WO2012098305A1 - Device for the treatment of osa with detection of snoring - Google Patents

Device for the treatment of osa with detection of snoring Download PDF

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Publication number
WO2012098305A1
WO2012098305A1 PCT/FR2011/052955 FR2011052955W WO2012098305A1 WO 2012098305 A1 WO2012098305 A1 WO 2012098305A1 FR 2011052955 W FR2011052955 W FR 2011052955W WO 2012098305 A1 WO2012098305 A1 WO 2012098305A1
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WIPO (PCT)
Prior art keywords
pressure
flow rate
flow
passage
patient
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Application number
PCT/FR2011/052955
Other languages
French (fr)
Inventor
Géraldine CARLOS
Jonathan Macron
Claude Weber
Original Assignee
L'air Liquide,Societe Anonyme Pour L'etude Et L'exploitation Des Procedes Georges Claude
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Application filed by L'air Liquide,Societe Anonyme Pour L'etude Et L'exploitation Des Procedes Georges Claude filed Critical L'air Liquide,Societe Anonyme Pour L'etude Et L'exploitation Des Procedes Georges Claude
Publication of WO2012098305A1 publication Critical patent/WO2012098305A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/087—Measuring breath flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A61B5/4818—Sleep apnoea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6814—Head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6814—Head
    • A61B5/682—Mouth, e.g., oral cavity; tongue; Lips; Teeth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/18—General characteristics of the apparatus with alarm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/35—Communication
    • A61M2205/3546—Range
    • A61M2205/3553—Range remote, e.g. between patient's home and doctor's office
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/35—Communication
    • A61M2205/3546—Range
    • A61M2205/3561—Range local, e.g. within room or hospital
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/35—Communication
    • A61M2205/3576—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver
    • A61M2205/3584—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver using modem, internet or bluetooth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/35—Communication
    • A61M2205/3576—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver
    • A61M2205/3592—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver using telemetric means, e.g. radio or optical transmission
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/82—Internal energy supply devices
    • A61M2205/8206—Internal energy supply devices battery-operated

Definitions

  • An autonomous device for monitoring a treatment of OSA further comprising means for detecting snoring emitted by a patient undergoing treatment for obstructive sleep apnea (OSA).
  • OSA obstructive sleep apnea
  • Obstructive sleep apnea syndrome is a widespread disorder affecting millions of adults, characterized by upper airway obstruction, which can cause snoring or breathing stops during sleep.
  • OSA treatment involves applying positive air pressure to the patient's airways.
  • the air pressure acts as an "air cushion” that keeps the upper airways open and prevents apnea.
  • a CPAP (Continuous Positive Airway Pressure) or CPAP (Continuous Positive Airway Pressure) type apparatus is typically used which delivers slightly pressurized air to the patient's airway via a flexible line called patient circuit, connected to a respiratory mask, usually a nasal mask.
  • treatment with CPAP is very effective if its application is well followed but its effects are negligible, or even nil, if the patient does not observe his treatment for at least 4 hours / night.
  • Knowing the patient's compliance, ie measuring the actual time during which they are following their treatment is therefore essential. Similarly, knowing in real time the effectiveness of treatment is a valuable aid to adjust the prescription treatment by the attending physician.
  • Snoring Detection with Event Detection Respiratory are used to evaluate the effectiveness or not of the treatment.
  • the problem to be solved is therefore to propose an autonomous device for monitoring or observing a treatment of sleep apnea that can provide an analysis of the collected data useful to the physician, in particular respiratory frequency data, flow rate of inspired and exhaled air, pressure supplied to the patient, apnea or hypopnea phases, and may further detect any snoring phases.
  • the solution of the invention is a device for monitoring or observing an AOS treatment with detection of the snoring of the patient, comprising:
  • a gas passage comprising an inlet and an outlet, for example a gas duct,
  • a flow rate determination device connected to the passage, adapted to and designed to determine a flow rate value Q of the gas flowing between the inlet and the outlet of said passage,
  • a first absolute pressure sensor connected at the inlet of the passage to determine a first pressure value P 1,
  • a second absolute pressure sensor connected at the outlet of the passage to determine a second pressure value P2
  • information processing means adapted to and designed to process the values of the flow rate Q and of the pressures P1, P2 and to deduce the occurrence of an information of presence or absence of snoring in the patient and
  • data storage means adapted to and designed to store at least the values of flow rate Q, first pressure P1 and second pressure P 2 measured by, respectively, the flow rate determination device, the first pressure sensor and the second pressure sensor; Pressure sensor.
  • the device of the invention may comprise one or more of the following characteristics:
  • the flow rate determination device is adapted to and designed to determine a volume flow value Q.
  • the gas passage, the flow rate determining device, the first absolute pressure sensor and the second absolute pressure sensor are included in a single housing, that is to say a shell or common cowling.
  • the data storage means and / or the information processing means are also included in the single housing or are located at a distance from said single housing.
  • the single box further comprises transmission means adapted to and designed to transmit data or information.
  • the information processing means comprise at least one micro-controller and an algorithm.
  • the data storage means comprise at least one memory chip, a memory card or any similar storage means, preferably a plug-in memory card, for example an SD card or the like.
  • the transmission means comprise a wireless transmitter system, in particular of the radio frequency, bluetooth, Zigbee, wifi, GSM or GPRS type, and an antenna for ensuring a wireless transmission of data adapted to the type of transmitter and inserted in the case.
  • the radio frequency transmitter system includes a GSM or GPRS modem integrated or external to the common housing.
  • the processing means such as an on-board processor, are adapted to and designed to process the flow and pressure values determined by said flow rate determination device and said sensors and to preferentially deduce therefrom at least one datum of daily processing time and OSA treatment efficacy data, such as apnea / hypopnea index, Respiratory Disturbance Index (RDI), mean treatment pressure, mean flow rate, etc.
  • OSA treatment efficacy data such as apnea / hypopnea index, Respiratory Disturbance Index (RDI), mean treatment pressure, mean flow rate, etc.
  • the processing means are further adapted and designed to determine, through an algorithm, the presence of snoring.
  • the power supply means comprise a power supply with a voltage less than 50 V, for example a battery, a rechargeable battery, a mains power supply with current transformer, typically at a voltage between 2 and 25 V.
  • the algorithm of the processing means is designed and capable of detecting the patient's respiration and the minimum treatment pressure by processing the flow rate and pressure signals measured by said flow rate determining device and said pressure sensor or sensors, depending on the case.
  • the device further comprises one or more indicators, such as colored LEDs, for example red and green, providing the user with information relating to the effectiveness of the treatment applied by means of the device.
  • indicators such as colored LEDs, for example red and green
  • the algorithm of the processing means is adapted to and designed to operate, in addition, a determination of gas flow in the passage from the pressure value PI measured by the first sensor and the volume flow rate Q measured by the device. flow rate determination.
  • the first absolute pressure sensor and the second absolute pressure sensor are preferably sampled at a frequency of 25 Hz.
  • another frequency may also be chosen, for example greater than or less than 25 Hz.
  • the invention also relates to a device for treating the AOS comprising a ventilation machine fluidly connected to the inlet of a device according to the invention, so as to supply said device with pressurized gas, preferably the output of the device according to the invention is connected in turn to a breathing mask or the like, via flexible gas conduits or the like.
  • the invention also relates to a method for detecting snoring of a patient following a treatment of OSA, wherein:
  • step b) the flow and pressure values measured in step a) are processed by means of treatment means
  • step d) detecting an occurrence of snoring during at least a portion of at least one inspiration phase determined in step c) and from the pressure value or values P1, P2 measured in step a),
  • step e) at least one of the values measured in step a) is stored in data storage means
  • step f transmitting, via transmission means, at least one of the values measured in step a).
  • the method of the invention may comprise one or more of the following technical characteristics:
  • step b information processing means comprising at least one microcontroller and an algorithm are implemented.
  • step e) storage means comprising at least one memory chip or a memory card are implemented.
  • step f) means of the transmission means comprising at least one wireless transmitter system and an antenna are implemented.
  • FIG. 1 is a block diagram of an embodiment of a device for monitoring or observing a treatment of AOS with detection of the snoring of the patient according to the present invention
  • FIG. 2 is a diagram of one embodiment of the communication principle of the device of FIG. 1 according to the invention
  • FIG. 3 represents a block diagram illustrating the principle of a computation algorithm applicable in the context of the present invention to determine the occurrence or not of snoring in the patient, and
  • FIG. 4 represents an algorithm for calculating compliance data.
