EP2982358B1

EP2982358B1 - Systems, methods, and devices for treatment of sleep disorders

Info

Publication number: EP2982358B1
Application number: EP15180086.9A
Authority: EP
Inventors: David Ribble; Charles A. Howell; Neal WIGGERMANN; Michael Scott Hood; Travis PELO; Kirsten EMMONS; Eric D. AGDEPPA
Original assignee: Hill Rom Services Inc
Current assignee: Hill Rom Services Inc
Priority date: 2014-08-08
Filing date: 2015-08-06
Publication date: 2020-11-04
Anticipated expiration: 2035-08-06
Also published as: EP2982358A1

Description

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. An exemplary mattress is described in Patent Publication No. WO 2017/177338 published on Nov. 28, 2011 in the name of Hill-Rom Services, Inc., wherein a person support surface is described having a mattress core including a fluid bladder configured to selectively protrude from a person contacting surface. While various systems have been developed, there is still room for improvement. Thus, a need persists for further contributions in this area of technology.
An exemplary person support apparatus may have 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.
In some examples, 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.
In some examples, 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 examples, 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.
In some examples, 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 examples, 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.
A system, method or apparatus according to this disclosure may comprise one or more of the following features alone or in any combination.
In accordance with the present disclosure, a person support apparatus is provided and has a longitudinal length from its head end to its foot end and a lateral width from side to side. The person support apparatus includes an inflatable 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 an inflatable 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 person support apparatus further has a knee gatch section located between the torso section and an inflatable leg section, wherein the knee gatch section has no lateral tilt and has a knee gatch bladder that is inflatable to control an amount of rounded contour in an upper surface of the knee gatch section. The person support apparatus further has an inflatable bolster extending along a side of the person support apparatus and extending above at least one of a side and an end of the person support apparatus. 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
In some embodiments, the slopes are achieved by linear surfaces, nonlinear 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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°. 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.
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.
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.
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° to about 20°. 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°. 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°. 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.
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.
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.
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.
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° 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.
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.
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.
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.
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.
The invention will now be further described by way of example with reference to the accompanying drawings, in which:

