments of a
support section (e.g., support section 5316, 5318, 5320) including
a bellows-type bladder construction (as in the support section
5500, for example) are shown. In FIG. 71, an embodiment 7100
includes a bellows-type inflatable bladder 7110. The bladder 7110
may be embodied as shown in FIGS. 55-56 and described above, for
example. A rigid or semi-rigid panel 7118 is supported by the
bladder 7110. A non-inflatable support portion 7114 is supported by
the panel 7118. When the bladder 7110 inflates, the panel 7118
pivots about a hinge point 7112 to position a top surface 7116 of
the non-inflatable portion 7114 at the desired lateral tilt angle
as described above.
[0333] A sensor 7120 is mounted to the panel 7118 and configured to
measure the lateral tilt angle 7122 as the inflatable bladder 7110
inflates and/or after the bladder 7110 is inflated. The sensor 7120
may be embodied as, for example, an accelerometer, inclinometer,
ball switch, or other suitable type of angle sensor. The sensor
7120 communicates the angle data to a control system (e.g., the
control system 5328) as described above. The sensor 7120 may be
embedded in the non-inflatable portion 7114, in some
embodiments.
[0334] In FIG. 72, an embodiment 7200 similar to the embodiment
7100 is shown. However, rather than an angle sensor mounted to the
panel 7118, the embodiment 7200 includes a string potentiometer
7210, which is mounted to a base portion 7216 of the bellows
bladder 7110. A distal end 7214 of the string 7212 is attached to
the panel 7118. As the bladder 7110 inflates, the string
potentiometer 7210 measures the distance traveled by the panel 7118
based on the change in length of the string 7212. The data
generated by the string potentiometer 7210 is processed (e.g., by
the control system 5328) to determine the angle 7122.
[0335] In FIG. 73, an embodiment 7300 utilizes a pair of sensors
7310, 7312, which are embedded in the interior region of the
bellows bladder 7110, to monitor the lateral tilt angle. While the
panel 7118 and support portion 7114 are omitted from FIG. 73, it
should be understood that one or both of the panel 7118 and the
support portion 7114 may be included in some versions of the
embodiment 7300.
[0336] The sensors 7310, 7312 are each mounted to the internal side
of the base portion 7216 of the bellows bladder 7110. The sensors
7310, 7312 are ultrasonic or laser sensors that transmit a signal
through the interior region of the bellows bladder 7110 and
vertically upwardly toward an internal side of the top portion
7314. As a result of the signal propagation, the output of the
sensors 7310, 7312 is used to determine the vertical height from
the base surface 7216 to the top surface 7316 at the locations of
the sensors. The difference in the vertical heights measured by the
two sensors 7310, 7312 is analyzed (e.g., by the control system
5328) to determine the angle 7122. While two sensors are shown in
the embodiment 7300, it should be understood that any number of
sensors may be used. Further, the spacing between the sensors 7310,
7312 may be varied according to the requirements of a particular
design.
[0337] In FIG. 74, another version of an internal angle sensor 7410
is shown. The sensor 7410 is constructed as a vertical column of
alternating portions of crushable/deformable foam 7412, 7416, 7420,
7424 and electrical switches 7414, 7418, 7422. The sensor 7410
extends vertically upwardly from the base portion 7216 to the top
surface 7314, within the interior region of the bladder 7110. When
the bladder 7110 is fully inflated, all of the switches 7414, 7418,
7422 are open. When the bladder 7110 is deflated, all of the
switches 7414, 7418, 7422 are closed. In other words, as the angle
7122 increases, the electrical signals generated by the sensor 7410
decrease, and vice versa. The data generated by the sensor 7410 can
thus be processed (e.g., by the control system 5328) to determine
the angle 7122.
[0338] Referring now to FIG. 75, an embodiment 7500 of a person
support apparatus includes a number of support sections 7510, 7512,
7514, which are inflatable to provide the progressive lateral tilt
angle as described above. The person support apparatus 7500 is in
communication with a weighing system 7516. In general, the weighing
system 7516 includes sensors, a processor, and computer
instructions executable by the process to determine the weight of a
person 7518 positioned on the person support apparatus 7500. For
example, the sensors of the weighing system 7516 may be embodied as
load cells mounted to a support frame supporting the person support
apparatus 7500. Some examples of beds with integrated weighing
systems are disclosed in, for example, U.S. Pat. No. 4,934,468.
[0339] An air system 7520 supplies and controls the amount of air
pressure delivered to each of the support sections 7510, 7512, 7514
by conduits 7522, 7524, 7526, respectively. The air system 7520
receives person weight information from the weighing system 7516
via a data communication link 7528. Instructions executable by the
air system 7520 (e.g., by a processor thereof) determine the
appropriate amount of air pressure to deliver to each of the
support sections 7510, 7512, and 7514 based on the person's weight
as detected by the weighing system 7516 and the desired lateral
tilt angle of each of the sections 7510, 7512, 7514. To do this,
the air system may, for example, consult a look-up table or
database that maps person weights, tilt angles, and air pressures.
Such mappings may be determined in advance, e.g., through
experimentation or through mathematical calculations. In one
example, the weighing system 7516 detects the person 7518's weight
as 300 pounds. In response, the air system 7520 supplies air
pressure at 9 inches of water to the sections 7510 and 7512, and
supplies air pressure at 5 inches of water to the section 7514. In
another example, the weighing system 7516 detects the person 7518's
weight as 151 pounds. In response, the air system 7520 supplies air
pressure at 6 inches of water to the sections 7510 and 7512, and
supplies air pressure at 5 inches of water to the section 7514.
[0340] Referring now to FIGS. 76-77, an embodiment 7600 of a
support section for a person support apparatus, which may be used
as a middle portion 5414A, 5414B, for example, is shown. The
support section 7600 includes a substantially triangularly shaped
non-rigid material 7610 and a pair of differently-sized air
bladders 7612, 7614 coupled to the material 7610. The material 7610
may be constructed of, for example, a type of nylon. The air
bladders 7612, 7614 may be coupled to the material 7610 by RF
welding or other suitable fastening technique. The bladder 7614 is
larger than the bladder 7612 (e.g., the bladder 7614 has a larger
diameter than the bladder 7612). The bladders 7612, 7614 are spaced
from one another so that the bladder 7612 is positioned nearer to
the vertex of the lateral tilt angle 7616. The spacing of the
bladders 7612, 7614 relative to the material 7610 and the size
difference between the bladder 7612 and the bladder 7614 allow the
support section 7600 to assume a substantially triangular shape
when the bladders 7612, 7614 are inflated (FIG. 76) and a
substantially flat shape when the bladders 7612, 7614 are deflated
(FIG. 77).
[0341] Referring now to FIGS. 78-80 and FIG. 81, an embodiment 7800
of a person support apparatus is shown. The person support
apparatus 7800 includes a base 7810, a number of support sections
7812, 7814, 7816 supported by the base 7810, and a side member 7818
supported by the base 7810. Each of the support sections 7812,
7814, 7816 includes, supported between the base 7810 and a top
surface 7822, 78243, 7826, 7828, a three-dimensional matrix of
longitudinal or log-shaped bladders 7820. The bladders 7820 are
arranged in columns of vertically stacked bladders, where the
columns are positioned adjacent one another across the lateral
width of the support section 7812, 7814, 7816. The top surface
7822, 7824, 7826, 7828 may be constructed of foam or fabric, for
example. A seam 7830 allows the top surface 7828 to move
independently of the top surfaces 7822, 7824, 7826.
[0342] The air pressure within each of the bladders 7820 can be
independently adjusted to create the desired progressive lateral
tilt angle as described above. That is, a control system may
control the inflation and deflation of each individual bladder 7820
independently of the other bladders. For example, as shown in FIG.
79, bladders that are nearer to the seam 7830 and thus nearer to
the vertex of the lateral tilt angle may be inflated to a lesser
degree than the bladders 7820 that are further away from the seam
7830. When all of the bladders 7820 are inflated by the same
amount, the support section 7800 assumes a substantially flat
position as shown in FIG. 80. As shown in FIG. 78, the bladders of
the different sections 7812, 7814, 7816 may have different lengths.
For example, the bladders 7814 may be longer in length than the
bladders 7812, and the bladders 7816 may be longer in length than
the bladders 7814. Illustratively, the bladders of each of the
sections 7812, 7814, 7816 have the same or similar diameter.
However, it should be understood that the bladder diameters may
differ in other embodiments. For example, the diameter of the
bladders in one of the sections 7812, 7814, 7816 may be different
than the diameter of the bladders in one or more of the other
sections 7812, 7814, 7816.
[0343] FIG. 81 illustrates a person support apparatus 8100 that is
similar to the support section 7800, except that the support
section 8100 has a number of bladder matrix subsections 7818. The
bladder matrix subsections 7818 can be grouped together (e.g., by
hook and loop fasteners or other fastening techniques) to form the
bladder sections 7812, 7814, 7816. As such, the progression of the
lateral tilt angle described herein can be controlled with a finer
degree of granularity. Additionally, the size of the bladder
sections 7812, 7814, 7816 can be dynamically adjusted (e.g., to
accommodate differently-sized persons, for different therapeutic
purposes, or other reasons).
[0344] Referring now to FIGS. 82-85, an embodiment 8200 of a person
support apparatus includes a base 8210 and a number of support
sections 8218, 8220, 8222 supported by the base 8210. The support
section 8218 includes a pair of side by side cylindrically-shaped
pleated bladders 8212, 8214 and a non-inflatable panel 8216
supported by the bladders 8212, 8214. Each of the support sections
8220, 8222 is similarly configured. The air pressure in the
bladders 8212, 8214 is selectively adjustable to alter the
respective vertical heights of the bladders 8212, 8214 to achieve
different angular orientations of the top surface 8228 of the
non-inflatable structure 8216. The structure 8216 has a pair of
recesses 8224, 8226 in its lower surface, which are sized to
receive and retain a top portion of the bladders 8212, 8214,
respectively. As shown in FIG. 83, the internal air pressure in the
bladder 8214 is higher than the pressure in the bladder 8212,
resulting in a lateral tilt toward the left side of the page. In
FIG. 84, the pressure in the bladder 8212 is higher than the
pressure in the bladder 8214, resulting in a lateral tilt toward
the right side of the page. In FIG. 85, both of the bladders 8212,
8214 are at a medium pressure, resulting in a substantially flat
surface 8228. To control the pressures in the bladders 8212, 8214,
the bladders 8212, 8214 are fluidly coupled to a control system as
described above.
[0345] Referring now to FIG. 86, a person support apparatus 8600
includes a support structure 8610, which is configured to provide a
progressive lateral tilt angle or "ramp" shape as described herein.
In the embodiment 8600, side members 8612, 8618, 8622 are
positioned along the vertex side of the structure 8610 so as to
prevent a person rotated by the structure 8610 from exiting the
structure unintentionally. The side members each have length that
is substantially less than the length of the support structure
8610, leaving gaps therebetween through which the person may exit
the support structure 8610 if desired. As shown by the dashed lines
in FIG. 86, such gaps may be filled by additional side members
8614, 8620 to form a continuous support member if desired. The
support members 8612, 8618, 8622, 8614, 8620 may be constructed of
inflatable bladders, such that the support members 8612, 8618,
8622, 8614, 8620 only need to be inflated when they are needed
(e.g., when the support structure 8610 is in a lateral tilt
position). Accordingly, the side members 8614, 8620 may be
deflated, e.g., to allow egress, and inflated, as needed.
[0346] Referring now to FIG. 87, a person support apparatus 8700
includes a support structure 8710, which is configured to provide
the progressive lateral tilt or "ramp" shape as described above,
and a side member 8712. The side member 8712 has a length that is
less than the entire length of the support structure 8710. As such,
ingress and egress are permitted through the area in which the side
member 8712 is not present.
[0347] Referring now to FIGS. 88-89, a person support apparatus
8800 includes a number of support sections 8812, 8816, 8818 and a
side member 8820. Each of the support sections 8812, 8816, 8818
includes a wedge-shaped non-inflatable support portion 8810, an
inflatable portion 8822 supported by the portion 8810, a stiffener
plate 8824 supported by the inflatable portion 8822, and a top
portion 8812. In the embodiment 8800, the inflatable portion 8822
of each of the support sections 8812, 8816, 8818 is deflated to
drop a person down into the progressive lateral tilt position
(rather than raising the person up into the lateral tilt position).
To accomplish the progressive lateral tilt position, the size of
the wedge 8810 is different for each of the sections 8812, 8816,
8818 (to provide the different lateral tilt angles as described
herein).
[0348] FIG. 88 shows the person support apparatus 8800 with the
inflatable portion 8822 deflated, while FIG. 89 shows the
inflatable portion 8822 inflated.
[0349] Referring now to FIG. 90, a person support apparatus 9000
has the same or similar construction as the person support
apparatus 7800, except that the three dimensional bladder matrix
includes spherical bladders 9010 rather than longitudinal or
log-shaped bladders. The spherical bladders 9010 are vertically
stacked and selectively inflatable to achieve the desired lateral
tilt position.