  • a device 10 for monitoring or observing a treatment of the AOS with detection of the snoring of the patient according to the present invention is formed by a housing 11 connected to the path of the patient.
  • respiratory gas typically pressurized air, i.e., on the patient circuit 22 usually formed of one or more flexible lines and connecting an AOS processing machine 20, such as a CPAP type machine or BiPAP, respiratory mask 21, generally nasal, equipping a patient 30 to be treated.
  • connection of the device 10 to the patient circuit 22 is made by means of flexible tubes with conventional tips, for example ferrules of diameter equal to 22 mm and conforming to the ISO 5356-1 standard.
  • the device 10 comprises a housing
  • a flow rate determination device 2 commonly called a “flow sensor” is arranged in the housing 11 and is connected to the passage 1 so as to allow a measurement of the flow rate Q of the gas flowing inside the passage 1 between the entry la and exit lb.
  • the flow rate determination device 2 may be a hot wire flow meter or a depressurizing flow meter, for example.
  • a first and a second absolute pressure sensor 3, 4 are also arranged on this passage 1 so as to allow a determination of the pressure inside the passage 1 of the housing 11 at the inlet 1a and of the output lb, respectively.
  • the pressure sensors 3, 4 may for example be SCP sensors 1000 marketed by the company VTI.
  • the first sensor 3 and the second absolute pressure sensor 4 are sampled at a frequency of 25 Hz, that is, a measurement is taken every 1 / 25th of a second.
  • the pressure tap of the first absolute pressure sensor 3 is connected to the level of the inlet 1a of the passage 1, that is to say at the level of the connection with the duct 22 bringing the air under pressure from the machine 20 , and makes it possible to determine, that is to say, measure, at least a first pressure value PI, while the pressure take-off of the second absolute pressure sensor 4 is connected at the output 1b of the passage 1 , that is to say at the level of the connection with the duct 22 bringing the air under pressure to the patient 30, so after its passage within the housing 11, and allows to determine therein, that is to say, to measure, at least a second pressure value P2.
  • the flow sensor 2, that is to say the flow rate determining device, and said pressure sensors 3, 4 are furthermore connected to processing means 6, such as a micro controller with algorithm (s) , for example the Texas Instruments Cl 110 microcontroller, capable of processing the pressure and flow measurements delivered by the pressure and flow sensors, in order to deduce the daily treatment time and the treatment efficiency of the AOS of the patient P.
  • processing means 6 such as a micro controller with algorithm (s) , for example the Texas Instruments Cl 110 microcontroller, capable of processing the pressure and flow measurements delivered by the pressure and flow sensors, in order to deduce the daily treatment time and the treatment efficiency of the AOS of the patient P.
  • Data storage means 5 are used to store all or part of the data thus measured and / or processed by the processing means 6, for example a data storage memory chip or a plug-in memory card, in particular a flash memory card. 8GB of S ST.
  • transmission means 7 such as an RF radio frequency transmitter and an associated antenna or a GSM / GPRS type modem, are provided in the device 1 1 to enable transmission, preferably via a wireless transmission. all or part of said data to a remote receiver, such as a computer 24 or a server 23, as illustrated in FIG. 2.
  • the radio frequency transmitter or the like may be equipped for example with an 870 MHz antenna of PHYCOMP .
  • Power supply means electrically connected to the various elements or components of the device of the invention provide their power supply, for example a low voltage power supply comprising one or more batteries, batteries ...
  • the device according to the present invention makes it possible to measure, independently of the AOS processing machine used and therefore without using information or data internal to this apparatus, and to remotely communicate, wirelessly, the information relating not only the compliance and effectiveness of a treatment with CPAP, ie the effective duration of treatment of patients, but also the possible presence of snoring phases in the patient treated in this way ...
  • the device of the invention has a recording capacity of several months, preferably at least 1 year, which can be further extended.
  • the device can communicate the data recorded by RF radio frequency, for example at a transmission frequency of 868 MHz or 2.4 GHz, to a computer, a PDA, a server or any other means capable of directly recording the transmitted data, as shown schematically. in Figure 2.
  • the device transmits remotely using the RF device or integrated GSM or GPRS modem which sends the data records of compliance and efficiency of the treatment of the patient to the care center for example, where a server 23 adapted to generate reports of compliance and treatment efficiency .
  • Figure 3 represents a block diagram illustrating the principle of a calculation algorithm applicable in the context of the present invention to determine the occurrence or not of snoring in the patient.
  • step 1 determination and storage / historization of PI, P2 and Q values
  • step 2 determination of the operating state of the machine for processing the
  • step 3 determining the beginning and end of the inspiratory phase from the value of Q.
  • step 4 actual determination of snoring during the inspiration phase from P2.
  • step 1 after determining the absolute pressures P1, P2 by the pressure sensors 2, 3 and the volume flow rate Q by the flow sensor 4, the measured values (ie signals) are stored and historized, as such. and / or in groups of n last values (with n> 2), within the data storage means 5.
  • step 2 the values of first pressure PI and volume flow are used
  • step 3 the volume flow value Q is used to detect the start and end times of the patient's inspiratory phases.
  • the flow signal Q is analyzed as follows:
  • the average flow rate Qmoy is first estimated from the flow data history stored in step 1.
  • the rate Q is such that: Q (to)> Q m0y + ⁇ ; and if and at time t 0 -dt, the rate Q is such that: Q (t 0 -dt) ⁇ Q moy + ⁇ ; where ⁇ is a margin to avoid detecting noise measuring like breaths, then the moment t 0 is considered to be the beginning of the patient's inspiration.
  • the inspired air volume V (t) is estimated by integrating the flow integral for a given duration, measured from the instant t 0 , that is: Q.dt
  • the end of the inspiration is then defined as the moment ti between to and t 2 , for which V (t) is maximal; t 2 being the start time of the patient's next inspiration.
  • step 4 the pressure signal or signals P2 are isolated during all or part of or inspiration phases, between the instants t 0 and ti estimated previously, and the standard deviation ⁇ is measured.
  • the device of the invention can also measure the patient's treatment time and its efficiency when it is treated, and this, using the pressure measurements PI, P2 and flow rate Q operated in the passage of gas 1 of the device of the invention.
  • the effectiveness of the treatment is then deduced from the variations in pressure and flow rate related to the inspirations / expirations of the patient and the level of treatment pressure, taking into account the number and / or the snoring time occurring during the treatment as determined. above.
  • the time can be divided into periods of a fixed duration that is called T, typically periods of 1 minute per minute. example.
  • a second algorithm also integrated in the processing means 6, determines whether during this period T the patient follows his treatment and if so, he counts the number of periods during which the patient has followed his treatment and calculates the duration of treatment follow-up.
  • conditionP and conditionQ Two conditions which are necessary and sufficient to determine if during this period the treatment was followed, to know :
  • conditionP a condition on the pressure: conditionP. If the average pressure P in the patient circuit is sufficiently elevated relative to atmospheric pressure Patm, then the patient circuit is connected to the OAS treatment apparatus and the latter operates, i.e. it delivers a positive pressure of at least 4 cm H 2 0, thus greater than a minimum pressure value prefixed P. limit. - a condition on the flow: conditionQ. If the standard deviation of the ETQ rate signal exceeds a certain threshold AND limit, then the flow measurements vary with an amplitude that can only be due to the breathing of the patient in the mask.
  • conditionP and conditionQ it is deduced whether the treatment has taken place or not during the time period T considered and, if so, the duration of treatment Dt which corresponds to the number N of treatment periods multiplied by the duration of period T.
  • the device of the invention allows an observance and an effective follow-up of the patients by detecting and taking into account the snoring of the patients.
  • the automatic delivery of the results of observance and effectiveness of the treatment is carried out daily and without moving of a speaker since everything is done at a distance.
  • the device of the invention is used in the context of any method of therapeutic treatment of obstructive sleep apnea syndrome (OSA) of a patient characterized in particular by an obstruction of his upper airways.
  • OSA obstructive sleep apnea syndrome

Abstract

The invention relates to a device for monitoring the treatment of OSA and the detection of snoring in a patient. The device comprises: a gas passage (1) including an inlet (1a) and an outlet (1b); a flow-rate-determining device (2) which is connected to the passage (1) and which is designed to determine a flow rate value (Q) for the gas flowing between the inlet (1a) and the outlet (1b) of the passage (1); a first absolute pressure sensor (3) connected at the inlet (1a) of the passage (1) in order to determine a first pressure value (P1); a second absolute pressure sensor (4) connected at the output (1b) of the passage (1) in order to determine a second pressure value (P2); information processing means (6) designed to process the flow rate (Q) and pressure (P1, P2) values and to deduce therefrom the occurrence of information relating to the presence or absence of snoring in a patient; and data storage means (5) designed to store at least the flow rate (Q), first pressure (P1) and second pressure (P2) values measured respectively by the flow-rate-determining device (2), the first pressure sensor (3) and the second pressure sensor (4).