FIG. 1 is a partial diagrammatic view of an adverse event mitigation system according to one embodiment of the current disclosure;
FIG. 2 is a side perspective view of a person support apparatus and person support surface of FIG. 1;
FIG. 3 is a cross-sectional side view of the deck of the upper frame and the person support surface of FIG. 2;
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;
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;
FIG. 6 is a block diagram of a proactive procedure according to one embodiment;
FIG. 7 is a block diagram of a reactive procedure according to one embodiment;
FIG. 8 is a block diagram of a predictive procedure according to one embodiment;
FIG. 9 is a partial diagrammatic view of a garment configured to rotate a person;
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;
FIG. 11 is a perspective view of an exemplary support system supporting a user on a sleep surface defined by the support system;
FIG. 12 is a perspective side view of the support system shown in FIG. 11;
FIG. 13 is a side elevational view of the support system shown in FIG. 11;
FIG. 14 is a front elevational view of the support system shown in FIG. 11;
FIG. 15 is a schematic view of an exemplary support system;
FIG. 16 is a partial front view of the support system shown in FIG. 15 illustrating a lateral rotation of planes;
FIG. 17 is a partial side view of the support system shown in FIG. 15 illustrating a longitudinal rotation of planes;
FIG. 18 shows an exemplary control system operatively coupled to the support system shown in FIG. 15;
FIG. 19 is a side view of an exemplary support system including a plurality of independently rotatable support pieces;
FIG. 20A is a cross-sectional view of the support system shown in FIG. 19 taken along sectional line 20A in FIG. 19;
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° about a longitudinal axis of the support system;
FIG. 21 is side view of an exemplary support system including a plurality of support pieces;
FIG. 22 is a side view of the support system shown in FIG. 21 including a spacer positioned between adjacent support pieces;
FIG. 23 is a side view of an exemplary support system including a plurality of support pieces;
FIG. 24 is a side view of the support system shown in FIG. 23 including a spacer replacing one of the support pieces;
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;
FIG. 26 is a top plan view of an exemplary support system supporting a user on a sleep surface defined by the support system;
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;
FIG. 28 is a top plan view of an exemplary dynamic support system;
FIG. 29 is a front view of an exemplary dynamic support system;
FIG. 30 is a top view of the dynamic support system shown in FIG. 29;
FIG. 31 is an end view of the dynamic support system shown in FIG. 29 illustrating a lateral rotation of planes;
FIGS. 32-35 illustrate various configurations of fluid bladders forming at least a portion of the dynamic support system shown in FIG. 29;
FIG. 36 is a schematic view of an exemplary dynamic support system;
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;
FIGS. 38-41 illustrate an exemplary heuristic control of an apnea therapy surface function;
FIG. 42 is a perspective view of an exemplary continuous lateral rotation therapy (CLRT) system;
FIG. 43 is a front view of a control system configured to control the CLRT system shown in FIG. 42;
FIG. 44 is a cross-sectional view of the support system shown in FIG. 42;
FIG. 45 is a cross-sectional view of a portion of the support system shown in FIG. 42;
FIG. 46 is a cross-sectional view of an exemplary support system with fixed-length bands to restrict fluid bladder inflation;
FIG. 47 is a front perspective view of a front portion of an exemplary posture shirt;
FIG. 48 is a rear view of a back portion of the posture shirt shown in FIG. 47;
FIG. 49 is a top view of an exemplary chest constriction device;
FIG. 50 is a top view of a constriction device of the chest constriction device shown in FIG. 49;
FIG. 51 is a top view of a portion of the constriction device shown in FIG. 50 with the lever in a relaxed position;
FIG. 52 is a top view of a portion of the constriction device shown in FIG. 50 with the lever in a constricted position;
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;
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;
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;
FIG. 56 is a simplified sectional view 56-56 of the support section of FIG. 55;
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;
FIG. 58 is a simplified perspective view of the embodiment of FIG. 57, shown in a substantially flat position;
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;
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;
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;
FIG. 63 is a simplified side view of the side support member of FIG. 62, taken while the side support member is inflated;
FIG. 64 is a simplified perspective view of at least one embodiment of a cover for the person support apparatus of FIG. 53;
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;
FIG. 66 is a simplified perspective view of the embodiment of FIG. 65, shown in a substantially flat position;
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;
FIG. 68 is a simplified perspective view of the embodiment of FIG. 67, shown in a flat position;
FIG. 69 is a simplified perspective view of at least one embodiment of a support section for the person support apparatus of FIG. 53;
FIG. 70 is a simplified side view of the support section of FIG. 69;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
FIG. 89 is a simplified perspective view of the person support apparatus of FIG. 88, shown in a substantially flat position;
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;
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;
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;
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;
FIG. 95 is a simplified flow diagram of a method for controlling lateral angles of a person support apparatus;
FIG. 96a is a perspective view of a mattress according to another illustrative embodiment of the present disclosure;
FIG. 96b is a top view of the illustrative embodiment of FIG. 96a looking in the direction labeled 96b in FIG. 96a;