[0350] Referring now to FIGS. 91-93, an embodiment 9100 of a person
support apparatus includes a base 9110 and two-dimensional matrix
of can-shaped or upright vertical bladders 9416. A row of bladders
9114 is selectively inflatable to form a side bolster or side
member. The arrangement of bladders 9116 allows a high degree of
customization of the progressive lateral tilt position. In the
illustrative embodiment, all of the bladders 9112, 9114 are
manufactured to have at least the same maximum vertical height but
the height of the individual bladders is varied by a control system
as described herein, to achieve the desired lateral tilt angles.
For example, as shown in FIG. 92, the progressively taller height
of the bladders 9210, 9212, 9214, 9216 is due to the degree to
which each of these bladders is inflated.
[0351] Referring now to FIG. 94, an embodiment 9400 of a person
support apparatus includes a support structure 9412 and a pair of
side members 9414, 9416. Each of the side members 9414, 9416 has
substantially the same length as the length of the base 9410 and
thereby can prevent the person from unintentionally exiting the
structure 9412.
[0352] Referring now to FIG. 95, a method 9500 for controlling the
lateral tilt angle of a support section (e.g., the support sections
5316, 6318, 5320 of FIG. 53) is shown. The method 5300 may be
embodied as computerized instructions, modules, or routines, which
may be executed by a processor (by the air control system 5328, for
example). Laterally angled support apparatuses can have multiple
sections that provide different lateral angles above the
horizontal, as described herein. To provide some forms of therapy,
or for other reasons, the lateral angle may be smallest toward the
foot end of the support apparatus and progressively increase toward
the head end of the support apparatus. This progression of
increasingly greater lateral angles can allow a person's head to
rotate laterally a desired amount while still providing a
comfortable and stable rest surface for the person.
[0353] Some embodiments include a static implementation, in which
the progressive lateral tilt angles are established at a point in
time (e.g., at manufacture) and then maintained throughout the use
of the person support apparatus. Other embodiments include a
dynamic implementation, in which control algorithms are used to
move the person support apparatus in and out of the progressive
lateral tilt position from time to time as needed or desired. For
example, control algorithms may wait until after the person using
the support apparatus has fallen asleep to implement the
progressive lateral tilt position, and then return the support
apparatus to the flat position before the person wakes up. In
either case, controlling the difference in the lateral tilt angles
of adjacent sections of the person support apparatus can, among
other things, reduce the risk of discomfort. In static
implementations, the person support apparatus can be designed
and/or customized so that the difference in the lateral tilt angles
of adjacent support sections (which may be referred to herein as
the "delta") is minimized or at least does not exceed a defined
threshold value (which may be referred to herein as the "maximum
delta." In dynamic implementations, the control algorithms can
monitor lateral tilt angle change requests and either minimize the
delta or enforce the maximum delta while the person support
apparatus is transitioning from one position to another (e.g., from
a flat position to a progressive lateral tilt position or vice
versa).
[0354] In FIG. 95, the person support apparatus control system
(e.g., control system 5328) monitors for and detects requests to
change the lateral angle of one or more support sections (e.g.,
section(s) 5316, 5318, 5320) of the person support apparatus, at
block 9510. Such requests may come from a user (e.g., by activation
of a touchscreen control to initiate the progressive lateral tilt
position) or an automated process (e.g., in response to expiration
of a timer). If a lateral angle change request is received, the
system begins to execute the requested angle change at block 9512
(e.g., by inflating/deflating bladders as needed). While executing
the angle change request, the system determines and monitors the
current lateral angles of the support sections (e.g., the support
section that is the subject of the request and the current lateral
angles of each of the adjacent support sections), at block 9514. To
do this, the system receives and analyzes sensor inputs that
indicate the current lateral angles. Such inputs may be provided to
the system by one or more angle sensors (e.g., accelerometers,
inclinometers, ball switches, etc.) that are mounted to the
respective support sections in, for example, any of the manners
described herein. At block 9516, the system determines the
difference (e.g., by mathematical subtraction) between the
requested lateral angle and the current lateral angle of the
support section being adjusted and each of its adjacent support
sections. At block 9518, the system compares the difference between
the requested angle and the current angles to the aforementioned
maximum delta. In some cases, the maximum delta may be defined
differently for different support sections, while in other cases,
the maximum delta may be the same for all of the support sections.
For instance, the maximum delta for a head support section with
respect to its adjacent (e.g., seat) section may be larger than the
maximum delta for the seat section with respect to the adjacent
foot section. If the system determines that the lateral angle
difference exceeds the maximum delta, the system adjusts the
lateral angles of the support sections as needed at block 9520, and
returns to block 9514. At block 9520, the system adjusts the
lateral angle of one or more of the support sections (e.g., the
support section for which the angle change is requested at block
9510 and/or the lateral angle(s) of one or more of the adjacent
support sections). For example, if the request is to increase the
lateral angle of the head support section, and the lateral angle
difference between the requested angle and the current lateral
angle of the adjacent (e.g., seat) section is greater than the
maximum delta, the system may increase the lateral angle of the
adjacent section. If the angle difference does not exceed the
maximum delta, the system continues executing the requested angle
change, at block 9522, and then ends the method 950 or returns to
block 9510 as shown.
[0355] FIGS. 96a-96d are views of a mattress 900 according to
another illustrative embodiment of the present disclosure. In this
embodiment, the mattress 900 comprises a base 902 which supports a
head section 904, a torso section 906, a leg section 908, and a
bolster 909. The mattress 900 has a longitudinal length l and a
lateral width w. A central longitudinal axis, or centerline, a1
runs through the middle of the mattress 900 longitudinally from end
to end and a central lateral axis a2 runs through the mattress
laterally from side to side. In this embodiment, the mattress 900
is made of polyurethane foam, although the mattress could be made
from many other foam (including memory foam or closed cell foam),
cloth, and/or fabric materials, and/or structural elements such as
springs and air bladders. For example, a viscoelastic foam with an
ILD (indention load deflection) rating of about 50 could be used
when the angle O1 (described below) is from about 25 to about 30
degrees. Depending on the stiffness (ILD) of the material, the
angles disclosed herein can be adjusted somewhat. Smaller angles
maybe used when a higher ILD (stiffer) material is utilized, and
vice versa. In some embodiments, the material comprises foam having
an ILD of from about 25 to about 275.
[0356] The mattress 900 in this embodiment is coated with three
coats of F-874 Muraculon vinyl based coating, and one coat of F-894
Muraculon vinyl based coating. Other coverings can be utilized,
including those which preserve the density or durability of the
foam, or increase its infection control or antimicrobial
properties. In some embodiments, no coatings or coverings could be
utilized.
[0357] FIG. 96b is a top view of the illustrative embodiment of
FIG. 96a looking in the direction labeled 96b in FIG. 96a. As seen
in this view, the head section 904 includes a flat top surface 903
and an angled top surface 905 which slants in the lateral direction
at an angle relative to the lateral axis a2. The bolster 909
includes a flat top surface 907 and an angled top surface 911 which
slants in the longitudinal direction at an angle relative to the
longitudinal axis a1. As seen in FIG. 96b, in this embodiment, the
bolster 909 extends along the leg section 908 and a portion of the
torso section 906, but not along the head section 904. As shown in
FIGS. 96a and 96b, a ramping or tapering down of the bolster 909
occurs about midway along the torso section 906 (below the location
where the elbow would typically be supported). Accordingly, when
this embodiment is used as intended, the head of the patient will
typically not migrate adjacent the bolster 909 and will turn
sideways at an angle, with a cheek supported by the angled top
surface 903, thereby supporting the head at an angle relative to
the lateral axis a2.
[0358] FIG. 96c is a longitudinal side view (viewed along the
longer side) of the illustrative embodiment of FIG. 96a, looking in
the direction labeled 96c in FIG. 96b. FIG. 96d is a lateral side
view (viewed along the shorter side, or end) of the illustrative
embodiment of FIG. 96a, looking in the direction labeled 96d in
FIG. 96c. As best seen in FIGS. 96a and 96d, each of the head
section 904, torso section 906, and leg section 908 includes an
angled top support surface in this embodiment. In particular, the
head section 904 includes the angled top surface 905 which slants
in the lateral direction, the torso section 906 includes an angled
top surface 915 which slants in the lateral direction, and the leg
section includes an angled top surface 917 which slants in the
lateral direction. The top surface 905 of the head section 904 is
intended to support at least a portion of a person's head, and is
generally tilted in the lateral direction at a first angle relative
the lateral axis a2. The top surface 915 of the torso section 906
is intended to support at least a portion of a person's torso, and
is generally tilted in the lateral direction at a second angle
relative to the lateral axis a2. The top surface 917 of the leg
section 908 is intended to support at least a portion of a person's
leg, and is generally tilted in the lateral direction at a third
angle relative to the lateral axis a2. In this embodiment, the top
surface 905 of the head section 904 is at an angle O1 of about 25
degrees, the top surface 915 of the torso section is at an angle O2
of about 17.5 degrees, and the top surface 917 of the leg section
is at an angle O3 of about 10 degrees. In some embodiments, the
angle O1 is from about 10 to about 30 degrees, and the angle O2 is
from about 0 to about 25 degrees (such as from about 1 to about 20
degrees). In some embodiments, angle O1 is at least about 10
degrees, and in some embodiments is at least about 15 degrees. In
some embodiments, angle O1 is at least 20 degrees, such as from
about 20 to about 25 degrees, and the angle O2 is at least about 10
degrees, such as from about 10 to about 25 degrees.
[0359] In some embodiments, the angle O2 is from about 5 to about
15 degrees less than the angle O1. In some embodiments, the angle
O2 is from about 5 to about 10 degrees less than the angle O1, and
in some embodiments the angle O2 is about 7.5 degrees less than the
angle O1. In some embodiments, the angle O2 is from about 15 to
about 17.5 degrees. In some embodiments where the head section
angle O1 is at about 30 degrees, the angle O2 is at about 15 to
about 22.5 degrees. In some embodiments, such gradual turning by
having angle O2 be somewhat less than angle O1, and somewhat more
horizontal, has been found to increase comfort while still
promoting a good sleeping position and urging the head turn
significantly away from the vertical up direction (e.g., 35 degrees
or more in both directions, clockwise and counterclockwise from
vertical up, regardless of sleeping position.)
[0360] In some embodiments, the angle O3 is from about 0 degrees to
about 15 degrees. In some embodiments, the angle O3 is from about 0
degrees to about 12.5 degrees, and in some embodiments is about 10
degrees. In some embodiments, the angle O3 is from about 0 to about
15 degrees less than the angle O2. In some embodiments, the angle
O3 is from about 5 to about 10 degrees less than the angle O2, and
in some embodiments the angle O3 is about 7.5 degrees less than the
angle O2.
[0361] Because the base 902 is flat in this embodiment, on both its
top and bottom, these angles O1, O2, and O3 are likewise relative
to the base and to the underside of the mattress in this
embodiment. In some embodiments, the top surfaces 905, 915, and 917
can be curved or non-linear or otherwise follow a non-straight or
smooth path in the longitudinal and/or lateral directions. In such
cases, where these angles are nonlinear in the lateral direction,
the angle O1 of general lateral sloping of the top surface 905 of
the head section can be defined by the angle of a line connecting a
point defining the lateral start of the head support surface to a
point defining its lateral end (laterally directly across, left to
right), or a point at the approximate middle of the support surface
(or by averaging the angles of all, or a plurality, of such lines,
taken along the section). Likewise, the angle O2 of general sloping
of the top surface 915 of the torso section can be defined by the
line connecting the point defining the lateral start of the torso
support surface to the point defining its lateral end, or a point
at the approximate middle of the support surface (or by averaging
the angles of all or a plurality of such lines taken along the
section). Furthermore, the angle O3 of general sloping of the top
surface 917 of the leg section can be defined by the line
connecting the point defining the lateral start of the leg support
surface to the point defining its lateral end, or a point at the
approximate middle of the support surface (or by averaging the
angles of all or a plurality of such lines taken along the
section).
[0362] In this embodiment of FIG. 96, the head support surface 905
is sized to support a person's head, the torso support surface 915
is sized to support a person's torso, and the leg support surface
917 is sized to support a person's legs. In some embodiments, the
head section 904 is from about 5 inches to about 30 inches in
length (such as from about 15 to about 25 inches, or at about 20
inches for example), the torso section 906 is from about 15 inches
to about 50 inches in length (such as from about 20 to about 35
inches, or at about 24 inches for example), and the leg section is
from about 25 inches to about 50 inches in length (such as from
about 30 to about 40 inches, or about 35 inches for example).
[0363] FIG. 97a is a perspective view of the base 902 (having the
side bolster 909 on top of it) of the illustrative embodiment of
FIG. 96. FIG. 97b is a top view of the base 902 and bolster 909 of
FIG. 97a, looking in the direction labeled 97b in FIG. 97a. FIG.
97c is a side view of the base 902 and bolster 909 of FIG. 97a,
looking in the direction labeled 97c in FIG. 97b. FIG. 97d is a
side view of the base 902 and bolster 909 of FIG. 97a, looking in
the direction labeled 97d in FIG. 97c.
[0364] FIG. 98a is a perspective view of the head section 904 of
the illustrative embodiment of FIG. 96. FIG. 98b is a top view of
the head section 904 of FIG. 98a, looking in the direction labeled
98b in FIG. 98a. FIG. 98c is a head end view of the head section
904 of FIG. 98a, looking in the direction labeled 98c in FIG. 98b.