Description

Dispositif de traitement de l'AOS avec détection des ronflements  AOS treatment device with snoring detection
L'invention porte sur un dispositif autonome de suivi d'un traitement de l'AOS comprenant en outre des moyens de détection des ronflements émis par un patient soumis à un traitement de l'apnée obstructive du sommeil (AOS). An autonomous device for monitoring a treatment of OSA further comprising means for detecting snoring emitted by a patient undergoing treatment for obstructive sleep apnea (OSA).
Le syndrome d'apnée obstructive du sommeil (SAOS) est un trouble répandu affectant des millions d'adultes, qui se caractérise par une obstruction des voies aériennes supérieures, laquelle peut provoquer des ronflements ou des arrêts de la respiration durant le sommeil.  Obstructive sleep apnea syndrome (OSA) is a widespread disorder affecting millions of adults, characterized by upper airway obstruction, which can cause snoring or breathing stops during sleep.
Un traitement classique du SAOS consiste à appliquer une pression positive d'air aux voies respiratoires du patient. La pression d'air agit comme un "coussin d'air" qui maintient ouvertes les voies respiratoires supérieures et empêche les apnées. Pour ce faire, on utilise typiquement un appareil de type à PPC (pour Pression Positive Continue) ou CPAP (en anglais pour Continuons Positive Airway Pressure) qui délivre de l'air légèrement pressurisé aux voies aériennes du patient, via une conduite souple, appelée circuit patient, reliée à un masque respiratoire, généralement un masque nasal.  Conventional OSA treatment involves applying positive air pressure to the patient's airways. The air pressure acts as an "air cushion" that keeps the upper airways open and prevents apnea. To do this, a CPAP (Continuous Positive Airway Pressure) or CPAP (Continuous Positive Airway Pressure) type apparatus is typically used which delivers slightly pressurized air to the patient's airway via a flexible line called patient circuit, connected to a respiratory mask, usually a nasal mask.
Toutefois, le traitement par PPC est vraiment efficace si son application est bien suivie mais ses effets sont négligeables, voire nuls, si le patient n'observe pas son traitement pendant au moins 4 h/nuit.  However, treatment with CPAP is very effective if its application is well followed but its effects are negligible, or even nil, if the patient does not observe his treatment for at least 4 hours / night.
Connaître l'observance des patients, c'est-à-dire mesurer le temps réel pendant lequel ils suivent leur traitement est donc essentiel. De même, connaître en temps « réel » l'efficacité du traitement est une aide précieuse pour ajuster la prescription du traitement par le médecin traitant.  Knowing the patient's compliance, ie measuring the actual time during which they are following their treatment is therefore essential. Similarly, knowing in real time the effectiveness of treatment is a valuable aid to adjust the prescription treatment by the attending physician.
Les systèmes d'observance et d'efficacité actuels sont généralement intégrés aux machines de traitement du SAOS et les résultats ne sont connus qu'en temps différé, c'est-à- dire typiquement entre 1 et 3 mois après passage au domicile du patient d'un personnel de suivi du traitement qui récupère les données enregistrées sur carte mémoire ou via une communication avec un ordinateur.  Current compliance and efficacy systems are generally integrated with OSAS machines, and results are known only in deferred time, typically between 1 and 3 months after passage to the patient's home. a treatment tracker who retrieves the data stored on a memory card or via a communication with a computer.
On comprend que ce délai n'est pas idéal si l'on veut obtenir un suivi en temps réel ou quasi réel du patient, de manière à pouvoir réagir rapidement si l'on s'aperçoit que le patient ne suit pas ou alors mal son traitement, et/ou que le traitement n'est pas adapté.  We understand that this delay is not ideal if we want to obtain a real-time or near-real-time follow-up of the patient, so that we can react quickly if we realize that the patient is not following his or her treatment, and / or that the treatment is not suitable.
En outre, les machines de traitement actuelles ont souvent une fonction d'observance intégrée mais totalement spécifique de chaque machine, ce qui n'est pas pratique. De plus, le format du rapport d'observance est également spécifique et il n'est donc pas toujours aisé d'interpréter des données d'observance provenant d'une machine par rapport à une autre.  In addition, current processing machines often have an integrated compliance function but totally specific to each machine, which is not practical. In addition, the format of the compliance report is also specific and it is not always easy to interpret compliance data from one machine to another.
Par ailleurs, pouvoir détecter les ronflements des patients atteints de SOAS est également primordial car ils sont le signe d'un affaissement des voies aériennes supérieures malgré le traitement. La détection des ronflements avec la détection des événements respiratoires (apnées, hypopnées et limitation de débit) permettent d'évaluer l'efficacité ou non du traitement. Moreover, being able to detect the snoring of patients with SOAS is also essential because they are the sign of a collapse of the upper airways despite the treatment. Snoring Detection with Event Detection Respiratory (apnea, hypopnea and flow limitation) are used to evaluate the effectiveness or not of the treatment.
Le problème à résoudre est dès lors de proposer un dispositif autonome de suivi ou d'observance d'un traitement de l'apnée du sommeil pouvant fournir une analyse des données recueillies utile au médecin, en particulier des données de fréquence respiratoire, débit d'air inspiré et expiré, pression fournie au patient, phases d'apnée ou d'hypopnée, et pouvant en outre détecter d'éventuelles phases de ronflements.  The problem to be solved is therefore to propose an autonomous device for monitoring or observing a treatment of sleep apnea that can provide an analysis of the collected data useful to the physician, in particular respiratory frequency data, flow rate of inspired and exhaled air, pressure supplied to the patient, apnea or hypopnea phases, and may further detect any snoring phases.
La solution de l'invention est un dispositif de suivi ou d'observance d'un traitement de Γ AOS avec détection des ronflements du patient, comprenant :  The solution of the invention is a device for monitoring or observing an AOS treatment with detection of the snoring of the patient, comprising:
- un passage de gaz comprenant une entrée et une sortie, par exemple un conduit de gaz,  a gas passage comprising an inlet and an outlet, for example a gas duct,
- un dispositif de détermination de débit, raccordé au passage, apte à et conçu pour déterminer une valeur de débit Q du gaz circulant entre l'entrée et la sortie dudit passage, a flow rate determination device, connected to the passage, adapted to and designed to determine a flow rate value Q of the gas flowing between the inlet and the outlet of said passage,
- un premier capteur de pression absolue connecté au niveau de l'entrée du passage pour déterminer une première valeur pression P 1 , a first absolute pressure sensor connected at the inlet of the passage to determine a first pressure value P 1,
- un deuxième capteur de pression absolue connecté au niveau de la sortie du passage pour déterminer une deuxième valeur pression P2,  a second absolute pressure sensor connected at the outlet of the passage to determine a second pressure value P2,
- des moyens de traitement d'information aptes à et conçus pour traiter les valeurs de débit Q et de pressions PI, P2 et en déduire l'occurrence d'une information de présence ou d'absence de ronflements chez le patient et  information processing means adapted to and designed to process the values of the flow rate Q and of the pressures P1, P2 and to deduce the occurrence of an information of presence or absence of snoring in the patient and
- des moyens de stockage de données aptes à et conçus pour mémoriser au moins les valeurs de débit Q, de première pression PI et de deuxième pression P2 mesurées par, respectivement, le dispositif de détermination de débit, le premier capteur de pression et le deuxième capteur de pression.  data storage means adapted to and designed to store at least the values of flow rate Q, first pressure P1 and second pressure P 2 measured by, respectively, the flow rate determination device, the first pressure sensor and the second pressure sensor; Pressure sensor.
Selon le cas, le dispositif de l'invention peut comprendre l'une ou plusieurs des caractéristiques suivantes : As the case may be, the device of the invention may comprise one or more of the following characteristics:
- le dispositif de détermination de débit est apte à et conçu pour déterminer une valeur de débit volumique Q.  the flow rate determination device is adapted to and designed to determine a volume flow value Q.
- le passage de gaz, le dispositif de détermination de débit, le premier capteur de pression absolue et le deuxième capteur de pression absolue sont compris dans un boîtier unique, c'est-à-dire une coque ou capotage commun.  - The gas passage, the flow rate determining device, the first absolute pressure sensor and the second absolute pressure sensor are included in a single housing, that is to say a shell or common cowling.