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;
FIG. 97a is a perspective view of the base, having a side bolster on top of it, of the illustrative embodiment of FIG. 96;
FIG. 97b is a top view of the base and bolster of FIG. 97a, looking in the direction labeled 97b in FIG. 97a;
FIG. 97c is a left side view of the base and bolster of FIG. 97a, looking in the direction labeled 97c in FIG. 97b;
FIG. 97d is a head end view of the base and bolster of FIG. 97a, looking in the direction labeled 97d in FIG. 97c;
FIG. 98a is a perspective view of the head section of the illustrative embodiment of FIG. 96;
FIG. 98b is a top view of the head section of FIG. 98a, looking in the direction labeled 98b in FIG. 98a;
FIG. 98c is an end view of the head section of FIG. 98a, looking in the direction labeled 98c in FIG. 98b;
FIG. 98d is an end view of the head section of FIG. 97a, looking in the direction labeled 98d in FIG. 98c;
FIG. 99a is a perspective view of the torso section of the illustrative embodiment of FIG. 96;
FIG. 99b is a top view of the torso section of FIG. 99a, looking in the direction labeled 99b in FIG. 99a;
FIG. 99c is a side view of the torso section of FIG. 99a, looking in the direction labeled 99c in FIG. 99b;
FIG. 99d is a side view of the torso section of FIG. 99a, looking in the direction labeled 99d in FIG. 99c;
FIG. 100a is a perspective view of the leg section of the illustrative embodiment of FIG. 96;
FIG. 100b is a top view of the leg section of FIG. 100a, looking in the direction labeled 100b in FIG. 100a;
FIG. 100c is an end view of the leg section of FIG. 100a, looking in the direction labeled 100c in FIG. 100b;
FIG. 100d is a side view of the leg section of FIG. 100a, looking in the direction labeled 100d in FIG. 100c;
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;
FIG. 102a is a perspective view of the first transition section of the illustrative embodiment of FIG. 101;
FIG. 102b is a top view of the first transition section of FIG. 101, looking in the direction labeled 102b in FIG. 102a;
FIG. 102c is a side view of the first transition section of FIG. 101, looking in the direction labeled 102c in FIG. 102b;
FIG. 102d is a side view of the first transition section of FIG. 101, looking in the direction labeled 102d in FIG. 102c;
FIG. 103a is a perspective view of the second transition section of the illustrative embodiment of FIG. 101;
FIG. 103b is a top view of the second transition section of FIG. 101, looking in the direction labeled 103b in FIG. 103a;
FIG. 103c is a side view of the second transition section of FIG. 101, looking in the direction labeled 103c in FIG. 103b;
FIG. 103d is a side view of the second transition section of FIG. 101, looking in the direction labeled 103d in FIG. 103b;
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;
FIG. 105a is a perspective view of a mattress 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 end) of the illustrative embodiment of FIG. 105a, looking in the direction labeled 105d in FIG. 105c;
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;
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 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;
FIG. 107 is a top, foot end, perspective view of a mattress design according to another embodiment;
FIG. 108 is a top plan view of the mattress of FIG. 107;
FIG. 109 is a back plan view of the mattress of FIG. 107;
FIG. 110 is a first side elevation view of the mattress of FIG. 107;
FIG. 111 is a second side elevation view of the mattress of FIG. 107;
FIG. 112 is a head end elevation view of the mattress of FIG. 107;
FIG. 113 is a foot end elevation view of the mattress of FIG. 107;
FIG. 114 is a top, foot end, perspective view of a mattress design according to another embodiment;
FIG. 115 is a top plan view of the mattress of FIG. 114;
FIG. 116 is a back plan view of the mattress of FIG. 114;
FIG. 117 is a first side elevation view of the mattress of FIG. 114;
FIG. 118 is a second side elevation view of the mattress of FIG. 114;
FIG. 119 is a head end elevation view of the mattress of FIG. 114;
FIG. 120 is a foot end elevation view of the mattress of FIG. 114;
FIG. 121 is a top, foot end, perspective view of a mattress according to another embodiment of an illustrative design;
FIG. 122 is a top plan view of the mattress of FIG. 121;
FIG. 123 is a back plan view of the mattress of FIG. 121;
FIG. 124 is a first side elevation view of the mattress of FIG. 121;
FIG. 125 is a second side elevation view of the mattress of FIG. 121;
FIG. 126 is a head end elevation view of the mattress of FIG. 121;
FIG. 127 is a foot end elevation view of the mattress of FIG. 121;
FIG. 128 is a top, foot end perspective view of a sleep apparatus according to another embodiment;
FIG. 129 is a side, foot end perspective view of a tilting insert device used in the apparatus of FIG. 128;
FIG. 130 is a head end elevation view of the device of FIG. 129;
FIG. 131 is a foot end elevation view of the device of FIG. 129;
FIG. 132 is a left side elevation view of the device of FIG. 129;
FIG. 133 is a right side elevation view of the device of FIG. 129;
FIG. 134A is a block diagram of an exemplary dynamic support system;
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;
FIGS. 135A-135B are head end views of an exemplary support system including a plurality of support pieces at a first and second time;
FIG. 136 is a block diagram of a predictive process according to one embodiment;
FIG. 137 is a block diagram of personalized support adjustment process according to one embodiment;
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;
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;
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;
FIG. 139 is a simplified block diagram of a process of adjusting a patient support based on head orientation;
FIG. 140 is a block diagram of a process of adjusting head end tilt parameters according to another embodiment;
FIG. 141 is a block diagram of a process of adjusting bed tilt parameters using a single initiating step;
FIGS. 142A-142B illustrate head end views before and after a patient positioner is used;
FIG. 143 is a top view of an embodiment of a patient positioner;
FIG. 144 is a top view of another embodiment of a patient positioner;
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
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.