FIG. 98d is a right side view of the head section 904 of FIG. 97a,
looking in the direction labeled 98d in FIG. 98c.
[0365] FIG. 99a is a perspective view of the torso section 906 of
the illustrative embodiment of FIG. 96. FIG. 99b is a top view of
the torso section 906 of FIG. 99a, looking in the direction labeled
99b in FIG. 99a. FIG. 99c is a head end view of the torso section
906 of FIG. 99a, looking in the direction labeled 99c in FIG. 99b.
FIG. 99d is a right side view of the torso section 906 of FIG. 99a,
looking in the direction labeled 99d in FIG. 99c.
[0366] FIG. 100a is a perspective view of the leg section 908 of
the illustrative embodiment of FIG. 96. FIG. 100b is a top view of
the leg section 908 of FIG. 100a, looking in the direction labeled
100b in FIG. 100a. FIG. 100c is a head end view of the leg section
908 of FIG. 100a, looking in the direction labeled 100c in FIG.
100b. FIG. 100d is a right side view of the leg section 908 of FIG.
100a, looking in the direction labeled 100d in FIG. 100c.
[0367] In use, the mattress 902 can be placed on a bed frame. The
user lies on the top surfaces 905, 915, and 917, with the head
section surface 905 generally supporting the user's head, the torso
section surface 915 generally supporting the user's torso, and the
leg section surface 917 generally supporting the user's legs. Due
to the angle O1 of the top surface 905, the side of the user's head
is urged to lie at a significant angle (e.g., plus or minus about
35 degrees or more relative to vertical). In this embodiment, it
has been found that, in use, a straight line along the approximate
surface of the user's face from the ear toward the eye will often
lie at an angle (or the plane defined generally by the centerline
of the nose), will be at an angle or offset from the vertical up
direction and vertical plane. It has been found that, in some
embodiments, regardless if the patient is being supported on the
patient's back, front, or side, and regardless of whether the
patient is sleeping with the face pointed "uphill" relative to the
surface 905 or pointed "downhill" relative to the surface 905, the
face will be urged to a left or right angle and away from looking
straight up to the ceiling, when the mattress 907 is in the
generally horizontal position. In some embodiments, this urging is
to an angle that is 35 degrees or more left or right of the plane
that the nose centerline would point if the patient had the
nose/face/eyes square with the ceiling, pointing straight ahead.
The face can be urged to an angle similar to the lateral plane
angle of the top surface 905 (or at least to an angle perpendicular
thereto), and it has been found that the effects of certain sleep
disorders, such as sleep apnea, can be reduced. In some
embodiments, the patient is urged by the surfaces to sleep in a
position wherein the soft tissues (e.g., the soft pallet, tongue,
uvula, tonsils, pharynx, and/or adenoids) in the upper respiratory
tract are at a significant angle relative to vertical down and/or
are less restrictive of the breathing passages so as to minimize
apnea events. In this embodiment of FIG. 100, because the mattress
has an angled top surface where the angle gradually reduces angle
from head end to foot end, it has been found that
tolerability/comfort of the mattress 902 for sleeping can be
improved. Because the mattress 900 is made of a flexible material
(which is a foam material in this embodiment) when placed on a
support deck or frame with a pivoting or raisable leg and/or thigh
portion, the leg section 908 can be pivoted relative to the torso
section 906, to thereby create a raised knee and/or thigh, and/or a
knee gatch or knee bed in the patient. It has been found that this
configuration can help resist the migration of the patient toward
the foot end and maintain the head in an angled position similar.
Furthermore, in this embodiment, the height of the head support
surface 905 is generally greater than the longitudinally
corresponding height of the torso support surface 915, which is
generally greater than the longitudinally corresponding height of
the leg support surface 917, so as to create a longitudinal slope
on the mattress as well, and causing the body to slop slightly
longitudinally downwardly during sleep as well.
[0368] Many other embodiments are also possible. For example,
instead of foam, the angled surfaces could be created by air
bladders, and moved between angles as desired, or moved from flat
to angled and back as desired, such as described above.
Additionally, fewer, none or more bolsters could be utilized.
Furthermore, instead of defined sections, the sections could
gradually transition to one another. The other figures herein
illustrate some such embodiments, although many others are
possible, by adding, subtracting or combining features or
aspects.
[0369] FIG. 101 is a perspective view of a sleep apparatus in the
form of a mattress 1000 according to another illustrative
embodiment of the present disclosure, where the mattress includes
transitions 1002 and 1004 sections between the head section 904'
and torso section 906' and between the torso section 906' and leg
section 908'. The sections 904', 906' and 908', and the bolster
909' are configured substantially the same as in the embodiment of
FIG. 96 and operate similarly. However, in this embodiment, instead
of discrete or stepped transitions between the sections, there are
gradual or sloped transitions, via the transition sections 1002,
which are each angled in both the lateral direction and the
longitudinal direction.
[0370] FIG. 102a is a perspective view of the first transition
section 1002 of the illustrative embodiment of FIG. 101. FIG. 102b
is a top view of the first transition section 1002 of FIG. 101,
looking in the direction labeled 102b in FIG. 102a. FIG. 102c is a
side view of the first transition section 1002 of FIG. 101, looking
in the direction labeled 102c in FIG. 102b. FIG. 102d is a side
view of the first transition section 1002 of FIG. 101, looking in
the direction labeled 102d in FIG. 102c. As shown in this FIG, the
transition section 1002 has a top surface 1003 that slants or
angles in both the longitudinal and the lateral directions. Thus,
top surface 1003 has an angle .alpha.1 relative to the longitudinal
axis of the mattress and an angle a2 relative to the lateral axis
of the mattress. Accordingly, a gradual transition is achieved
between the head section 904' and the torso section 906'.
[0371] FIG. 103a is a perspective view of the second transition
section 1004 of the illustrative embodiment of FIG. 101. FIG. 103b
is a top view of the second transition section 1004 of FIG. 101,
looking in the direction labeled 103b in FIG. 103a. FIG. 103c is a
side view of the second transition section 1004 of FIG. 101,
looking in the direction labeled 103c in FIG. 103b. FIG. 103d is a
side view of the second transition section 1004 of FIG. 101,
looking in the direction labeled 103d in FIG. 103b. As shown in
these FIGS., the transition section 1004 has a top surface 1005
that slants or angles in both the longitudinal and the lateral
directions. Thus, top surface 1005 has an angle relative to the
longitudinal axis of the mattress and an angle relative to the
lateral axis of the mattress. Accordingly, a gradual transition is
achieved between the torso section 906' and the leg section 908'.
These transition sections 1002 and 1004 can thereby help support
the user's back, rear, and/or side during use. The mattress 1000 of
this embodiment is made of a foam material.
[0372] FIG. 104 is a perspective view of a sleep apparatus in the
form of a person support apparatus 1040, according to another
illustrative embodiment of the present disclosure, that includes a
leg section that articulates near the knee of the person supported.
In this embodiment, the person support apparatus 1040 includes a
castered base 1044, and an frame 1049 movable in the vertical
direction relative the base 1044 via actuators 1046. The frame 1049
supports a deck 1047 on which sits mattress 1050. The deck 1047 is
movable via actuator 1048 to raise or tilt one or more deck
sections. Siderails 1041 can move upwardly and downwardly at the
lateral sides of the person support apparatus 1040, and headboard
1042 is positioned at the longitudinal head end of the person
support apparatus 1040.
[0373] The mattress 1050 has an angled head support surface 1051
and a horizontal head section 1053, as well as a torso section
1052, and a leg section 1054. The angled head support surface 1051
slants laterally toward the side of the person support apparatus
1040, toward the siderail 1041. The torso section 1052 supports the
torso of the patient, and the leg section 1054 supports the legs of
the patient. The angled head support surface 1051 slopes laterally
at an angle .alpha.1 relative to horizontal, while the flat head
section 1053 is relatively flat to horizontal. Due to the
articulation of the deck 1047 in the leg section 1054 and the
flexibility of the foam material from which mattress 1050 is made,
a pivot or bend is formed in the leg section 1054 near the knee
1057 of the patient. The angle a2 defined by the bend in the
mattress 1050 near the knee 1057 causes the leg section 1054 to
slope upwardly then downwardly (or to flat) in the longitudinal
direction from head toward foot. Preferably, this angle .alpha.2 is
from about 90 to about 175 degrees (i.e., the angle between the
lower leg support surface and the upper leg support surface is from
about 185 degrees to about 270 degrees, such as from about 210 to
about 240 degrees for example.) The angled head surface 1051 can
cause the head 1055 of the patient to slope away from vertical
during sleep, at angle .omega., while the bent leg section 1054 can
cause the knees 1057 of the patient to be bent during sleep such
that the legs and thighs form an angle corresponding to
approximately .alpha.2 while the patient sleeps in a semi-supine
position where the patient is supported on the backside of their
legs and torso, and the side of their face tilts generally at an
angle to vertical. The angle co can be defined by the straight
ahead line of site of the eyes, and can be greater than 35 degrees,
such as greater than about 40 degrees, or greater than about 45
degrees. In some embodiments, this angle .omega. to goes up to the
limit permitted by the angle .alpha.1 of the head support surface
1051, such as up to about 130 degrees for example. It is also
possible in the embodiments of this disclosure that the patient
sleeps in a semi-prone position where the patient is supported on
the front side of their legs and torso, and/or stomach, but
generally on the side of their face as the face tilts generally
downwardly toward the floor at approximately angle .alpha.1.
[0374] FIG. 105a is a perspective view of a mattress 1060 according
to another illustrative embodiment of the present disclosure. FIG.
105b is a top view of the illustrative embodiment of FIG. 105a
looking in the direction labeled 105b in FIG. 105a. FIG. 105c is a
longitudinal side view (viewed along the longer side) of the
illustrative embodiment of FIG. 105a, looking in the direction
labeled 105c in FIG. 105b. FIG. 105d is a lateral side view (viewed
along the shorter side, or head end) of the illustrative embodiment
of FIG. 105a, looking in the direction labeled 105d in FIG. 105c.
In this embodiment, the mattress 1060 has a laterally sloped head
section 1062, a laterally sloped torso section 1064 and a laterally
sloped leg section 1066. In addition, a side bolster 1068 is
provided along a portion of the longitudinal side, rising above
bottom part of the slopes of the leg section 1066 and torso section
1064. Moreover, a foot bolster 1070 runs laterally along the foot
end of the mattress 1060 and has a top surface 1071 that rises
least a portion of the foot section 1066. The foot bolster 1070 can
help minimize patient migration toward the foot end, and can help
keep the patient's head on the angled head support surface of the
head section 1062 and tilted laterally downwardly as some or all of
the rest of the patient's body is in a generally more prone or more
supine sleeping position (depending on if the patient is sleeping
on the stomach or on the back).
[0375] As can best be seen in FIGS. 105A, 105B, and 105D, the
mattress 1060 has four corners C1, C2, C3, and C4 around its body
supporting surfaces. The height of the mattress 1060 at corner C1
(near the head end left side) is greater than the height of the
mattress at corner C2 (near the foot end left side), which in turn
is greater than the height of the mattress's patient support at
corner C3 (near the foot end right side). Accordingly, the mattress
1060 of this embodiment generally slopes downwardly in the
longitudinal direction, but also downwardly in the lateral
direction In one embodiment, the height at C1 is about 12 inches,
and in another embodiment is about 9 inches. In one embodiment, the
height at C2 is about 7.5 inches, and in another embodiment is
about 6 inches. In one embodiment, the height at C3 is about 2.5
inches and in another embodiment is about 1.5 inches. In some
embodiments, the height at C1 is from about 3-7 times the height at
C4. In some embodiments the height at C2 is from about 2-4 times
the height at C3, but is less than the height at C1. Therefore, in
some embodiments H(C1) is greater than H(C2) which is greater than
H(C3).
[0376] As also can be seen in FIGS. 105A, 105B, and 105D, the
sloped surface of the head support section 1062 has an upper
midpoint h.sub.u at one lateral side and a lower midpoint h.sub.l
at its opposite lateral side. Likewise, the sloped surface of the
torso support section 1064 has an upper midpoint T.sub.u (which is
longitudinally inline with the midpoint h.sub.u), and a lower
midpoint T.sub.l at its opposite lateral side. Finally, the sloped
surface of the leg support section 1066 has an upper midpoint
L.sub.l (which is longitudinally in line with midpoints II, and
T.sub.u), and a lower midpoint L.sub.l at its opposite lateral
side. In this embodiment, the height of the mattress 1060 at point
h.sub.u (which in FIG. 105A is referred to as H(h.sub.u)) is
greater than the height of the mattress 1060 at point T.sub.u
(which in FIG. 105A is referred to as H(T.sub.u)). Likewise, the
height of the mattress 1060 at point T.sub.u (which in FIG. 105A is
referred to as H(T.sub.u)) is greater than the height of the
mattress at point L.sub.u (which in FIG. 105A is referred to as
H(L.sub.u)). The heights at the lower midpoints (H(h.sub.l),
H(T.sub.l), and H(L.sub.l)) can be substantially equal in some
embodiments. In some embodiments, the height H(h.sub.u)) is from
about 8 to about 14 inches, the height H(T.sub.u) is from about 6
to about 12 inches, the height H(L.sub.u) is from about 2 to about
8 inches, such as 4.5 or 6 inches for example, and the height at
the lower points (H(L.sub.l)), H(T.sub.l), and H(h.sub.l)) is from
about 1 to about 3 inches. In one embodiment, the height H(h.sub.u)
is about 12 inches, the height H(T.sub.u) is about 10 inches, the
height H(L.sub.u) is about 6 inches, and the heights at the lower
points is about 2.5 inches. In another embodiment, the height
H(h.sub.u) is about 9 inches, the height H(T.sub.u) is about 7
inches, the height H(L.sub.u) is about 4.5 inches, and the heights
at the lower points is about 1.5 inches.