- les moyens de stockage de données et/ou les moyens de traitement d'information sont également compris dans le boîtier unique ou sont situés à distance dudit boîtier unique.  - The data storage means and / or the information processing means are also included in the single housing or are located at a distance from said single housing.
- le boîtier unique comprend en outre des moyens d'émission aptes à et conçus pour transmettre des données ou des informations.  the single box further comprises transmission means adapted to and designed to transmit data or information.
- les moyens de traitement d'information comprennent au moins un micro contrôleur et un algorithme. - les moyens de stockage de données comprennent au moins une puce mémoire, une carte mémoire ou tout moyen de stockage analogue, de préférence une carte mémoire enfichable, par exemple une carte SD ou similaire. the information processing means comprise at least one micro-controller and an algorithm. - The data storage means comprise at least one memory chip, a memory card or any similar storage means, preferably a plug-in memory card, for example an SD card or the like.
- les moyens d'émission comprennent un système émetteur sans fil, notamment de type radio fréquence, bluetooth, Zigbee, wifi, GSM ou GPRS, et une antenne permettant d'assurer une transmission sans fil des données adaptée au type d'émetteur et insérée dans le boîtier.  the transmission means comprise a wireless transmitter system, in particular of the radio frequency, bluetooth, Zigbee, wifi, GSM or GPRS type, and an antenna for ensuring a wireless transmission of data adapted to the type of transmitter and inserted in the case.
- le système émetteur radio fréquence comprend un modem GSM ou GPRS intégré ou extérieur au boîtier commun.  - The radio frequency transmitter system includes a GSM or GPRS modem integrated or external to the common housing.
- les moyens de traitement, tel un processeur embarqué, sont aptes à et conçus pour traiter les valeurs de débit et de pression déterminées par ledit dispositif de détermination de débit et lesdits capteurs et en déduire préférentiellement au moins une donnée de durée de traitement journalier et des données d'efficacité de traitement de l'AOS, par exemple l'indice d'apnée/hypopnée, l'indice de troubles respiratoire ou Respiratory Disturbance Index (RDI) , la pression de traitement moyenne, le débit moyen...  the processing means, such as an on-board processor, are adapted to and designed to process the flow and pressure values determined by said flow rate determination device and said sensors and to preferentially deduce therefrom at least one datum of daily processing time and OSA treatment efficacy data, such as apnea / hypopnea index, Respiratory Disturbance Index (RDI), mean treatment pressure, mean flow rate, etc.
- les moyens de traitement sont, en outre, aptes à et conçus pour déterminer, grâce à un algorithme, la présence de ronflements.  - The processing means are further adapted and designed to determine, through an algorithm, the presence of snoring.
- il comprend en outre des moyens d'alimentation en courant électrique raccordés électriquement au dispositif de détermination de débit, aux capteurs de pression, aux moyens de stockage de données et/ou aux moyens d'émission.  it furthermore comprises power supply means electrically connected to the flow rate determination device, pressure sensors, data storage means and / or transmission means.
- les moyens d'alimentation en courant électrique comprennent une alimentation électrique à tension inférieure à 50 V, par exemple une pile, une batterie rechargeable, une alimentation secteur avec transformateur de courant, typiquement à tension comprise entre 2 et 25 V.  - The power supply means comprise a power supply with a voltage less than 50 V, for example a battery, a rechargeable battery, a mains power supply with current transformer, typically at a voltage between 2 and 25 V.
- l'algorithme des moyens de traitement est conçu pour et apte à détecter la respiration du patient et la pression minimale de traitement par traitement des signaux de débit et de pression mesurés par ledit dispositif de détermination de débit et ledit ou lesdits capteurs de pression, selon le cas.  the algorithm of the processing means is designed and capable of detecting the patient's respiration and the minimum treatment pressure by processing the flow rate and pressure signals measured by said flow rate determining device and said pressure sensor or sensors, depending on the case.
- il comprend en outre un ou des indicateurs, telles des LEDs de couleurs, par exemple rouge et verte, fournissant à l'utilisateur une information relative à l'efficacité du traitement appliqué au moyen du dispositif.  it further comprises one or more indicators, such as colored LEDs, for example red and green, providing the user with information relating to the effectiveness of the treatment applied by means of the device.
- l'algorithme des moyens de traitement est apte à et conçu pour opérer, en outre, une détermination de circulation de gaz dans le passage à partir de la valeur de pression PI mesurée par le premier capteur et de débit volumique Q mesuré par le dispositif de détermination de débit.  the algorithm of the processing means is adapted to and designed to operate, in addition, a determination of gas flow in the passage from the pressure value PI measured by the first sensor and the volume flow rate Q measured by the device. flow rate determination.
- le premier capteur de pression absolue et le deuxième capteur de pression absolue sont échantillonnés de préférence à une fréquence de 25 Hz. Toutefois, si besoin est, une autre fréquence peut aussi être choisie, par exemple supérieure ou inférieure à 25 Hz. Selon un autre aspect, l'invention porte aussi sur un appareillage de traitement de l'AOS comprenant une machine de ventilation reliée fluidiquement à l'entrée d'un dispositif selon l'invention, de manière à alimenter ledit dispositif en gaz sous pression, de préférence la sortie du dispositif selon l'invention est reliée quant à elle, à un masque respiratoire ou analogue, par l'intermédiaire de conduits de gaz flexibles ou similaires. the first absolute pressure sensor and the second absolute pressure sensor are preferably sampled at a frequency of 25 Hz. However, if need be, another frequency may also be chosen, for example greater than or less than 25 Hz. According to another aspect, the invention also relates to a device for treating the AOS comprising a ventilation machine fluidly connected to the inlet of a device according to the invention, so as to supply said device with pressurized gas, preferably the output of the device according to the invention is connected in turn to a breathing mask or the like, via flexible gas conduits or the like.
Selon encore un autre aspect, l'invention concerne également un procédé de détection des ronflements d'un patient suivant un traitement de l'AOS, dans lequel :  In yet another aspect, the invention also relates to a method for detecting snoring of a patient following a treatment of OSA, wherein:
a) on détermine au moyen d'un premier et d'un deuxième capteur de pression absolue et d'un capteur de débit des valeurs de pressions PI, P2 et de débit Q du gaz circulant entre l'entrée et la sortie du passage de gaz d'un dispositif selon l'invention relié fluidiquement à un appareil de traitement de l'AOS,  a) determining by means of a first and a second absolute pressure sensor and a flow sensor the pressure values PI, P2 and flow rate Q of the gas flowing between the inlet and the outlet of the flow passage; gas of a device according to the invention fluidly connected to an apparatus for treating AOS,
b) on traite les valeurs de débit et de pression mesurées à l'étape a), au moyen de moyens de traitement,  b) the flow and pressure values measured in step a) are processed by means of treatment means,
c) on détermine le début et la fin de chaque phase inspiratoire du patient à partir d'au moins une valeur de débit Q mesurée à l'étape a),  c) determining the beginning and the end of each inspiratory phase of the patient from at least one flow rate value Q measured in step a),
d) on détecte une survenance de ronflements pendant au moins une partie d'au moins une phase d'inspiration déterminée à l'étape c) et à partir de la ou des valeurs de pressions PI, P2 mesurées à l'étape a),  d) detecting an occurrence of snoring during at least a portion of at least one inspiration phase determined in step c) and from the pressure value or values P1, P2 measured in step a),
e) on mémorise dans des moyens de stockage de données, au moins l'une des valeurs mesurées à l'étape a),  e) at least one of the values measured in step a) is stored in data storage means,
f) on transmet, via des moyens d'émission, au moins l'une des valeurs mesurées à l'étape a).  f) transmitting, via transmission means, at least one of the values measured in step a).
Selon le cas, le procédé de l'invention peut comprendre l'une ou plusieurs des caractéristiques techniques suivantes :  Depending on the case, the method of the invention may comprise one or more of the following technical characteristics:
- à l'étape b), on met en œuvre des moyens de traitement d'information comprenant au moins un microcontrôleur et un algorithme.  in step b), information processing means comprising at least one microcontroller and an algorithm are implemented.
- à l'étape e), on met en œuvre des moyens de stockage comprenant au moins une puce mémoire ou une carte mémoire.  in step e), storage means comprising at least one memory chip or a memory card are implemented.
- à l'étape f), on met en œuvre des moyens des moyens d'émission comprenant au moins un système émetteur sans fil et une antenne.  in step f) means of the transmission means comprising at least one wireless transmitter system and an antenna are implemented.