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.
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.
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° with respect to a reference plane RP1 passing through the upper frame 20.
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 α, β and γ 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.
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.
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.
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.
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° with respect to the reference plane RP1 and the head is at an angle of about 180° 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° 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° 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°. 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® 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.
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™ VPC Therapy Surface, and NP200 Wound Surfaces sold by Hill-Rom Company, Inc.
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.
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.

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:

Predisposing physical characteristics	BMI in the 95th percentile for age and gender (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 airway obstruction during sleep	loud or frequent snoring
History of apparent airway obstruction during sleep	observed pauses in breathing 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
Somnolence	falling asleep easily in a nonstimulating place despite adequate sleep
Sleep study results
Invasiveness of surgery and anesthesia	superficial under local or peripheral nerve block 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 postoperative opioids	none
Requirement of postoperative opioids	low-dose oral opioids
	high-dose oral opioids or neuraxial or parenteral opioids
Estimation of perioperative risk
Sex and age of occupant	Estimated sleep disordered 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

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.

I. Severity of apnea	Based on sleep study	0-3 points
	Based on predisposing physical characteristics, history of apparent
	airway obstruction during sleep, and somnolence	0 points
	airway obstruction during sleep, and somnolence	1 point
	None
	2 points
	Mild	3 points
	Moderate
	Severe
II. Surgery and Anesthesia	Invasiveness	0-3 points
	Type
	Superficial under local or peripheral nerve block without sedation Superficial with moderate sedation or	0 points
	general anesthesia	1 point
	Peripheral with spinal or epidural anesthesia and no more than moderate sedation	1 point
	Peripheral with general anesthesia Airway surgery with moderate sedation	2 points
	Major surgery with general anesthesia	2 points
	Airway surgery with general anesthesia	3 points
		3 points
III. Postoperative opioids	Requirement	0-3 points
	Dosage
	None
	0 points
	Low-dose oral	1 point
	High dose oral, parenteral or neuraxial	3 points

Risk = Score from I +	Score from the greater of II and III (0-6	points)