[0377] FIG. 106a is a perspective view of a mattress 1080 according
to another illustrative embodiment of the present disclosure, where
the mattress includes an articulating leg section. FIG. 106b is a
top view of the illustrative embodiment of FIG. 106a looking in the
direction labeled 106b in FIG. 106a. FIG. 106c is a left
longitudinal side view of the illustrative embodiment of FIG. 106a,
looking in the direction labeled 106c in FIG. 106b, but showing the
leg section articulated. In this embodiment, the mattress 1080
includes a laterally angled head section 1082, a laterally angled
torso section 1084, and a leg section comprising a thigh section
1086 and a lower leg section 1088. The bolster 1090 is provided
along the longitudinal side. Flexible material 1092 separates the
lower leg section 1088 and the thigh section 1086. The flexible
material can comprise fabric, plastic, flexible foam, or corrugated
foam, or foam or other material that is scored or includes voids to
induce articulation along that point of the mattress 1080.
Accordingly, the mattress 1080 can more easily flex at the
approximate knee position of the patient, to facilitate bending
near the knee when the bed on which the mattress sits is placed
into a knee gatch or bent knee position, such as one where the
angle between the lower leg support surface and the upper leg/thigh
support surface is from about 185 degrees to about 270 degrees.
[0378] FIGS. 107-113 are views of a mattress 1090 according to
another embodiment and having other various design elements.
[0379] FIGS. 114-120 are views of a mattress 1091 according to
another embodiment, while having nonlinear surfaces. In this
embodiment, the mattress 1091 includes a head section 1094, a torso
section 1096 and a leg section 1098, each of which slope laterally
downwardly, when moving in the direction w1 from the first long
1093 of the mattress to the second long side 1095 of the mattress.
As shown in this embodiment, the head section 1094 can include a
flat section. Additionally, the torso section 1096 includes a
curved portion 1097 that curves downwardly when moving in the
direction w1 and when moving in the direction l.sub.1. This curved
portion slopes generally laterally downwardly at an angle O2.
Likewise, the leg section 1098 includes a curved portion 1099 that
curves downwardly when moving in the direction w1 and when moving
the direction l.sub.1. Furthermore, the mattress 1091 also includes
a bolster 1095 that extends upwardly adjacent the leg section 1098
and a portion of the torso section 1096 but does not extend
upwardly adjacent the head section 1094.
[0380] As can best be seen by FIG. 119, when a person is in a
resting position on the mattress 1091, with their head resting on
the head support surface of the head section 1094, the head h is
urged to tilt to the side such that the center plane of the face,
generally running along the middle of the nose n, forms an angle
.omega. with the vertically upward plane v. This embodiment, and
one or more of the other embodiments described herein can urge the
head h to tilt during sleep such that the angle co is at least
about +/-35 degrees from vertical, such as about +/-45 degrees or
more, and could be up to about +130 degrees in some embodiments.
This urged tilting can be accomplished by a head section that
slopes generally downward laterally across the longitudinal
centerline of the mattress, and/or a torso section that does the
same, with an angle sufficient to cause the urged tilting. The
embodiments shown by FIG. 27 and FIG. 104 also can urge the head to
tilt at an angle co of at least about 35 degrees during sleep,
while not restraining the head substantially, so as to still allow
the head to turn sideways at least in one direction during sleep.
Other embodiments may also achieve a similar result, but not all
embodiments need achieve this result. Such a result may be
achievable too by a mattress having a head support section and/or a
torso support section that is generally laterally sloped by about
15 or more degrees, such as about 20 or more degrees, 25 or more
degrees, or 30 or more degrees.
[0381] FIGS. 121-127 depict yet another illustrative embodiment of
the present disclosure. In this embodiment, the sleep apparatus is
in the form of a mattress 3000 having a head support section 3002,
a torso support section 3004, and a leg support section 3006.
Additionally, the mattress 3000 of this embodiment includes a
bolster 3010. The mattress 3000 includes a head end 3001, a foot
end 3003, a right side 3005, a left side 3007, a longitudinal
central axis and a lateral (or latitudinal) central axis. In this
embodiment, the vertical support sections of the mattress 3000
generally slope downwardly in both the lateral direction and in the
longitudinal direction. In this example, the sloping occurs in a
curved manner in both directions, rather than in a linear or
stepped manner (although other embodiments may include other
sloping, such as linear, curved, and/or stepped sloping for
example).
[0382] Each of the sloped lying (vertical person support) sections
3002, 3004, and 3006 include a maximum height. In this example, the
head section has a maximum height h.sub.h, the torso section has a
maximum height h.sub.t, and the leg section has a maximum height
h.sub.l, and h.sub.h is greater than h.sub.t which is greater than
h.sub.l. In some embodiments, there may be irregularly shaped
portions of these sections 3002, 3004, and 3006, but the average
heights of these sections (taken for example by averaging the
maximum heights of all lateral cross sections of each section) are
generally different from one another. For example, in one
embodiment, the average height of the head section is at least
about 20% larger than the average height of the torso section, and
the average height of the torso section is at least about 20%
larger than the average height of the leg section. Accordingly, the
vertical support sections of the mattress 3000 slope generally
downwardly in the longitudinal direction from the head end 3001 to
the foot end 3003.
[0383] Additionally, in this embodiment, the vertical support
sections of the mattress 3000 slope generally downwardly in the
lateral direction from the left side 3007 toward the right side
3005. Accordingly, the maximum slope of each of the sections
(defined by the tangents to the curves at the highest points
h.sub.t, h.sub.h, and h.sub.l) relative to horizontal, is indicated
by the angles .theta..sub.h, .theta..sub.t, and .theta..sub.l. In
this embodiment .theta..sub.h is greater than .theta..sub.t which
in turn is greater than .theta..sub.l. In other words, the lateral
slope of the head section 3002 is generally greater than the
lateral slope of the torso section 3004, and the lateral slope of
the torso section 3004 is generally greater than the lateral slope
of the leg section 3006. These angles .theta..sub.h, .theta..sub.t,
and .theta..sub.l of slope could, alternatively, be determined by
determining the average slope of lateral cross sections of each
section 3002, 3004, and 3006.
[0384] In this embodiment, angle. .theta..sub.h, is about 25
degrees, .theta..sub.t, is about 17.5 degrees, and .theta..sub.l is
about 10 degrees. In some embodiments, the angle .theta..sub.h is
from about 10 to about 30 degrees, and the angle .theta..sub.t is
from about 0 to about 25 degrees (such as from about 1 to about 20
degrees). In some embodiments, angle .theta..sub.h is at least
about 20 degrees, such as from about 20 to about 25 degrees, and
the angle .theta..sub.t is at least about 10 degrees, such as from
about 10 to about 25 degrees.
[0385] In some embodiments, the angle .theta..sub.t is from about 5
to about 15 degrees less than the angle .theta..sub.h. In some
embodiments, the angle .theta..sub.t is from about 5 to about 10
degrees less than the angle .theta..sub.h, and in some embodiments
the angle .theta..sub.t is about 7.5 degrees less than the angle
.theta..sub.h. In some embodiments, the angle .theta..sub.t is from
about 15 to about 17.5 degrees.
[0386] In some embodiments, the angle .theta..sub.l is from about 0
degrees to about 15 degrees. In some embodiments, the angle
.theta..sub.l is from about 0 degrees to about 12.5 degrees, and in
some embodiments is about 10 degrees. In some embodiments, the
angle .theta..sub.l is from about 0 to about 15 degrees less than
the angle .theta..sub.t. In some embodiments, the angle
.theta..sub.l is from about 5 to about 10 degrees less than the
angle .theta..sub.t, and in some embodiments the angle
.theta..sub.l is about 7.5 degrees less than the angle
.theta..sub.t.
[0387] FIG. 128 is a top, foot end perspective view of a sleep
apparatus according to another embodiment, comprising a bed frame
having a siderail 2004, a mattress 2000 which is bendable along at
least one flexible portion 2001, and a curved tilting device 2002
which supports the mattress 2000. FIGS. 129-133 show the tilting
device 2002 in more detail. The flexible portion 2001 of the
mattress 2000 allows the mattress to pivot at the need along with
flexing of the deck of the bed, such as described above. In this
embodiment, the tilting device 2002 comprises an inflatable bellows
having creases or folds 2006 allowing its size to increase when
inflated. The tilting device 2002 may be inflated using a pump and
the valve 2008. At its four corners, the tilting device takes on
four different heights (h.sub.1, h.sub.2, h.sub.3, and h.sub.4).
The heights at the head end (h.sub.3, and h.sub.1) are larger than
those at the foot end (h.sub.4, h.sub.2). The heights on the left
side (h.sub.1, h.sub.2) are larger than the heights directly
laterally across from them (h.sub.3, and h.sub.4 respectively).
Accordingly, the bellows creates a slope in both the lateral
direction (w.sub.l) and the longitudinal direction (l.sub.l). When
placed under the flexible or twistable mattress 2000 near the head
end, a corresponding slope is created in the mattress in both the
longitudinal direction of the mattress and the lateral direction of
the mattress. Accordingly, an angle can be created .theta..sub.l
near the head support section of the mattress 2000 (and smaller
angle created in the torso support section of the mattress).
Preferably, this angle, .theta..sub.l, relative to horizontal, is
at least about 20 degrees, and near the torso section is at least
about 10 degrees. However, air can be provided or removed, via
valve 2008, to increase or decrease these angles. The device 2002
can be made of materials other than air bladders, such as foam,
plastic, fabric, textile, and/or rigid materials, for example,
sufficient to support a flexible or semi-flexible or twistable
mattress. In some embodiments, the device 2002 can be made from
foam, and/or can be longer than shown so as to extend about half or
more of the length of the mattress. In some embodiments, the device
2002 can be used on top of the mattress as an overlay to create a
gradual lateral and longitudinal tilting effect.
[0388] While certain features have been described in the context of
certain illustrative embodiments, it should be understood that such
features may be adopted or applied to any of the disclosed
embodiments or to other embodiments.
[0389] At least some of the above embodiments may be described in
terms of functional block components and various processing steps.
Such functional blocks may be realized by any number of hardware
and/or software components configured to perform the specified
functions. For example, embodiments may employ various integrated
circuit components, e.g., memory elements, processing elements,
logic elements, look-up tables, and the like, which may carry out a
variety of functions under the control of one or more processors,
microprocessors or other control devices. Similarly, where the
elements of the above embodiments are implemented using software
programming or software elements the embodiments may be implemented
with any programming or scripting language such as C, C++, Java,
assembler, or the like, with the various algorithms being
implemented with any combination of data structures, objects,
processes, routines or other programming elements. Furthermore,
such embodiments could employ any number of techniques for
electronics configuration, signal processing and/or control, data
processing and the like.
[0390] The particular implementations shown and described herein
are illustrative examples of some of many possible embodiments, and
are not intended to otherwise limit the scope of the claims in any
way. For the sake of brevity, conventional electronics, control
systems, software development and other functional aspects of the
systems (and components of the individual operating components of
the systems) may not be described in detail. Furthermore,
connecting lines, or connectors shown in various figures are
intended to represent exemplary functional relationships and/or
physical or logical couplings between the various elements. It
should be noted that many alternative or additional functional
relationships, physical connections or logical connections may be
present in a practical device.
[0391] No item or component is essential or required to the
practice of the invention unless the element is specifically
described as "essential" or "critical." Numerous modifications and
adaptations will be readily apparent to those skilled in this art
without departing from the spirit and scope of the embodiments.
[0392] The order of execution or performance of the operations in
embodiments illustrated and described herein is not essential,
unless otherwise specified. That is, the operations may be
performed in any order, unless otherwise specified, and embodiments
as described may include additional or fewer operations than those
disclosed herein. For example, it is contemplated that executing or
performing a particular operation before, contemporaneously with,
or after another operation is within the scope of aspects of the
invention.
[0393] Some embodiments may be implemented with computer-executable
instructions. The computer-executable instructions may be organized
into one or more computer-executable components or modules. Aspects
of the disclosure may be implemented with any number and
organization of such components or modules. For example, aspects of
the disclosure are not limited to the specific computer-executable
instructions or the specific components or modules illustrated in
the figures and/or described herein. Other embodiments may include
different computer-executable instructions or components having
more or less functionality than illustrated and described
herein.