L'invention va être mieux comprise grâce à la description suivante, faite en références aux Figures annexées parmi lesquelles :  The invention will be better understood thanks to the following description, given with reference to the appended figures among which:
- la Figure 1 est un schéma de principe d'un mode de réalisation d'un dispositif de suivi ou d'observance d'un traitement de l'AOS avec détection des ronflements du patient selon la présente invention,  FIG. 1 is a block diagram of an embodiment of a device for monitoring or observing a treatment of AOS with detection of the snoring of the patient according to the present invention,
- la Figure 2 est un schéma d'un mode de réalisation du principe de communication du dispositif de la Figure 1 selon l'invention, - la Figure 3 représente un synoptique illustrant le principe d'un algorithme de calcul applicable dans le cadre de la présente invention pour déterminer la survenance ou non de ronflements chez le patient, et FIG. 2 is a diagram of one embodiment of the communication principle of the device of FIG. 1 according to the invention, FIG. 3 represents a block diagram illustrating the principle of a computation algorithm applicable in the context of the present invention to determine the occurrence or not of snoring in the patient, and
- la Figure 4 représente un algorithme de calcul de données d'observance.  FIG. 4 represents an algorithm for calculating compliance data.
Comme illustré sur les Figures 1 et 2, un dispositif 10 de suivi ou d'observance d'un traitement de l'AOS avec détection des ronflements du patient selon la présente invention est formé d'un boîtier 11 venant se raccorder sur le trajet du gaz respiratoire, typiquement de l'air sous pression, c'est-à-dire sur le circuit 22 patient formé habituellement d'une ou plusieurs conduites flexibles et reliant une machine 20 de traitement de l'AOS, telle une machine de type CPAP ou BiPAP, au masque respiratoire 21, en général nasal, équipant un patient 30 à traiter.  As illustrated in FIGS. 1 and 2, a device 10 for monitoring or observing a treatment of the AOS with detection of the snoring of the patient according to the present invention is formed by a housing 11 connected to the path of the patient. respiratory gas, typically pressurized air, i.e., on the patient circuit 22 usually formed of one or more flexible lines and connecting an AOS processing machine 20, such as a CPAP type machine or BiPAP, respiratory mask 21, generally nasal, equipping a patient 30 to be treated.
La connexion du dispositif 10 au circuit patient 22 se fait au moyen de tubes flexibles à embouts classiques, par exemple des embouts de diamètre égal à 22 mm et conformes à la norme ISO 5356-1.  The connection of the device 10 to the patient circuit 22 is made by means of flexible tubes with conventional tips, for example ferrules of diameter equal to 22 mm and conforming to the ISO 5356-1 standard.
Plus précisément, comme schématisé en Figure 1, le dispositif 10 comporte un boîtier More specifically, as shown diagrammatically in FIG. 1, the device 10 comprises a housing
11 avec un passage 1 interne de gaz, tel un conduit, avec une entrée la et une sortie lb au sein duquel transite le gaz débité par l'appareil de traitement de l'AOS, avant d'être envoyé au patient. Le gaz y circule depuis l'entrée la vers la sortie lb. 11 with an internal gas passage 1, such as a conduit, with an inlet 1a and an outlet 1b in which transits the gas delivered by the AOS treatment apparatus, before being sent to the patient. The gas flows from the inlet to the outlet lb.
Un dispositif de détermination de débit 2, couramment appelé « capteur de débit », est agencé dans le boîtier 11 et est relié au passage 1 de manière à permettre une mesure du débit Q du gaz circulant à l'intérieur du passage 1 entre l'entrée la et la sortie lb.  A flow rate determination device 2, commonly called a "flow sensor", is arranged in the housing 11 and is connected to the passage 1 so as to allow a measurement of the flow rate Q of the gas flowing inside the passage 1 between the entry la and exit lb.
Le dispositif de détermination de débit 2 peut être un débitmètre à fil chaud ou un débitmètre déprimogène par exemple.  The flow rate determination device 2 may be a hot wire flow meter or a depressurizing flow meter, for example.
Par ailleurs, un premier et un deuxième capteur de pression absolue 3, 4 sont également agencés sur ce passage 1 de manière à permettre une détermination de la pression régnant à l'intérieur du passage 1 du boîtier 11 au niveau de l'entrée la et de la sortie lb, respectivement.  Furthermore, a first and a second absolute pressure sensor 3, 4 are also arranged on this passage 1 so as to allow a determination of the pressure inside the passage 1 of the housing 11 at the inlet 1a and of the output lb, respectively.
Les capteurs de pression 3, 4 peuvent être par exemple des capteurs SCP 1000 commercialisés par la société VTI.  The pressure sensors 3, 4 may for example be SCP sensors 1000 marketed by the company VTI.
Avantageusement, le premier capteur 3 et le deuxième capteur de pression absolue 4 sont échantillonnés à une fréquence de 25 Hz, c'est-à-dire qu'une mesure est prise tous les l/25ème de seconde.  Advantageously, the first sensor 3 and the second absolute pressure sensor 4 are sampled at a frequency of 25 Hz, that is, a measurement is taken every 1 / 25th of a second.
La prise de pression du premier capteur de pression absolue 3 est connectée au niveau de l'entrée la du passage 1, c'est-à-dire au niveau de la connexion avec le conduit 22 amenant l'air sous pression depuis la machine 20, et permet d'y déterminer, c'est-à-dire y mesurer, au moins une première valeur pression PI, alors que la prise de pression du deuxième capteur de pression absolue 4 est connectée au niveau de la sortie lb du passage 1, c'est-à-dire au niveau de la connexion avec le conduit 22 amenant l'air sous pression vers le patient 30, donc après son passage au sein du boîtier 11, et permet d'y déterminer, c'est-à-dire mesurer, au moins une deuxième valeur pression P2. The pressure tap of the first absolute pressure sensor 3 is connected to the level of the inlet 1a of the passage 1, that is to say at the level of the connection with the duct 22 bringing the air under pressure from the machine 20 , and makes it possible to determine, that is to say, measure, at least a first pressure value PI, while the pressure take-off of the second absolute pressure sensor 4 is connected at the output 1b of the passage 1 , that is to say at the level of the connection with the duct 22 bringing the air under pressure to the patient 30, so after its passage within the housing 11, and allows to determine therein, that is to say, to measure, at least a second pressure value P2.
Le capteur de débit 2, c'est-à-dire le dispositif de détermination de débit, et lesdits capteurs de pression 3, 4 sont connectés par ailleurs à des moyens de traitement 6, tel qu'un micro contrôleur à algorithme(s), par exemple le micro contrôleur Cl 110 de Texas Instruments, capables de traiter les mesures de pression et de débit délivrées par les capteurs de pression et débit, afin d'en déduire la durée de traitement journalier et l'efficacité du traitement de l'AOS du patient P.  The flow sensor 2, that is to say the flow rate determining device, and said pressure sensors 3, 4 are furthermore connected to processing means 6, such as a micro controller with algorithm (s) , for example the Texas Instruments Cl 110 microcontroller, capable of processing the pressure and flow measurements delivered by the pressure and flow sensors, in order to deduce the daily treatment time and the treatment efficiency of the AOS of the patient P.
Des moyens de stockage de données 5 sont utilisés pour mémoriser tout ou partie des données ainsi mesurées et/ou traitées par les moyens de traitement 6, par exemple une puce mémoire d'enregistrement de données ou une carte mémoire enfichable, notamment une carte mémoire flash de 8 Go de S ST.  Data storage means 5 are used to store all or part of the data thus measured and / or processed by the processing means 6, for example a data storage memory chip or a plug-in memory card, in particular a flash memory card. 8GB of S ST.
Par ailleurs, des moyens d'émission 7, tel un émetteur de type radio fréquence RF et une antenne associée ou un modem de type GSM/GPRS, sont prévus dans le dispositif 1 1 pour permettre de transmettre, de préférence via une transmission sans fil, tout ou partie desdites données vers un récepteur situé à distance, tel un ordinateur 24 ou un serveur 23, comme illustré sur la Figure 2. L'émetteur radio fréquence ou analogue peut être équipé par exemple d'une antenne de 870 MHz de PHYCOMP.  Furthermore, transmission means 7, such as an RF radio frequency transmitter and an associated antenna or a GSM / GPRS type modem, are provided in the device 1 1 to enable transmission, preferably via a wireless transmission. all or part of said data to a remote receiver, such as a computer 24 or a server 23, as illustrated in FIG. 2. The radio frequency transmitter or the like may be equipped for example with an 870 MHz antenna of PHYCOMP .