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.
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° and the lateral tilt angle to be greater than 15° 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° to about 15° and the lateral tilt angle to be about 10° to about 15° 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.
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.
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.
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.
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.
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.
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 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.
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. . Another example of such a system is disclosed in U.S. Pat. No. 4,967,195 issued on May 8, 2006 to Shipley.
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 . Another example of such a system is disclosed in U.S. Patent Publication No. 2008/0095156 issued on Apr. 24, 2008 to Schuman .
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. . 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. . 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. . It should be appreciated that the work-flow process software can be the NaviCare® 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. . It should further be appreciated that the badge can be of the type available as part of the ComLinx™ 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.
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. . 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. . 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. .
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° 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° 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.
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.
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°. 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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° 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° 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° 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° 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° 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.
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 α of 20° to 30°, or more specifically, 20° to 25°, or, even more specifically, 25° 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° to 20°, or more specifically, 10° to 15°, or, even more specifically, 15°, 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 γ of 5° to 15°, or more specifically, 10°, 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 (SpO₂), 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° 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.
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.
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.
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.
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.
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 SpO₂ 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.
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° to 15°, or more specifically, 10°, 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 γ of 5° to 15°, or more specifically, 10°, 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° with respect to base plane 1310 of base support 1306 (the sum of angle .theta. and angle γ). In alternative embodiments, the total lateral rotational angle may be any suitable angle, less than 20° or greater than 20°. 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The support sections 5316, 5318, 5320 are positioned along a length I 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.
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 I 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.
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.
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)).
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.
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.
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.
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, l4 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 11, 12, 13, l4 and the distances d1, d2, d3 are configured to retain the support section 5500 in the proper position to achieve such angle.
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.
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.
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.
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_x, l_y, l_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.
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 y 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.
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.
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.
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_s, which is less than the length of the person support apparatus (e.g., the length I 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.
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.
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.
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.
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.
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.
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.
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.
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.
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 h₁, h₂, h₃, respectively, which extends vertically upwardly from the base sheet 6910 and also equally vertically downwardly below the base sheet 6910. The vertical heights h₁, h₂, h₃ progressively increase, such that the height h₁ is smaller than the height h₂ and the height h₂ is smaller than the height h₃. As such, when inflated, the bladders 6912, 6914, 6916 can provide the desired lateral tilt angle.
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.
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.
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.
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.
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.
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.
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.
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 .
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.
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).
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.
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.
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).
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.
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.
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.
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).
FIG. 88 shows the person support apparatus 8800 with the inflatable portion 8822 deflated, while FIG. 89 shows the inflatable portion 8822 inflated.
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.
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.
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.
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.
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).
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.
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 I 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.
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.
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.
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.
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.)
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.
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).
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).
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.
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.
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.
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.
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.
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.
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.
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 α1 relative to the longitudinal axis of the mattress and an angle α2 relative to the lateral axis of the mattress. Accordingly, a gradual transition is achieved between the head section 904' and the torso section 906'.
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.