[0394] Many other embodiments of the present disclosure are also
envisioned. For example, a method comprises determining a person's
level of risk for developing an adverse condition; selecting a care
protocol based on the level of risk; displaying a proposed
configuration of a person support structure corresponding to the
care protocol for a caregiver to approve; and upon approval by the
caregiver, implementing the configuration. In another contemplated
embodiment, the configuration causes the person support structure
to raise a first section of the person support structure such that
the first section forms an angle of greater than 0.degree. with
respect to the reference plane. In another contemplated embodiment,
the configuration causes the person support structure to laterally
tilt an occupant supported on the person support structure to a
side such that the occupant is are at an angle of greater than
0.degree. with respect to the reference plane. In another
contemplated embodiment, the configuration causes the person
support structure to move to at least one of a Trendelenburg and
reverse Trendelenburg position. In another contemplated embodiment,
the configuration causes a therapy to be initiated. In another
contemplated embodiment, the therapy includes heat and moisture
regulating therapy. In another contemplated embodiment, the therapy
includes continuous lateral rotation therapy. In another
contemplated embodiment, the therapy includes at least one of
percussion therapy and vibration therapy. In another contemplated
embodiment, the proposed configuration is modified as a function of
a second input indicative of the orientation of a person supported
on the person support structure. In another contemplated
embodiment, the proposed configuration is modified as a function of
a second input indicative of the position of a person supported on
the person support structure. In another contemplated embodiment,
the method further comprises the steps of: receiving an input
indicative of the sleep state of the person supported on the person
support structure; and if the person is waking up, restoring the
person support structure to a previous configuration. In another
contemplated embodiment, the person support structure is configured
upon an occupant reaching a predetermined sleep stage. In another
contemplated embodiment, the method further comprises the steps of:
receiving a configuration override command; and restoring the
person support structure to a previous configuration. In one
contemplated embodiment, the configuration override command is
communicated from a remote location. In another contemplated
embodiment, the configuration override command is communicated when
a CPR function is activated. In another contemplated embodiment,
the configuration override command is communicated from a GUI
coupled to the person support structure. In another contemplated
embodiment, the method further comprises the step of notifying a
caregiver if the presence of a material would aggravate an adverse
condition. In another contemplated embodiment, the method further
comprises the steps of: receiving an input indicative of a material
proximate to the person supported on the person support structure
determining if the material increases the person's risk for
developing an adverse condition.
[0395] In another example, a method comprises receiving a signal
indicative of a physiological characteristic; comparing the signal
to a threshold to determine if an adverse event is in progress; and
upon detecting that an adverse event is in progress, initiating an
intervention to stop the adverse event. In one contemplated
embodiment, the second intervention includes increasing the
magnitude of the first intervention. In another contemplated
embodiment, the second intervention includes alerting a
caregiver.
[0396] In another example, a person support surface comprises a
mattress ticking and a mattress core. The mattress core is enclosed
by the mattress ticking and includes at least one fluid bladder
configured to selectively protrude from the person contacting
surface and support a portion of at least one of the neck and the
upper back of an occupant supported on the person support surface.
In one contemplated embodiment, the at least one fluid bladder is
configured to support the cervical vertebrae of an occupant. In
another contemplated embodiment, the at least one fluid bladder is
configured to protrude a distance of at least about 70 mm from the
occupant facing surface. In another contemplated embodiment, the at
least one fluid bladder is configured to support the scapula of an
occupant. In another contemplated embodiment, the at least one
fluid bladder is configured to protrude a distance of at least
about 20 mm from the occupant facing surface. In another
contemplated embodiment, the at least one fluid bladder is
configured to protrude a distance of about 20 mm to about 30 mm
from the occupant facing surface. In another contemplated
embodiment, the at least one fluid bladder is configured to
protrude a distance of less than about 30 mm from the occupant
facing surface. In another contemplated embodiment, the at least
one fluid bladder is configured to laterally tilt an occupant's
head when inflated. In another contemplated embodiment, the at
least one fluid bladder is inflated upon detecting the onset of an
adverse condition.
[0397] In another example, a method comprises determining a
person's level of risk for developing an adverse condition;
selecting a care protocol based on the level of risk; sensing a
first physiological characteristic of a person supported on a
person support structure; sensing a second physiological
characteristic of the person; comparing the first physiological
characteristic to the second physiological characteristic; if the
difference between the first physiological characteristic and
second physiological characteristic is outside a predefined range,
configuring the person support structure as a function of the care
protocol.
[0398] In another example, a method comprises determining a
person's level of risk for developing an adverse condition;
selecting a care protocol based on the level of risk; sensing a
first physiological characteristic of a person supported on a
person support structure; sensing a second physiological
characteristic of the person; comparing the first physiological
characteristic to the second physiological characteristic; if the
difference between the first physiological characteristic and
second physiological characteristic is outside a predefined range,
alerting a caregiver that an adverse condition is going to
occur.
[0399] In another example, a person support apparatus to support a
person in at least a horizontal position includes a plurality of
support sections arranged along a length of the person support
apparatus, where each of the support sections has a support surface
to support a body portion of the person and an inflatable portion
supporting the support surface, where the inflatable portion of the
support section is selectively inflatable and deflatable to
position the support surface of the support section in a tilt
position in which the support surface is angled at a maximum
lateral tilt angle and position the support surface in a flat
position in which the support surface is angled at a substantially
flat angle, wherein the support surfaces of at least two of the
support sections have different maximum lateral tilt angles.
[0400] In some embodiments, the plurality of support sections may
include a head section to support the person's head, a seat section
to support the person's torso, and a foot section to support the
person's feet, where the maximum lateral tilt angle of the support
surface of the head section is greater than the maximum lateral
tilt angle of the support surface of the seat section and the
maximum lateral tilt angle of the seat section is greater than the
maximum lateral tilt angle of the foot section. The inflatable
portion of each of the support sections may be inflated to position
the support surface in the tilt position and deflated to position
the support surface in the flat position. The inflatable portion of
each of the support sections may be deflated to position the
support surface in the tilt position and inflated to position the
support surface in the flat position. Each of the support sections
may include a non-inflatable support member in cooperation with the
inflatable portion to selectively position the support surface of
the support section in the tilt position and the flat position. The
inflatable portion may be supported by the non-inflatable support
member. The inflatable portion may support the non-inflatable
support member. The inflatable portion may include a bellows-shaped
bladder. The bellows-shaped bladder may be inflatable to position
the support surface of the support section at the maximum lateral
tilt angle by rotating the support surface about a longitudinal
axis of the person support apparatus located adjacent a first side
of the person support apparatus.
[0401] In some embodiments, the person support apparatus may
include a second bellows-shaped bladder supported by the first
bellows shaped bladder and inflatable to position the support
surface of the support section at the maximum lateral tilt angle by
rotating the support surface about a second longitudinal axis of
the person support apparatus located adjacent a second side of the
person support apparatus, wherein the second side of the person
support apparatus is laterally spaced from the first side.
[0402] In some embodiments, the person support apparatus may
include a plurality of baffles in an interior region of the
bellows-shaped bladder, wherein each of the baffles has a different
length. The support section may include a side member positioned
adjacent a vertex of the maximum lateral tilt angle of the support
surface. The side member may extend along the length of the person
support apparatus and the side member may have a length that is
less than the length of the person support apparatus.
[0403] In some embodiments, the person support apparatus may
include a cover sized to enclose the support sections in an
interior region, where the cover includes expandable sections
corresponding to the support sections to accommodate the support
sections when the support surface of each of the support sections
is in the tilt position and when the support surface of each of the
support sections is in the flat position. The inflatable portion of
each of the support sections may include a multiple-chamber bladder
assembly, and each of the bladders in the multiple-chamber bladder
assembly may be inflatable to a different height. Each of the
bladders of the multiple-chamber bladder assembly may be
substantially log shaped and the bladders may be in fluid
communication with each other. Each support section may include a
sensor to measure the lateral tilt angle of the support surface of
the support section, where the sensor is coupled to the support
section. The sensor may be enclosed within an interior region of
the support section. The person support apparatus may be in
communication with an air control system and a person weighing
system to determine the weight of a person positioned on the person
support apparatus, where the air control system adjusts the amount
of air pressure supplied to the inflatable portion of each of the
support sections to achieve the maximum tilt angle of the support
surface of the support section in response to a weight detected by
the person weighing system. The inflatable portion of each of the
support sections may include a three-dimensional matrix defined by
a plurality of horizontally aligned columns of vertically stacked
inflatable bladders.
[0404] In some embodiments, each of the inflatable bladders may be
configured to assume a log-like shape when inflated. Each of the
inflatable bladders may be configured to assume a sphere-like shape
when inflated. The inflatable portion of each of the support
sections may include a two-dimensional matrix including a plurality
of rows and columns of horizontally aligned inflatable bladders,
where the maximum height of the bladders is adjustable to achieve
the maximum tilt angle of the support section. The inflatable
portion may include a pair of laterally-spaced inflatable bladders
and a non-inflatable member supported by the pair of
laterally-spaced inflatable bladders, where the non-inflatable
member supports the support surface and the support surface assumes
the tilt position when both of the inflatable bladders are at least
partially inflated and one of the inflatable bladders is inflated
to a different height than the other inflatable bladder. Each of
the support sections may include a wedge-shaped non-inflatable base
and the inflatable portion may be supported by the wedge-shaped
non-inflatable base.
[0405] According to one embodiment, a mattress is provided having a
longitudinal length defined by a longitudinal axis of the mattress
when the mattress is in its most horizontal position and a lateral
width defined by a lateral axis of the mattress when the mattress
is in its most horizontal position. The mattress comprises a head
section having a head support surface to support at least a portion
of a person's head. At least a portion of the head support surface
is generally sloped in the lateral direction at a first angle
relative the lateral axis. The first angle is from about 10 to
about 30 degrees. The mattress further comprises a torso section
having a torso support surface to support at least a portion of a
person's torso. At least a portion of the torso support surface is
generally sloped in the lateral direction at a second angle
relative to the lateral axis. The second angle is from about 1 to
about 25 degrees less than the first angle, such as from about 5 to
about 15 degrees less than the first angle for example. In some
embodiments, the first angle can be from about 15 to about 30
degrees, and the second angle can be from about 0 to about 20
degrees, for example. In some embodiments, the first angle can be
from about 20 to about 30 degrees and the second angle can be from
about 5 to about 15 degrees less than the first angle. Some
embodiments of the mattress can include a leg section having a leg
support surface to support at least a portion of a person's legs,
the leg support surface being generally sloped in the lateral
direction at a third angle relative to the underside surface. The
third angle can be from about 0 degrees to about 15 degrees. In
some embodiments, a bolster is positioned adjacent at a bottom side
of the sloped torso support surface and rising above at least a
portion of the torso support surface. In some embodiments, the head
section is from about 5 inches to about 30 inches in length, the
torso section is from about 15 inches to about 50 inches in length,
and the leg section is from about 25 inches to about 50 inches in
length. Some embodiments may include a lower leg support surface
and thigh surface which are pivotable in the longitudinal direction
relative one another, so as to form an angle between the surfaces
of from about 100 to about 170 degrees. In some embodiments, the
mattress is made at least partially of a flexible material to allow
for the pivoting of the lower leg support surface and the thigh
surface. According to some embodiments, at least one of the head
section and torso section of the mattress comprises an air bladder
configured to inflate to create at least one of the first and
second angles.
[0406] In accordance with one embodiment, a person support
apparatus is provided having a longitudinal length from its head
end to its foot end, and a lateral width from side to side. The
person support apparatus comprises a head section having a head
support surface to support at least a portion of a person's head.
At least a portion of the head support surface is generally sloped
downward in a lateral direction. The person support apparatus
further comprises a torso section having a torso support surface to
support a least a portion of the person's torso. At least a portion
of the torso support surface is generally sloped downward in the
lateral direction, and the slope of the torso support surface is
different from the slope of the head support surface. The apparatus
further comprises a bolster extending along a side of person
support apparatus and extending above the side. In some
embodiments, the bolster does not extend along at least a portion
of a side of the head section. The person support apparatus in some
embodiments further comprises a leg section having a leg support
surface to support at least a portion of a person's leg, and the
leg support surface is flat or has a slope in the lateral direction
which is about equal to or less than the slope of the torso support
surface. In some embodiments, the bolster extends along at least a
portion of the leg section. According to some embodiments, the side
comprises a foot end of the person support apparatus. The head
support surface in some embodiments is sloped at an angle of from
about 10 to about 30 degrees, and the torso support surface is
sloped at an angle of from about 1 to about 20 degrees. In some
embodiments, at least one of the head section and torso section
comprises an air bladder configured to inflate to create at least a
portion of the slope of the section. The person support apparatus
of some embodiments comprises a leg section having a leg support
surface to support at least a portion of a person's leg, and the
leg support surface is flat or is generally downwardly sloped in
the lateral direction at an angle that is less than the angle of
the head support surface, and the leg section is pivotable between
a thigh section and a lower leg section. In some embodiments, the
person support apparatus further comprises a transition surface
sloping between the head section and the torso section.
[0407] Furthermore, a sleeping apparatus is provided in one
embodiment having a longitudinal centerline. The apparatus
comprises at least one bottom surface that is generally horizontal
when the person support apparatus is in a generally horizontal
position for sleeping. The apparatus comprises a head support
section sized to support a person's head. The support section has a
top surface extending from a first side of the longitudinal
centerline to a second side of the longitudinal centerline. The top
surface slopes generally laterally downwardly relative to
horizontal, at an angle of at least approximately 15 degrees, when
the person support apparatus is in a horizontal position, and, at
the same time, has a maximum height greater than the torso support
section, such that the apparatus slopes downwardly from the head
toward the foot.