Des moyens d'alimentation en courant électrique raccordés électriquement aux différents éléments ou composants du dispositif de l'invention assurent leur alimentation électrique, par exemple une alimentation électrique à basse tension comprenant une ou plusieurs batteries, piles...  Power supply means electrically connected to the various elements or components of the device of the invention provide their power supply, for example a low voltage power supply comprising one or more batteries, batteries ...
Le dispositif selon la présente invention permet de mesurer, indépendamment de la machine de traitement de l'AOS utilisée et donc sans utiliser d'information ou de donnée interne à cet appareil, et de communiquer à distance, sans fil, les informations relatives non seulement à l'observance et à l'efficacité d'un traitement par PPC, c'est-à-dire la durée de traitement effective des patients, mais aussi la présence éventuelle de phases de ronflements chez le patient ainsi traité...  The device according to the present invention makes it possible to measure, independently of the AOS processing machine used and therefore without using information or data internal to this apparatus, and to remotely communicate, wirelessly, the information relating not only the compliance and effectiveness of a treatment with CPAP, ie the effective duration of treatment of patients, but also the possible presence of snoring phases in the patient treated in this way ...
Ceci permet, d'une part, d'obtenir un suivi quotidien et une sécurité dans le suivi du traitement du patient à domicile grâce à la possibilité d'alarmer le patient et son centre de soins en cas de non suivi de la prescription et, d'autre part, d'évaluer l'efficacité du traitement et d'alarmer le patient et son centre de soins si le traitement n'est pas suffisamment efficace.  This allows, on the one hand, to obtain a daily follow-up and a security in the follow-up of the treatment of the patient at home thanks to the possibility of alarming the patient and his center of care in the event of non-monitoring of the prescription and, on the other hand, to evaluate the effectiveness of the treatment and to alarm the patient and his / her care center if the treatment is not effective enough.
Le dispositif de l'invention possède une capacité d'enregistrement de plusieurs mois, de préférence d'au moins 1 an, laquelle peut être encore étendue.  The device of the invention has a recording capacity of several months, preferably at least 1 year, which can be further extended.
II peut communiquer les données enregistrées par radio fréquence RF, par exemple à une fréquence d'émission de 868 MHz ou 2.4 GHz, vers un ordinateur, un PDA, un serveur ou tout autre moyen capable d'enregistrer directement les données transmises, comme schématisé en Figure 2. En fait, le dispositif transmet à distance à l'aide du dispositif RF ou modem GSM ou GPRS intégré qui envoie les enregistrements de données d'observance et d'efficacité du traitement du patient jusqu'au centre de soins par exemple, où un serveur 23 adapté permet de générer des rapports d'observance et d'efficacité de traitement. It can communicate the data recorded by RF radio frequency, for example at a transmission frequency of 868 MHz or 2.4 GHz, to a computer, a PDA, a server or any other means capable of directly recording the transmitted data, as shown schematically. in Figure 2. In fact, the device transmits remotely using the RF device or integrated GSM or GPRS modem which sends the data records of compliance and efficiency of the treatment of the patient to the care center for example, where a server 23 adapted to generate reports of compliance and treatment efficiency .
La Figure 3 représente un synoptique illustrant le principe d'un algorithme de calcul applicable dans le cadre de la présente invention pour déterminer la survenance ou non de ronflements chez le patient.  Figure 3 represents a block diagram illustrating the principle of a calculation algorithm applicable in the context of the present invention to determine the occurrence or not of snoring in the patient.
Le processus de traitement des données en vue de la détection des ronflements se fait en 4 étapes principales, à savoir :  The process of processing data for snoring detection is done in 4 main steps, namely:
étape 1 : détermination et de stockage/historisation des valeurs PI, P2 et Q ;  step 1: determination and storage / historization of PI, P2 and Q values;
- étape 2 : détermination de l'état de fonctionnement de la machine de traitement des step 2: determination of the operating state of the machine for processing the
AOS à partir des valeurs de PI et Q ; AOS from the values of PI and Q;
étape 3 : détermination du début et de la fin de la phase inspiratoire à partir de la valeur de Q ; et  step 3: determining the beginning and end of the inspiratory phase from the value of Q; and
étape 4 : détermination proprement dite de ronflements pendant la phase inspiration à partir de P2.  step 4: actual determination of snoring during the inspiration phase from P2.
Durant l'étape 1, après détermination des pressions absolues PI, P2 par les capteurs de pression 2, 3 et du débit volumique Q par le capteur de débit 4, les valeurs (i.e. signaux) mesurées sont stockées et historisées, en tant que telles et/ou par groupes des n dernières valeurs (avec n> 2), au sein des moyens de stockage de données 5.  During step 1, after determining the absolute pressures P1, P2 by the pressure sensors 2, 3 and the volume flow rate Q by the flow sensor 4, the measured values (ie signals) are stored and historized, as such. and / or in groups of n last values (with n> 2), within the data storage means 5.
Durant l'étape 2, on utilise les valeurs de première pression PI et de débit volumique During step 2, the values of first pressure PI and volume flow are used
Q pour déterminer si le patient suit bien son traitement, c'est-à-dire pour déterminer si l'appareil 20 de traitement de l'AOS alimente bien le dispositif 10 et le masque 21 en gaz sous pression, à savoir de l'air à une pression de l'ordre de 4 à 25 mbar. Pour ce faire, on détermine : Q to determine whether the patient is following its treatment, that is to say, to determine whether the AOS treatment device 20 is feeding the device 10 and the mask 21 with pressurized gas, namely air at a pressure of the order of 4 to 25 mbar. To do this, we determine:
- si la valeur de première pression PI mesurée en entrée la est telle que : PI > ερ où ερ est une valeur de pression seuil donnée, par exemple ερ = 3 if the value of the first pressure PI measured at the input la is such that: PI> ε ρ where ε ρ is a given threshold pressure value, for example ε ρ = 3
- et si l'écart-type du débit est tel que : σ((¾> σηιίη  - and if the standard deviation of the flow is such that: σ ((¾> σηιίη
où σηιίη est une valeur de l'écart type du débit seuil donnée, par exemple σηιίη = 3 Si les deux conditions sont remplies, alors on considère que le patient suit bien son traitement car cela signifie que non seulement l'appareil 20 délivre de l'air sous pression mais aussi que le patient inspire cet air.  where σηιίη is a value of the standard deviation of the given threshold flow rate, for example σηιίη = 3 If both conditions are fulfilled, then it is considered that the patient is following its treatment well since this means that not only does the apparatus 20 deliver air under pressure but also that the patient inspires this air.
Puis, durant l'étape 3, on utilise la valeur de débit volumique Q pour détecter les moments de début et de fin des phases inspiratoires du patient. Pour ce faire, on analyse le signal de débit Q de la manière suivante :  Then, during step 3, the volume flow value Q is used to detect the start and end times of the patient's inspiratory phases. To do this, the flow signal Q is analyzed as follows:
- on estime d'abord le débit moyen Qmoy à partir de l'historique de données de débit stocké à l'étape 1.  the average flow rate Qmoy is first estimated from the flow data history stored in step 1.
- puis, si à un instant t0, le débit Q est tel que : Q(to) > Qm0y + ε ; et si et à l'instant t0-dt , le débit Q est tel que : Q(t0-dt) < Qmoy + ε ; où ε est une marge pour éviter de détecter le bruit de mesure comme des respirations , alors l'instant t0 est considéré comme étant le début de l'inspiration du patient. then, if at a time t 0 , the rate Q is such that: Q (to)> Q m0y + ε; and if and at time t 0 -dt, the rate Q is such that: Q (t 0 -dt) <Q moy + ε; where ε is a margin to avoid detecting noise measuring like breaths, then the moment t 0 is considered to be the beginning of the patient's inspiration.
- ensuite, on estime le volume d'air inspiré V(t) en intégrant l'intégrale de débit durant une durée dt donnée, mesurée à partir de l'instant t0, soit :
Figure imgf000010_0001
Q.dt then, the inspired air volume V (t) is estimated by integrating the flow integral for a given duration, measured from the instant t 0 , that is:
Figure imgf000010_0001
Q.dt
La fin de l'inspiration est alors définie comme l'instant ti compris entre to et t2, pour lequel V(t) est maximal ; t2 étant l'instant de début de l'inspiration suivante du patient. The end of the inspiration is then defined as the moment ti between to and t 2 , for which V (t) is maximal; t 2 being the start time of the patient's next inspiration.