[0408] In one embodiment, a sleep support apparatus is provided
having a longitudinal axis when in a horizontal position. The sleep
support apparatus comprises a body part support section. The body
support section comprises at least one surface configured to
support at least a portion of a person's body during sleep. The
body support section allows the person's head to turn sideways
substantially in at least one direction. The body support section
urges the longitudinal center plane of the person's face to rest at
a first angle during sleep relative to a vertical plane extending
upwardly against the direction of gravity and along the
longitudinal axis of the sleep support apparatus. The first angle
is equal to or greater than about 35 degrees from the upwardly
extending vertical plane.
[0409] In one embodiment, a sleep apparatus is provided having a
longitudinal dimension moving from a head end to a foot end, and a
lateral dimension moving from a first side to a second side when in
a generally horizontal position for sleeping. The apparatus
comprises a head support section sized to support a person's head.
The head support section is generally laterally sloped moving from
the first side toward the second side, and the head support section
has a height when the sleeping apparatus is in the generally
horizontal position. The apparatus further comprises a torso
support section sized to support a person's torso. The torso
support section is generally laterally sloped moving from the first
side toward the second side, and the torso support section has a
height when the sleeping apparatus is in the generally horizontal
position. The height of the head support section is greater than
the height of the torso support section. In some embodiments, the
height of the head section is the average of the maximum heights of
lateral cross sections of the head section, and the height of the
torso section is the average of the maximum heights of lateral
cross sections of the torso section. In some embodiments, the head
support section slopes generally laterally downwardly relative to
horizontal at an angle of at least about 20 degrees, and the torso
support section slopes generally laterally downwardly relative to
horizontal an angle of at least about 10 degrees. In some
embodiments, the angle of the head support section is the average
angle of slope of tangents to horizontal cross sections of the head
support section, and the angle of the torso support section is the
average angle of slope of tangents to horizontal cross sections of
the torso support section. In some embodiments, the apparatus
comprises a leg support section sized to support a person's legs,
the leg support section is generally laterally sloped moving from
the first side toward the second side, the leg support section has
a height when the sleeping apparatus is in the generally horizontal
position, and the height of the torso support section is greater
than the height of the leg support section.
[0410] In one embodiment, a sleep apparatus is provided having a
longitudinal axis when in a horizontal position. The apparatus
comprises a body part support section, the support section having
at least one surface configured to support at least a portion of a
person's body during sleep, and the body support section allows the
person's head to turn substantially in at least one direction. The
body support section urges the longitudinal center plane of the
person's face to rest at a first angle during sleep relative to a
vertical plane extending upwardly against the direction of gravity
and along the longitudinal axis of the sleep support apparatus. The
first angle is equal to or greater than about 35 degrees from the
upwardly extending vertical plane. In some embodiments, the support
section comprises a head support section or torso support section
sloping generally laterally downwardly. In some embodiments, the
support section further comprises a head support section sloping
generally laterally downwardly at a first angle, and a torso
support section sloping generally laterally downwardly at a second
angle that is different from the first angle. In some embodiments,
the sleep apparatus comprises a bed or mattress.
[0411] In one embodiment, a sleep apparatus is provided having a
longitudinal dimension moving from a head end to a foot end, and a
lateral dimension moving from a first side to a second side when in
a generally horizontal position for sleeping. The apparatus
includes a head support section sized to support a person's head,
and the head support section is generally laterally sloped moving
from the first side toward the second side. The apparatus further
includes a torso support section sized to support a person's torso,
and the torso support section is generally laterally sloped moving
from the first side toward the second side. The sleeping apparatus
is generally longitudinally sloped moving from the head end to the
foot end. In some embodiments, the slopes are achieved by linear
surfaces, non-linear surfaces, or stepped surfaces. In some
embodiments, the apparatus further comprises a leg support section
sized to support a person's legs, and the leg support section is
generally laterally sloped moving from the first side toward the
second side.
[0412] Referring now to FIGS. 134A and 134B, a sleep apnea
prevention apparatus 2100 includes an overlay or ticking 2111 and a
set of inflatable bladders 2118a-e tethered or otherwise coupled to
the overlay 2111 for placement on a support 2104, such as a
mattress. The overlay 2111 covers a top surface 2105 of mattress
2104. The inflatable bladders 2118a-e are connected via pneumatic
lines 2119 (only two of which are shown in FIG. 134B) to a control
unit 2102 having at least one compressor and valve assembly 2120 to
control inflation and deflation of each of the bladders 2118a-e
individually. The control unit is also sometimes referred to herein
as a "controller" or "control box." The apparatus also includes a
sleep monitor 2106 in communication with the controller 2102.
Controller 2102 includes a display 2110 that includes a field
labeled "SLEEP MONITOR" as shown in FIG. 134B (see the field on the
right hand side of display 2110) that shows the user his sleep
progress over one or multiple nights. In the illustrative example,
a daily history graph of sleep information is shown along with
numerical values for the number hours of rapid eye movement (REM)
sleep and light sleep.
[0413] Inflatable bladders 2118a-e include a head tilt bladder
2118a, a torso tilt bladder 2118b, a knee gatch bladder 2118c, a
leg tilt bladder 2118d, and a side bolster bladder 2118e as shown
in FIG. 134b. The amount of inflation of the head, torso and leg
tilt bladders 2118a, 2118b, 2118d dictate the degree of lateral
tilt in the head, torso, and leg sections, respectively, of overlay
2111. More specifically, a head support surface 2121a of the head
section is laterally tilted by bladder 2118a, a torso support
surface 2121b of the torso section is laterally tilted by bladder
2118b, and leg support surface 2121d of the leg section is
laterally tilted by bladder 2118d. Surfaces 2121a-d support the
portions of a person thereabove that their names imply and the
bladders 2118a-d underlie the respective portions of the
person.
[0414] Knee gatch bladder 2118c is inflated to control an amount of
rounded contour in an upper surface 2121c of a knee gatch section
which is located between the torso section and leg section. There
is no lateral tilt to surface 2121c in the illustrative example but
that is not intended to rule out the possibility that surface 2121c
has lateral tilt in other embodiments. The side bolster bladder
2118e is inflated to control an amount of height of a bolster
section above surfaces 2121c, 2121d in the illustrative example.
That is, the bolster section extends longitudinally along one of
the sides of overlay 2111 from a head end of the knee gatch section
to the foot end of the leg section. Thus, there is no bolster
section that extends alongside the head and torso sections in the
illustrative example. The bolster section provides a barrier to
block a person's legs from inadvertently slipping off of overlay
2111.
[0415] As indicated diagrammatically in FIG. 134A, the controller
2102 is controlled by at least one user input 2018 which are
manipulated by a user to adjust the bladders 2118a-e. In some
embodiments, the inflation levels of bladders 2118a-e cannot be
lowered to pressures less than the minimum needed to prevent an
adverse sleep event. Also in some embodiments, the inflation levels
of bladders 2118a-e cannot be raised to pressures greater than the
maximum needed to prevent an adverse sleep event. In other words,
bladders 2118a-e are each inflatable between minimum and maximum
pressures that are within a range of pressures that have been
determined to prevent an adverse sleep event, such as sleep
apnea.
[0416] Again referring to FIG. 134A, controller 2102 includes a
processor 2112 and display 2110 as well as communications circuitry
2114 to permit wired and/or wireless communication with a network
2116 and with the sleep monitor 2106. Sleep monitor 2106 includes
one or more sensors 2122 and communications circuitry 2124 to
provide feedback to the controller 2102 for display 2110 of sleep
progress and trends to a user. In some embodiments, the sleep
monitor 2106 includes a FITBIT.TM. device or similar wearable
device and the one or more sensors comprise an accelerometer.
[0417] Referring now to FIG. 134B, display 2110 of control unit
2102 displays fields having the headings "HEAD SECTION," "TORSO
SECTION," "KNEE GATCH & BOLSTER," and "LEG SECTION." The head,
torso and leg section fields each include an up arrow icon or
button 2130, a down arrow icon or button 2132, and a tilt angle
window 2134. Icons 2130, 2132 of FIG. 134B correspond to the at
least one user input 2108 of FIG. 134A. Each icon 2130 is pressed,
touched, or otherwise selected by a user to increase an amount of
inflation of the respective bladder 2118a, 2118b, 2118d and
therefore, to increase an amount of lateral tilt in the
corresponding surface 2121a, 2121b, 2121d. In a similar fashion,
each icon 2132 is selected by a user to decrease an amount of
inflation of (aka deflate) the respective bladder 2118a, 2118b,
2118d and therefore, to decrease an amount of lateral tilt in the
corresponding surface 2121a, 2121b, 2121d. The angle of tilt of
surfaces 2121a, 2121b, 2121d is indicated in respective windows
2134 and corresponds to an amount of inflation (e.g., a pressure)
of the corresponding bladder 2118a, 2118b, 2118d.
[0418] In the illustrative example, the amount of inflation and
deflation of the knee gatch bladder 2118c and bolster bladder 2118e
is controlled by respective up and down arrow icons 2130, 2132. No
window 2134 is provided in connection with the "KNEE GATCH &
BOLSTER" field because knee gatch bladder 2118c and the bolster
bladder 2118e do not have literal tilts to their respective upper
surfaces. These bladders 2118c, 2118e are inflated and deflated by
any amounts that the user desires within there respective upper and
lower inflation and deflation limits.
[0419] In the illustrative example, overlay 2111 is included as
part of a mattress ticking and so material including sidewall
extensions 2136 and end wall extensions 2138 extend downwardly from
overlay 2111 to cover respective sides 2140 and ends 2142 of
mattress 2104. A stretchable cord or elastic band or similar type
of extensible and retractable element 2144 is provided adjacent the
bottom edges of extensions 2136, 2138 to cinch the lower edges of
extensions 2136, 2138 beneath a bottom surface of mattress 2140 to
retain overlay 2111 of apparatus 2100 in its proper position atop
surface 2105 of mattress 2104. In alternative embodiments, the
ticking includes additional material covering the bottom surface of
mattress 2140 in which case an opening, such as a zippered opening,
is provided in the ticking to permit insertion of mattress 2104
into the interior region of the mattress-receiving envelope defined
by the mattress ticking. In a further variant embodiment, straps
are provided in lieu of, or in addition to, extensions 2136, 2138
and are configured to secure overlay 2111 on mattress 2104. Such
straps are depicted diagrammatically in FIG. 134A in the block
2136, 2138 which is labeled SIDE AND END EXTENSIONS AND/OR
STRAPS
[0420] In another embodiment, a therapeutic sleep surface or person
support apparatus 2200 is provided that will achieve a therapeutic
shape over time as shown in FIGS. 135A-B. As shown in FIG. 135A, an
apparatus 2200 includes one or more foam filled air bladders 2204
and a firm foam base 2202. The firm foam base 2202 is preformed
into a "sleep apnea shape" in this embodiment, although other
therapeutic shapes may be achieved within the scope of this
disclosure. The therapeutic sleep shape of the foam base 2202
includes a lateral angle 2210 defined between an imaginary
horizontal plane 2209 extending horizontally from a nadir or trough
2211 and an inclined upper surface 2212 that extends from the
trough 2211 upwardly toward one side (toward a right side of
apparatus 2200 in the illustrative example). Thus, surface 2212
slopes downwardly, in the illustrative example, from the right side
of apparatus 2200 toward the left side. Angle 2210 may also be
thought of as being defined between a flat bottom surface 2213 of
base 2202 and surface 2212 because plane 2209 and surface 2213 are
parallel (and horizontal) in the illustrative example.
[0421] A lip or bolster hump 2214 is formed in base 2202 to the
left side of trough 2211 to keep the user positioned on the foam
base 2202 when the one or more foam filled bladders 2204 are in the
sleep apnea shape. Thus, the hump 2214 includes an inclined upper
surface 2216 to the left of trough 2211 as viewed in FIGS. 135A-B.
Surface 2216 extends upwardly from trough 2211 toward the left side
of apparatus 2200. The top of hump 2214 and trough 2211 are
generally rounded in shape in the illustrative example. As is
apparent in FIGS. 135A-B, trough 2211 is closer to one side of base
2202 than the other. Thus, trough 2211 is "off center." In the
illustrative example, trough 2211 is closer to the left side of
base 2202 than the right side and is located to accept a person's
left shoulder therein as shown in FIG. 135B when the person is
lying generally in the center of apparatus 2200 and the one or more
bladders 2204 are in the sleep apnea shape.
[0422] At an initial time when the user first gets on the sleep
surface, the foam filled air bladder(s) 2204 has a generally flat
(e.g., horizontal) upper surface 2206, as is typical of sleep
surfaces. An opening 2215 such as an orifice in the one or more
bladders 2204 provides for air to be released from the one or more
bladders 2204 over a predetermined period of time due to the user's
weight on the bladders 2204. In some embodiments, a valve 2217,
such as a check valve, is located within opening 2215 or is
otherwise in communication with opening 2215 such as via a
pneumatic conduit such as tubing as shown in FIG. 135A (in
phantom). After a sufficient amount of time, the one or more
bladders 2204 compress into a shape matching the sleep apnea shape
of base 2202 shown in FIG. 135B due to the application of the
person's weight to upper surface 2206.
[0423] At least some of the air being evacuated from bladder 2204
is air that previously occupied spaces within pores or pockets of
the foam within the bladder(s) 2204, thereby resulting in
compression of the foam within bladder(s) 2204. As the foam inside
the one or more air bladders 2204 compresses, flat surface 2206
slowly transitions from the traditional flat arrangement into a
contoured shape 2208 that conforms generally with the predetermined
sloped shape of the foam base 2202 as shown in FIG. 135B. After
compression of the foam inside bladder(s) 2204 when a person is
lying on apparatus 2200, a first surface portion 2206a slopes
downwardly from the right side of apparatus 2200 toward a trough
2206b that is formed in bladder(s) 2204 above trough 2211 of base
2202.
[0424] As shown in FIG. 135B, an angle 2210' is defined between an
imaginary horizontal plane 2209' extending horizontally from trough
2206b and the inclined surface 2206a that extends from the trough
2206b upwardly toward the right side of apparatus 2200 in the
illustrative example. Angle 2210 and angle 2210' are substantially
the same in the illustrative example. Furthermore, an upper surface
2206c of each bladder 2204 generally matches the contour of upper
surface 2216 of base 2202 after the foam within bladder 2204 has
been compressed. Thus, after the foam in bladder(s) 2204 is
compressed, the sloped shape of surfaces 2206a, 2206b, and 2206c of
bladder(s) 2204 generally matches the sloped shape of surfaces
2212, 2211, and 2216, respectively, of base 2202. When the person
exits apparatus 2200, the foam inside the one or more bladders 2204
is able to expand, due to its natural resiliency, which draws air
through opening 2215 into the respective one or more foam filled
bladders 2204, thereby returning the one or more bladders 2204 to
the configuration having a generally flat upper surface 2206 as
shown in FIG. 135A.
[0425] In some embodiments contemplated by this disclosure, the
time for the air bladder(s) 2204 to transition, or release air,
provides sufficient time for the user to fall asleep on the
traditional flat surface 2206 they are accustomed to and provides
the therapeutic sleep apnea shape, as seen in FIG. 135B, while the
user is asleep. As stated above, in some embodiments, the opening
2215 in the one or more foam filled bladder(s) 2204 each comprises
a check valve that is configured to release air over a
predetermined period of time in response to the weight of the
person on the at least one foam filled bladder. In such
embodiments, the air begins leaving the bladder(s) substantially
immediately upon the user climbing onto surface 2206.
[0426] In some other embodiments, the person support apparatus 2200
includes a controller 2219, such as those disclosed herein in
connection with other embodiments. Controller 2219 includes a timer
2221 in the illustrative example. The controller controls the
transition of apparatus 2200 from the configuration shown in FIG.
135A to the configuration shown in FIG. 135B based on the operation
of timer 2221. For example, in some embodiments, the person support
apparatus 2200 further includes a plug 2223 that blocks the opening
2215 and the controller 2219 is configured to send a signal to move
the plug to open the opening 2215 after a period of time, as
measured by the timer 2221, has elapsed subsequent to the person
lying on the foam filled bladder 2204. The plug 2223 may be
included as a component of a controllable valve 2217 such as a
butterfly valve, gate valve, rotary plate valve, spool valve, ball
valve, solenoid valve, etc. as well as being of the types discussed
herein in connection with other embodiments, for example. It should
be appreciated from the foregoing discussion that, in some
embodiments, the mattress foundation 2202 includes first foam of a
first compressibility (e.g., a first density) and the foam filled
bladder 2204 includes second foam of a second compressibility
(e.g., a second density) that is less than the first
compressibility.
[0427] Referring now to FIG. 136, a process 2300 is provided to
predict a person's intention to shift in his sleep and respond to
the intention with a corresponding therapeutic adjustment of a
person support apparatus or surface of the types disclosed herein
to maintain the person in a therapeutic sleep position. It will be
appreciated that process 2300 is illustrative of software
instructions that are stored in a memory of a controller or control
system that controls a person support apparatus of the types
disclosed throughout the present disclosure and that are executed
by a processor (e.g., a microprocessor or a microcontroller) to
cause the processor to perform the functions indicated in process
2300.
[0428] The system or apparatus implementing process 2300 receives
signals from one or more sensors related to a user on a sleep
surface as indicated at block 2302. The one or more physiological
signals are sensed, for example, by load cells included in the
sleep surface or a bed frame that supports the sleep surface, video
monitoring equipment such as cameras or thermal imaging devices,
acoustic sensors, and/or accelerometers present in the garments or
devices worn by the patient or included in the sleep surface or bed
frame. The received physiological signals are processed to identify
user movement on the sleep surface as indicated at block 2304.
Sensed movement may include, for example, acceleration of body
movement or a particular portion of the body; head tilt; torso,
hip, or shoulder motion; eye movement; changes in bladder pressure;
changes in breathing pattern; and increased agitation or actual
movement, just to name a few.
[0429] As indicated at block 2306, the process determines if the
user intends to move to a new position based on the sensed
movements. If it is determined that the user does not intend to
move to a new position, the process returns to block 2302 and
generally continuously monitor the sensors in a loop. If the user
intends to move to a new position, the process 2300 predicts the
new position the user will most likely move to based on the sensed
movement as indicated at block 2308. Using the predicted new
position, the system implementing process 2300 recalls therapeutic
ranges for the patient support adjustment corresponding to the
predicted new position as indicated at block 2310 and then adjusts
the patient support based on the prediction and therapeutic ranges
for support adjustment as indicated at block 2312, thereby
maintaining the user in a position that is in compliance within
therapeutic ranges during movement on the support surface.
[0430] In some embodiments such as the one illustrated in FIG. 137,
a process 2400 is performed to personalize the therapeutic support
positioning of a person on a person support apparatus based on a
person condition. It will be appreciated that process 2400 is also
illustrative of software instructions that are stored in a memory
of a controller or control system that controls a person support
apparatus of the types disclosed throughout the present disclosure
and that are executed by a processor (e.g., a microprocessor or a
microcontroller) to cause the processor to perform the functions
indicated in process 2400. The processor of the controller receives
physiological parameters of a person or user of the support
apparatus as indicated at block 2402. The received physiological
parameters are compared with stored physiological parameters as
indicated at block 2404. After the received and stored
physiological parameters have been matched, as indicated at 2406,
the corresponding optimum patient support angles corresponding to
the matched stored parameters are received, as indicated at block
2408, and the person support apparatus is adjusted to the optimum
support angles as indicated at block 2410.
[0431] More specifically, person specific measurements are used to
prevent the person from sleeping in a supine position, thereby
avoiding obstructive sleep apnea. Process 2400 uses customized
relationships between sleep surface angle and head rotation in some
embodiments. For example, a gymnast's head may rotate 45 degrees
from a vertical on a 5 degree lateral slope of the patient support.
On the other hand, a football lineman's head may need 45 degree
lateral slope of the patient support to experience the same 45
degree head rotation. Physiological parameters (aka physiological
measurements) are received from stored patient electronic medical
records when the person is a patient, or on-the-spot measurement,
in some embodiments. Alternatively or additionally, physiological
measurements are received from sensors such as those discussed
above in connection with process 2300. The physiological parameters
include one or more of neck circumference, neck/torso range of
motion, body mass index (BMI) and stop-bang index. In some
instances, the matching of the physiological parameters may be a
best-fit determination or a determination of the stored parameters
that most closely match the user's parameters. Process 2400 permits
the therapeutic support system to adjust to provide the minimum
intervention required for the specific patient rather than the tilt
angles required by the average patient.
[0432] Referring now to FIGS. 138A, 138B and 138C, a therapeutic
patient surface system 2500 is provided that is modular and able to
be transferred to various patient supports. System 2500 includes
tilting units 2520a-e that are situated between a mattress 2502 and
a bed frame 2504. In particular, tilting units 2520a-e of system
2500 are placed between a bottom surface of mattress 2502 and an
upper surface of an articulated mattress support deck of bed frame
2504. Such articulated mattress support decks are well known in the
art of patient beds, for example, and are considered to be an
example of a mattress foundation according to this disclosure. Each
of tilting units 2520a-e are situated beneath respective head,
torso, seat (e.g., pelvis), upper leg, and lower leg support
sections of mattress 2592. Thus, in the illustrative example, five
tilting units 2520a-e are provided. In other embodiments of system
2500, more or less that five tilting units are provided.
[0433] System 2500 also includes a controls box or electronics
module 2506 and a handheld controller pendant 2508. Box 2506 is
removably attached to a footboard of bed frame 2504 and pendant
2508 is removably attached to a siderail of bed frame 2504. Thus,
tilting units 2520a-e, box 2506, and pendant 2508 are all coupled
to each other and transferable to different beds. Thus, in some
embodiments, tilting units 2520a-e are coupled together, such as
with flexible tethers or bands, or by placement of tilting units
2520a-e within an envelope of material sized to receive the tilting
units 2520a-e therein. In such embodiments, the coupled-together
units 2520a-e form a unitary layer that is placeable on the
mattress foundation of bed frame 2504.
[0434] Illustrative tilting units 2520a-e each include first,
second and third plates 2522, 2524, 2526 that are coupled together
by first and second hinges 2528, 2530 in a Z-shaped formation as
shown in FIGS. 138B and 138C. Plates 2522, 2524 are pivotably
coupled together by hinge 2528 and plates 2524, 2526 are pivotably
coupled together by hinge 2530. Hinges 2528, 2530 are located at
opposite of the respective tilting units 2520a-e. A first bladder
2532 is situated between plates 2522, 2524 and a second bladder
2534 is situated between plates 2524, 2526. When both bladders
2532, 2534 are deflated, plates 2522, 2524, 2526 are collapsed
together and the section of mattress 2502 above the respective
tilting unit 2520a-e is not tilted laterally in either
direction.
[0435] When bladder 2532 is inflated with bladder 2534 remaining
deflated, the end of plate 2522 opposite from hinge 2528 is lifted
upwardly such that plate 2522 is tilted in a first direction, shown
in FIG. 138B, thereby to tilt the section of mattress 2502 above
the respective tilting unit 2520a-e in the first direction. When
bladder 2534 is inflated with bladder 2532 remaining deflated, the
end of plate 2524 opposite from hinge 2530 is lifted upwardly such
that plate 2524 if tilted in a second direction opposite the first
direction. This movement of plate 2524 also moves hinge 2528
upwardly and tilts plate 2522 along with the deflated bladder 2532
in the second direction. The portion of mattress 2502 above the
respective tilting unit 2520a-e also tilts in the second direction
when plate 2524 is tilted in the second direction.
[0436] In the illustrative example, each of the tilting units
2520a-e includes first and second straps 2536, 2538 that are used
to attach the tilting units 2520a-e to bed frame 2504 such as by
wrapping around an underlying section of the patient support deck
of frame 2504. Straps 2536, 2538 include respective fasteners 2540,
2542 that couple together to thereby secure straps 2536, 2538
together. Fasteners 2540, 2542 comprise hook-and-loop fastener
material, such as VELCRO.RTM. material, in some embodiments.
Alternatively, fasteners 2540, 2542 comprises snaps or buckles or
the like. In other embodiments, fasteners such as hook-and-loop
fastener material patches are provided on plates 2526 for coupling
to underlying mating fasteners provided on the deck sections of bed
frame 2504.
[0437] The inflatable bladders 2532, 2534 are connected via air
fill and sensor lines 2510 to control box 2506 as shown in FIG.
138A. Control box 2506 includes electronics, valves, and one or
more compressors necessary to introduce and remove air from the
bladders 2532, 2534 of tilting units 2520a-e. Thus, controller 2102
of FIG. 134A is also illustrative of the components of control box
2506 shown in FIG. 138A. Handheld control pendant 2508 is connected
to the control box 2506 and has a user interface to allow a patient
or caregiver to control system 2500. In some embodiments the
electronics module 2506 or pendant 2508 includes a timer (see, for
example, the timer 2221 in FIG. 135A) that communicates with the
electronics of module 2506. During a time period in which a patient
typically takes to fall asleep, the tilting units 2520a-e are
controlled to be in the flat or collapsed positions and thereafter,
the components of module 2506 operate to slowly inflate bladders
2532, 2534, as the case may be, to preset therapeutic angles over a
predetermined span of time. The angle of each tilting unit 2520a-e
is individually selectable with pendant 2508.
[0438] Referring now to FIG. 139, a process 2600 is provided to
adjust a patient surface or patient support apparatus, based on the
position of the upper respiratory tract (URT) using the sensed
position of the head as a proxy for the URT position. It will be
appreciated that process 2600 is illustrative of software
instructions that are stored in a memory of a controller or control
system that controls a person support apparatus of the types
disclosed throughout the present disclosure and that are executed
by a processor (e.g., a microprocessor or a microcontroller) to
cause the processor to perform the functions indicated in process
2600.