Enfin, durant l'étape 4, on isole le ou les signaux de pression P2 pendant tout ou partie de ou des phases d'inspiration, entre les instants t0 et ti estimés précédemment, et on en mesure l'écart type σ. Finally, during step 4, the pressure signal or signals P2 are isolated during all or part of or inspiration phases, between the instants t 0 and ti estimated previously, and the standard deviation σ is measured.
Si cet écart type est supérieur à une valeur ET lim donnée, soit σ > ET lim, alors cela signifie que le signal de pression est perturbé par le ronflement du patient. On en déduit donc que le patient a ronflé pendant cette phase d'inspiration.  If this standard deviation is greater than a given value ET lim, ie σ> AND lim, then this means that the pressure signal is disturbed by the snoring of the patient. It follows that the patient has snored during this phase of inspiration.
Lorsqu'un tel ronflement est détecté, alors il est signalé pour la minute en cours. Toutes les quinze minutes, on enregistre avec les autres données d'utilisation du traitement et d'efficacité du traitement pendant quelle(s) minute(s) un ronflement a été signalé.  When such snoring is detected, then it is reported for the current minute. Every fifteen minutes, one records with the other data of use of the treatment and efficiency of the treatment during which minute (s) a snoring was reported.
Par ailleurs, le dispositif de l'invention peut également mesurer la durée de traitement du patient et son efficacité lorsqu'il se traite, et ce, à l'aide des mesures de pression PI, P2 et de débit Q opérées dans le passage de gaz 1 du dispositif de l'invention.  Furthermore, the device of the invention can also measure the patient's treatment time and its efficiency when it is treated, and this, using the pressure measurements PI, P2 and flow rate Q operated in the passage of gas 1 of the device of the invention.
L'efficacité du traitement est alors déduite des variations de pression et de débit liées aux inspirations/expirations du patient et du niveau de pression de traitement, en prenant en compte le nombre et/ou le temps de ronflement survenant pendant le traitement tel que déterminé ci-avant.  The effectiveness of the treatment is then deduced from the variations in pressure and flow rate related to the inspirations / expirations of the patient and the level of treatment pressure, taking into account the number and / or the snoring time occurring during the treatment as determined. above.
A titre d'exemple illustré sur la Figure 4, pour calculer la durée de suivi du traitement par un patient donné, le temps peut être divisé en périodes d'une durée fixée que l'on appelle T, typiquement des périodes de 1 minute par exemple.  As an example shown in Figure 4, to calculate the duration of treatment follow-up by a given patient, the time can be divided into periods of a fixed duration that is called T, typically periods of 1 minute per minute. example.
Pour chacune de ces périodes T, un deuxième algorithme, également intégré aux moyens de traitement 6, détermine si pendant cette période T, le patient suit son traitement et si oui, il comptabilise le nombre de périodes pendant lesquelles le patient a suivi son traitement et calcule ainsi la durée de suivi du traitement.  For each of these periods T, a second algorithm, also integrated in the processing means 6, determines whether during this period T the patient follows his treatment and if so, he counts the number of periods during which the patient has followed his treatment and calculates the duration of treatment follow-up.
A partir des mesures de pression PI et/ou P2 et de débit Q, le deuxième algorithme vérifie sur une période donnée, deux conditions (conditionP et conditionQ) qui sont nécessaires et suffisantes pour déterminer si pendant cette période le traitement a été suivi, à savoir :  From the measurements of pressure PI and / or P2 and flow Q, the second algorithm verifies over a given period, two conditions (conditionP and conditionQ) which are necessary and sufficient to determine if during this period the treatment was followed, to know :
- une condition sur la pression : conditionP. Si la pression Pmoyenne dans le circuit du patient est suffisamment surélevée par rapport à la pression atmosphérique Patm, alors le circuit du patient est branché sur l'appareil de traitement de l'OAS et ce dernier fonctionne, c'est-à-dire qu'il délivre une pression positive d'au moins 4 cm H20, donc supérieure à une valeur de pression minimum préfixée P. limite. - une condition sur le débit : conditionQ. Si l'écart-type du signal de débit E.T.Q dépasse un certain seuil fixé E. T. limite, alors les mesures de débit varient avec une amplitude qui ne peut être due qu'à la respiration du patient dans le masque. - a condition on the pressure: conditionP. If the average pressure P in the patient circuit is sufficiently elevated relative to atmospheric pressure Patm, then the patient circuit is connected to the OAS treatment apparatus and the latter operates, i.e. it delivers a positive pressure of at least 4 cm H 2 0, thus greater than a minimum pressure value prefixed P. limit. - a condition on the flow: conditionQ. If the standard deviation of the ETQ rate signal exceeds a certain threshold AND limit, then the flow measurements vary with an amplitude that can only be due to the breathing of the patient in the mask.
En fonction des résultats du calcul des conditionP et conditionQ, on déduit si le traitement a bien eu lieu ou non pendant la période de temps T considérée et, dans l'affirmative, la durée du traitement Dt qui correspond au nombre N de périodes de traitement multiplié par la durée de la période T.  According to the results of the calculation of conditionP and conditionQ, it is deduced whether the treatment has taken place or not during the time period T considered and, if so, the duration of treatment Dt which corresponds to the number N of treatment periods multiplied by the duration of period T.
Le dispositif de l'invention permet une observance et un suivi efficace des patients en détectant et en prenant en compte les ronflements des patients.  The device of the invention allows an observance and an effective follow-up of the patients by detecting and taking into account the snoring of the patients.
La délivrance automatique des résultats d'observance et d'efficacité du traitement est opérée quotidiennement et sans déplacement d'un intervenant puisque tout se fait à distance.  The automatic delivery of the results of observance and effectiveness of the treatment is carried out daily and without moving of a speaker since everything is done at a distance.
Le dispositif de l'invention est utilisable dans le cadre de toute méthode de traitement thérapeutique du syndrome d'apnée obstructive du sommeil (SAOS) d'un patient se caractérisant notamment par une obstruction de ses voies aériennes supérieures.  The device of the invention is used in the context of any method of therapeutic treatment of obstructive sleep apnea syndrome (OSA) of a patient characterized in particular by an obstruction of his upper airways.

Claims

Revendications claims
1. Dispositif de suivi d'un traitement de Γ AOS et de détection de ronflements chez un patient, comprenant : A device for monitoring AOS treatment and snoring detection in a patient, comprising:
- un passage (1) de gaz comprenant une entrée (la) et une sortie (lb),  a passage (1) of gas comprising an inlet (1a) and an outlet (1b),
- un dispositif de détermination de débit (2), raccordé au passage (1), apte à et conçu pour déterminer une valeur de débit (Q) du gaz circulant entre l'entrée (la) et la sortie (lb) dudit passage (1),  a flow rate determining device (2), connected to the passage (1), adapted to and designed to determine a flow rate value (Q) of the gas flowing between the inlet (1a) and the outlet (1b) of said passage ( 1),
- un premier capteur de pression absolue (3) connecté au niveau de l'entrée (la) du passage (1) pour déterminer une première valeur pression (PI),  a first absolute pressure sensor (3) connected at the inlet (1a) of the passage (1) to determine a first pressure value (PI),
- un deuxième capteur de pression absolue (4) connecté au niveau de la sortie (lb) du passage (1) pour déterminer une deuxième valeur pression (P2),  a second absolute pressure sensor (4) connected at the outlet (1b) of the passage (1) to determine a second pressure value (P2),
- des moyens de traitement d'information (6) aptes à et conçus pour traiter les valeurs de débit (Q) et de pressions (PI, P2) et en déduire l'occurrence d'une information de présence ou d'absence de ronflement chez le patient, et  - information processing means (6) adapted to and designed to process the values of flow (Q) and pressure (PI, P2) and to deduce the occurrence of a presence or absence of snoring information in the patient, and
- des moyens de stockage de données (5) aptes à et conçus pour mémoriser au moins les valeurs de débit (Q), de première pression (PI) et de deuxième pression (P2) mesurées par, respectivement, le dispositif de détermination de débit (2), le premier capteur de pression (3) et le deuxième capteur de pression (4).  data storage means (5) adapted to and designed to store at least the flow rate (Q), first pressure (PI) and second pressure (P2) values measured by, respectively, the flow rate determination device (2), the first pressure sensor (3) and the second pressure sensor (4).
2. Dispositif de suivi selon la revendication 1, caractérisé en ce qu'au moins le passage (1) de gaz, le dispositif de détermination de débit (2), le premier capteur de pression absolue (3) et le deuxième capteur de pression absolue (4) sont compris dans un boîtier unique (10). 2. Tracking device according to claim 1, characterized in that at least the gas passage (1), the flow rate determining device (2), the first absolute pressure sensor (3) and the second pressure sensor. absolute (4) are included in a single housing (10).
3. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que les moyens de stockage de données (5) ou les moyens de traitement d'information (6) sont compris dans le boîtier unique (10) ou sont situés à distance dudit boîtier unique (10). 3. Tracking device according to one of the preceding claims, characterized in that the data storage means (5) or the information processing means (6) are included in the single housing (10) or are located in distance from said single housing (10).
4. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que le boîtier unique (10) comprend en outre des moyens d'émission (7) aptes à et conçus pour transmettre des données ou des informations. 4. Tracking device according to one of the preceding claims, characterized in that the single housing (10) further comprises transmitting means (7) adapted to and designed to transmit data or information.
5. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que les moyens de traitement d'information (6) comprennent au moins un micro contrôleur et un algorithme, ou les moyens de stockage (5) comprennent au moins une puce mémoire ou une carte mémoire. 5. Tracking device according to one of the preceding claims, characterized in that the information processing means (6) comprise at least one micro controller and an algorithm, or the storage means (5) comprise at least one chip memory or a memory card.
6. Dispositif de suivi selon la revendication 4, caractérisé en ce que les moyens d'émission (7) comprennent un système émetteur sans fil et une antenne permettant d'assurer une transmission sans fil des données ou informations, de préférence le système émetteur radio fréquence comprend un modem GSM ou GPRS. 6. Tracking device according to claim 4, characterized in that the transmitting means (7) comprises a wireless transmitter system and an antenna for ensuring a wireless transmission of data or information, preferably the radio transmitter system frequency includes a GSM or GPRS modem.
7. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que les moyens de traitement d'information (6) sont aptes à et conçus pour traiter les valeurs de débit et de pression déterminées par le dispositif de détermination de débit (2) et ledit ou lesdits capteurs de pression absolue (3, 4) et en déduire au moins une donnée de durée de traitement journalier et au moins une donnée d'efficacité de traitement de l'AOS, 7. Tracking device according to one of the preceding claims, characterized in that the information processing means (6) are adapted to and designed to process the flow rate and pressure values determined by the flow rate determination device ( 2) and said one or more absolute pressure sensors (3, 4) and deriving therefrom at least one daily treatment time data and at least one AOS processing efficiency data,
8. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que l'algorithme des moyens de traitement (6) est apte à et conçu pour opérer : 8. Tracking device according to one of the preceding claims, characterized in that the algorithm of the processing means (6) is adapted to and designed to operate:
- une détermination et un stockage des valeurs de pressions (PI, P2) et de débit (Q) mesurées par les capteurs de pression (3, 4) et de débit (2),  a determination and storage of the pressure (PI, P2) and flow (Q) values measured by the pressure (3, 4) and flow (2) sensors,
- une détermination du début et de la fin de chaque phase inspiratoire du patient à partir de la valeur de débit (Q) mesurées, et  a determination of the beginning and the end of each inspiratory phase of the patient from the measured flow value (Q), and
- une détection de la survenance de ronflements pendant une phase d'inspiration à partir de la ou des valeurs de pressions mesurées (PI, P2).  a detection of the occurrence of snoring during an inspiration phase from the measured pressure value (s) (PI, P2).
9. Dispositif de suivi selon la revendication 8, caractérisé en ce que l'algorithme des moyens de traitement (6) est apte à et conçu pour opérer, en outre, une détermination de circulation de gaz dans le passage (1) à partir de la valeur de pression (PI) mesurée par le premier capteur (3) et de débit volumique (Q) mesuré par le dispositif de détermination de débit (2). 9. Tracking device according to claim 8, characterized in that the algorithm of the processing means (6) is adapted to and designed to operate, in addition, a determination of gas flow in the passage (1) from the pressure value (PI) measured by the first sensor (3) and the volume flow rate (Q) measured by the flow rate determination device (2).
10. Dispositif de suivi selon l'une des revendications précédentes, caractérisé en ce que le premier capteur de pression absolue (3) et le deuxième capteur de pression absolue (4) sont échantillonnés à une fréquence de 25 Hz. 10. Tracking device according to one of the preceding claims, characterized in that the first absolute pressure sensor (3) and the second absolute pressure sensor (4) are sampled at a frequency of 25 Hz.
11. Appareillage de traitement de l'AOS comprenant une machine de ventilation (M) reliée f uidiquement à l'entrée (la) d'un dispositif selon l'une des revendications précédentes, de manière à alimenter ledit dispositif en gaz sous pression. 11. Apparatus for processing the AOS comprising a ventilation machine (M) operably connected to the inlet (la) of a device according to one of the preceding claims, so as to supply said device with pressurized gas.
12. Procédé de détection des ronflements susceptibles de survenir chez un patient suivant un traitement de l'AOS, dans lequel : 12. A method of detecting snoring that may occur in a patient following OSA treatment, wherein:
a) on détermine au moyen d'un premier et d'un deuxième capteur de pression absolue et d'un capteur de débit des valeurs de pressions (PI, P2) et de débit (Q) du gaz circulant entre l'entrée et la sortie du passage de gaz d'un dispositif selon l'une des revendications 1 à 10, relié fluidiquement à un appareil de traitement de l'AOS, a) determining by means of a first and a second absolute pressure sensor and a flow sensor the pressure (PI, P2) and flow (Q) values of the gas flowing between the inlet and the outlet of the gas passage of a device according to one of claims 1 to 10, fluidly connected to an AOS treatment apparatus,
b) on traite les valeurs de débit (Q) et de pression (PI, P2) mesurées à l'étape a), au moyen de moyens de traitement d'information (6),  b) the flow (Q) and pressure (PI, P2) values measured in step a) are processed by means of information processing means (6),
c) on détermine le début et la fin de chaque phase inspiratoire du patient à partir d'au moins une valeur de débit (Q) mesurée à l'étape a),  c) determining the beginning and the end of each inspiratory phase of the patient from at least one flow rate value (Q) measured in step a),
d) on détecte une survenance de ronflements pendant au moins une partie d'au moins une phase d'inspiration déterminée à l'étape c) et à partir de la ou des valeurs de pressions (PI, P2) mesurées à l'étape a),  d) detecting an occurrence of snoring during at least a portion of at least one inspiration phase determined in step c) and from the pressure value or values (PI, P2) measured in step a )
e) on mémorise dans des moyens de stockage de données, au moins l'une des valeurs mesurées à l'étape a), et  e) at least one of the values measured in step a) is stored in data storage means, and
f) on transmet, via des moyens d'émission (7), au moins l'une des valeurs mesurées à l'étape a).  f) transmitting, via transmission means (7), at least one of the values measured in step a).
13. Procédé selon la revendication 12, caractérisé en ce qu'à l'étape b), on met en œuvre des moyens de traitement d'information (6) comprenant au moins un microcontrôleur et un algorithme. 13. The method of claim 12, characterized in that in step b), implementation of information processing means (6) comprising at least one microcontroller and an algorithm.
14. Procédé selon la revendication 12, caractérisé en ce qu'à l'étape e), on met en œuvre des moyens de stockage (5) comprenant au moins une puce mémoire ou une carte mémoire. 14. The method of claim 12, characterized in that in step e), it implements storage means (5) comprising at least one memory chip or a memory card.
15. Procédé selon la revendication 12, caractérisé en ce qu'à l'étape f), on met en œuvre des moyens des moyens d'émission (7) comprenant au moins un système émetteur sans fil et une antenne. 15. The method as claimed in claim 12, characterized in that in step f) means of the transmission means (7) comprising at least one wireless transmitter system and an antenna are implemented.
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WO2014106696A1 (en) * 2013-01-04 2014-07-10 Air Liquide Medical Systems Device having a heat-sensitive cell for monitoring the observance of a medical treatment
US10143820B2 (en) 2014-12-12 2018-12-04 Dynasthetics, Llc System and method for delivery of variable oxygen flow
US10159815B2 (en) 2014-12-12 2018-12-25 Dynasthetics, Llc System and method for detection of oxygen delivery failure
US10980965B2 (en) 2014-12-12 2021-04-20 Dynasthetics, Llc System and method for detection of oxygen delivery failure
US11638801B2 (en) 2014-12-12 2023-05-02 Dynasthetics, Llc System and method for delivery of variable oxygen flow
CN105395201A (en) * 2015-12-09 2016-03-16 上海朔茂网络科技有限公司 Lung function measurement instrument and measurement method thereof

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