[0439] As indicated at block 2602, sensor signals are received of a
user on the patient support apparatus or surface. The sensor
signals are received via a machine vision acquisition or a body
worn accelerometer at locations such as the forehead, hear, throat,
or chest in some embodiments. Based on the received sensors
signals, the system determines the head orientation and/or URT
orientation as indicated at block 2604. As indicated at block 2606,
a determination is made regarding whether the head orientation
and/or URT orientation is greater than or equal to 45 degrees
rotated from the vertical orientation. If it is determined at block
2606 that the head orientation and/or URT orientation is greater
than or equal to 45 degrees rotated from the vertical orientation,
this means that the patient is likely not supine, and therefore not
at risk for an apnea episode and no intervention is needed. In such
instances, process 2600 returns back to block 2602 and continues to
sense and receive signals from the patient.
[0440] If it is determined at block 2606 that the head and/or URT
orientation is less than 45 degrees from vertical orientation, this
means the patient is at risk for an apnea event. In response to
this at risk determination at block 2606, the system 2600 advances
to block 2608 and performs an operation to remedy the head
orientation. In some embodiments, the operation indicated at block
2608 includes alerting the patient by providing an audible alert
sufficient to wake the patient so that he may reposition to a safe
sleep orientation. In some embodiments, the operation indicated at
block 2608 includes providing physical or audible patient feedback
to arouse the patient to a lighter sleep state, thus preventing a
sleep state that would be unsafe given their head and/or URT
orientation. In some embodiments, the operation indicated at block
2608 includes the surface adjusting the tilt of the bed to shift
the patient to a new head and/or URT orientation within the safe
range greater than or equal to 45 degrees from the vertical.
Alternatively or additionally, the operation indicated at block
2608 includes providing an alert to a caregiver such as by sending
a notification to one or more of the following: a local audio alert
unit, a local visual alert unit, a nurse call computer, a handheld
device of the caregiver, and an electronic status board. When the
operation 2608 includes movement of the support surface, the system
senses movement of the patient support to the new therapeutic
position as indicated at block 2610. System loops back to block
2606 after sensing movement at block 2610 in the illustrative
example.
[0441] Referring now to FIG. 140, a process 2700 is provided to
minimize uphill supine sleeping of a person on a person support
apparatus. It will be appreciated that process 2700 is illustrative
of software instructions that are stored in a memory of a
controller or control system that controls a person support
apparatus of the types disclosed throughout the present disclosure
and that are executed by a processor (e.g., a microprocessor or a
microcontroller) to cause the processor to perform the functions
indicated in process 2700.
[0442] As indicated at block 2702, sensor signals are received for
a user on a person support apparatus having a head end and a foot
end. Based on the sensor signals, a determination is made regarding
an amount of tilt of a head end of a support relative to a foot end
as indicated at block 2704. As indicated at block 2706 of process
2700, if it is determined that the head end of the bed is tilted to
an elevated position by a sufficient amount relative to the foot
end, the process proceeds to block 2708. If not, the process 2700
returns to block 2702 and again senses the sensor signals. If the
head end is determined at block 2706 to be tilted to an elevation
position sufficiently higher than the foot end, a physiological
parameter of the user is sensed and determined as indicated at
block 2708. The physiological parameter includes, for example, the
amount of head tilt of the person to either side of a vertical
plane of the person. The head tilt may be measured by direct
measurement of a head angle with an accelerometer on the patient's
head, video imaging processing, or microphones placed on the
support at each side of the patient's head to collect and compare
sounds on each side of the head.
[0443] After block 2708, process 2700 proceeds to block 2710 and
determines if the parameter, such as head tilt, is adverse.
Examples of adverse head tilt angles are described above in
connection with FIG. 139. If an adverse parameter is identified,
the head end tilt of the support is adjusted as indicated at block
2712 to avoid a high risk sleeping position and potential apnea
event. In some embodiments, adjustment of the head end tilt
includes elevation and/or lateral adjustments of the support
surface or other portion of the person support apparatus. If an
adverse parameter is not identified at block 2710, process 2700
returns to block 2702 and proceeds therefrom as described
above.
[0444] Referring now to FIG. 141, a process 2800 is provided in
which a single input is used to adjust multiple therapeutic
positional settings of a therapeutic patient surface or a person
support apparatus. An example of a single user input contemplated
by this disclosure is a button 2801 provided on one of the
siderails of bed frame 2504 as shown in FIG. 138A. It will be
appreciated that process 2800 is illustrative of software
instructions that are stored in a memory of a controller or control
system that controls a person support apparatus of the types
disclosed throughout the present disclosure and that are executed
by a processor (e.g., a microprocessor or a microcontroller) to
cause the processor to perform the functions indicated in process
2800.
[0445] As indicated at block 2802, a control receives a user input
such as from button 2801 and in response, proceeds to block 2804 to
recall a number of settings for therapeutic support positions that
are stored in memory of the respective patient support apparatus.
Process 2800 then proceeds to block 2806 to adjust the bed, or
other patient support to achieve the stored therapeutic support
positions. After the stored therapeutic support positions are
achieved, process 2800 proceeds to block 2808 and a bed/support
exit alarm is set.
[0446] Based on the foregoing, it will be appreciated that process
2800 all of the therapeutic support position settings are
accomplished with a single push button 2801, or other command, to
provide the support therapy in a less time consuming manner and
prevent user error in forgetting or failure to accurately set one
or more of the positions. For example, the single user input may
execute an algorithm defining the particular support therapy to be
performed. In a sleep apnea support therapy, for example, the
therapeutic support positions may include: a lateral angle of head
section of the support set to 15 degrees, a lateral angle of a
torso section set to 10 degrees, lateral angle of leg section set
to 0 degrees, a head end of bed angle elevation at 10 degrees, and
a reverse Trendelenburg angle of 2 degrees. Once the support
apparatus has been adjusted to these positions, a bed exit alarm
may be set automatically to alert a caregiver if the person exits
the support apparatus.
[0447] FIGS. 142A-146B illustrate a plurality of positioning
mechanisms that are used to optimize head positional therapy. FIGS.
142A-B, 143, 144 show various mechanisms to address downhill
over-rotation of a patient head on a support surface. For example
and with reference to FIG. 142A, if an upper surface 2900 of a
patient support 2902 is therapeutically laterally tilted, a
patient's head 2904 may rotate past 90.degree. from a vertical head
position plane P, as measured by the position of the patient's nose
eyes, or other facial features, resulting in constriction of the
upper respiratory tract through pressure from compressed tissues.
FIGS. 145A-B and 146 A-B show positioning mechanisms to address
uphill under-rotation of a patient's head 3104, 3204, respectively,
on a patient support 3102, 3202, respectively. For example, if the
patient support 3102, 3202 has a respective upper surface 3100,
3200 that is therapeutically laterally tilted and the patient's
head 3104, 3204, respectively, is facing the uphill direction, the
patient's head 3104, 3203 may be unable to rotate to an angle to
which it would otherwise rotate. This could result in a more
vertical or supine angle of the head as described above with
reference to FIG. 139.
[0448] Referring once again to FIG. 142A, a patient on a support
2902 is shown on surface 2900 with the patient's head 2904 in an
over-rotated downhill position. FIG. 142B shows a head
over-rotation component 2906 in the form of a wedge or shelf that
provides a trimmed uphill angle 2908 to reduce the over-rotation of
the head 2904 while maintaining the angle of tilt of surface 2900
in other regions of the patient's body. In other words, component
2906 occupies the space beneath the patient's head on support 2902
but not the regions under the patient's torso and legs, for
example. As shown in FIG. 142B, component 2906 is configured to
rest atop the therapeutic support 2902 on the downhill side as
viewed from plane P in order to correct over rotation of the head
2904. In the illustrative example, component 2906 is shaped so that
surface 2908 is about 90.degree. with respect to plane P, which
thereby corrects the head over rotation to approximately 90 degrees
from the vertical orientation P, it is within the scope of this
disclosure that shape of component 2906 be modified such that the
trimmed uphill angle provided by component 2906 has different
angles with respect to plane P to provide different angles of head
support for patient-specific correction. In some embodiments,
component 2906 is made of a foam, or other material that provides
sufficient support while providing comfort to the user.
[0449] As shown in FIGS. 143 and 144, over rotation of the head
and/or URT may also be prevented by placing a shoulder shelf, or
pad 3002 or hip block 3004 at positions other than the head. Thus,
pad 3002 and 3004 are examples of head over-rotation components
according to this disclosure. When the torso or lower body rotates,
the head will typically follow. Thus, the embodiments of FIGS. 143
and 144 prevent rotation of the torso and lower body to prevent
corresponding over-rotation of the patient's head.
[0450] In the illustrative example shoulder shelf 3002 comprises a
triangular projection that extends upwardly from an upper surface
3006 of mattress 3000 adjacent to one of the sides of mattress
3000. Such a projection is provided by form or a shaped pillow in
some embodiments and is formed integrally with the rest of mattress
3000 in other embodiments. The shoulder pad 3002 is situated at
approximately the shoulder region of the support and, if not
integrally formed with the rest of mattress 3000, is secured to a
siderail or other support surface using straps and/or VELCRO.RTM.
material in some embodiments. Hip block 3004 is used in addition to
or in lieu of the shoulder pad 3002 to prevent rotation of the
lower body and corresponding rotation of the upper body and
therefore, the person's head. In the illustrative example, hip
block 3004 comprises a cylindrical projection that extends upwardly
from upper surface 3006 of mattress 3000 adjacent one of the sides
of mattress 3000. Cylindrical hip pad 3004 is foam or a pillow
similar to the triangular shaped pad 3002 of FIG. 143 in some
embodiments, and is formed integrally with the rest of mattress
3000 in other embodiments. It is contemplated that, in alternative
embodiments, the cylindrical hip pad 3004 comprises a
longitudinally extending bolster pad to extend along a lower half
of the support.
[0451] FIG. 145A illustrates a tilted patient support 3102 with a
user in an uphill facing orientation on an upper surface 3100 of
support 3102 which is blocking the user's head 3104 from rotating
further away from a vertical supine position. As shown in FIG.
145B, the user's head is no longer blocked from uphill rotation.
Dotted line 3106 in FIG. 145B is indicative of a cut made to the
support 3102 to remove the uphill portion of the support 3102 that
is prohibiting rotation of the patient's head 3104. Alternatively,
line 3106 is indicative of a region of decreased firmness in the
uphill region of the support, allowing the head to rotate more
freely on the uphill side. For example, the region of support 3102
below line 3106 comprises foam of a first density and the region
above line 3106 comprises foam of a second density in which the
first density is greater than the second density. Thus, the region
of support 3102 above line 3106 compresses more easily under the
weight of the person's head 3104 than the region of support 3102
beneath line 3106.
[0452] FIG. 146A shows a support 3202 with an upper surface 3200
that has generally the same rotation inhibiting uphill angle as
shown in FIG. 146A. In FIG. 146B, upper surface 3200 extends
upwardly from a first side of support 3202 and terminates at an
apex or peak 3206. A surface 3200' slopes downwardly from apex 3206
toward the opposite side of support 3202 as also shown in FIG.
146B. Thus, in the embodiment of FIG. 146B free head 3204 rotation
is provide on either side of apex 3206. In some embodiments of
support 3202, inflatable bladders such as those described above are
deflated on the uphill side of head 3204, thereby forming peak 3206
and the surfaces 3200, 3200' sloping downwardly therefrom so that
the therapeutic uphill incline is still maintained on the opposites
sides of peak 3206. Furthermore, it is contemplated in this
embodiment that other sections of the support 3202, such as torso
and leg sections, will still remain in the previous planes while
the head angle is adjusted. In this embodiment, the adjustment of
the bladders may be performed by a control system using sensed
inputs to determine the face angle relative to the uphill and
downhill lateral tilt of the support 3202 using sensors and
processes described above.
[0453] Any theory, mechanism of operation, proof, or finding stated
herein is meant to further enhance understanding of principles of
the present disclosure and is not intended to make the present
disclosure in any way dependent upon such theory, mechanism of
operation, illustrative embodiment, proof, or finding. It should be
understood that while the use of the word preferable, preferably or
preferred in the description above indicates that the feature so
described can be more desirable, it nonetheless cannot be necessary
and embodiments lacking the same can be contemplated as within the
scope of the disclosure, that scope being defined by the claims
that follow.
[0454] In reading the claims it is intended that when words such as
"a," "an," "at least one," "at least a portion" are used there is
no intention to limit the claim to only one item unless
specifically stated to the contrary in the claim. When the language
"at least a portion" and/or "a portion" is used the item can
include a portion and/or the entire item unless specifically stated
to the contrary.
[0455] It should be understood that only selected embodiments have
been shown and described and that all possible alternatives,
modifications, aspects, combinations, principles, variations, and
equivalents that come within the spirit of the disclosure as
defined herein or by any of the following claims are desired to be
protected. While embodiments of the disclosure have been
illustrated and described in detail in the drawings and foregoing
description, the same are to be considered as illustrative and not
intended to be exhaustive or to limit the disclosure to the precise
forms disclosed. Additional alternatives, modifications and
variations can be apparent to those skilled in the art. Also, while
multiple inventive aspects and principles can have been presented,
they need not be utilized in combination, and many combinations of
aspects and principles are possible in light of the various
embodiments provided above.
* * * * *