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.
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 α1 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 α2 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 α2 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 ω, 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 α2 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 ω 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 ω to goes up to the limit permitted by the angle α1 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 α1.
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).
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).
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_u at one lateral side and a lower midpoint h_l at its opposite lateral side. Likewise, the sloped surface of the torso support section 1064 has an upper midpoint T_u (which is longitudinally inline with the midpoint h_u), and a lower midpoint T_l at its opposite lateral side. Finally, the sloped surface of the leg support section 1066 has an upper midpoint L_u (which is longitudinally in line with midpoints h_u and T_u), and a lower midpoint L_l at its opposite lateral side. In this embodiment, the height of the mattress 1060 at point h_u (which in FIG. 105A is referred to as H(h_u)) is greater than the height of the mattress 1060 at point T_u (which in FIG. 105A is referred to as H(T_u)). Likewise, the height of the mattress 1060 at point T_u (which in FIG. 105A is referred to as H(T_u)) is greater than the height of the mattress at point L_u (which in FIG. 105A is referred to as H(L_u)). The heights at the lower midpoints (H(h_l), H(T_l), and H(L_l)) can be substantially equal in some embodiments. In some embodiments, the height H(h_u)) is from about 8 to about 14 inches, the height H(T_u) is from about 6 to about 12 inches, the height H(L_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_l)), H(T_l), and H(h_l)) is from about 1 to about 3 inches. In one embodiment, the height H(h_u) is about 12 inches, the height H(T_u) is about 10 inches, the height H(L_u) is about 6 inches, and the heights at the lower points is about 2.5 inches. In another embodiment, the height H(h_u) is about 9 inches, the height H(T_u) is about 7 inches, the height H(L_u) is about 4.5 inches, and the heights at the lower points is about 1.5 inches.
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.
FIGS. 107-113 are views of a mattress 1090 according to another embodiment and having other various design elements.
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 l₁. 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 l₁. 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.
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 ω 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 ω 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 ω 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.
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).
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_h, the torso section has a maximum height h_t, and the leg section has a maximum height h_l, and h_h is greater than h_t which is greater than h_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.
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_t, h_h, and h_l) relative to horizontal, is indicated by the angles θ_h, θ_t, and θ_l. In this embodiment θ_h is greater than θ_t which in turn is greater than θ_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 θ_h, θ_t, and θ_l of slope could, alternatively, be determined by determining the average slope of lateral cross sections of each section 3002, 3004, and 3006.
In this embodiment, angle . θ_h, is about 25 degrees, θ_t, is about 17.5 degrees, and θ_l is about 10 degrees. In some embodiments, the angle θ_h is from about 10 to about 30 degrees, and the angle θ_t is from about 0 to about 25 degrees (such as from about 1 to about 20 degrees). In some embodiments, angle θ_h is at least about 20 degrees, such as from about 20 to about 25 degrees, and the angle θ_t is at least about 10 degrees, such as from about 10 to about 25 degrees.
In some embodiments, the angle θ_t is from about 5 to about 15 degrees less than the angle θ_h. In some embodiments, the angle θ_t is from about 5 to about 10 degrees less than the angle θ_h, and in some embodiments the angle θ_t is about 7.5 degrees less than the angle θ_h. In some embodiments, the angle θ_t is from about 15 to about 17.5 degrees.
In some embodiments, the angle θ_l is from about 0 degrees to about 15 degrees. In some embodiments, the angle θ_l is from about 0 degrees to about 12.5 degrees, and in some embodiments is about 10 degrees. In some embodiments, the angle θ_l is from about 0 to about 15 degrees less than the angle θ_t. In some embodiments, the angle θ_l is from about 5 to about 10 degrees less than the angle θ_t, and in some embodiments the angle θ_l is about 7.5 degrees less than the angle θ_t.
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 (h₁, h₂, h₃, and h₄). The heights at the head end (h₃, and h₁) are larger than those at the foot end (h₄, h₂). The heights on the left side (h₁, h₂) are larger than the heights directly laterally across from them (h₃, and h₄ respectively). Accordingly, the bellows creates a slope in both the lateral direction (w₁) and the longitudinal direction (l₁). 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 θ₁ near the head support section of the mattress 2000 (and smaller angle created in the torso support section of the mattress). Preferably, this angle, θ₁, 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.
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.
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.
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.
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 scope of the appended claims.
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.
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.
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° 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° 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 2121 d 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.
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.
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.
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™ device or similar wearable device and the one or more sensors comprise an accelerometer.
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.
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.
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
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.
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.
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 the sleep apnea shape of base 2202 shown in FIG. 135B due to the application of the person's weight to upper surface 2206.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 transferrable 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.
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.
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.
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® 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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° 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.
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° 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.
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.
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® 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.
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.
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.
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 are contemplated.
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, without departing from the scope of the appended claims.

Claims

A person support apparatus having a longitudinal length from its head end to its foot end, and having a lateral width from side to side, the person support apparatus comprising:
an inflatable head section having a head support surface (2121a) to support at least a portion of a person's head, wherein at least a portion of the head support surface (2121a) is generally sloped downward in a lateral direction;

an inflatable torso section having a torso support surface (2121b) to support a least a portion of the person's torso, wherein at least a portion of the torso support surface (2121b) is generally sloped downward in the lateral direction, wherein the slope of the torso support surface is different from the slope of the head support surface;

a knee gatch section located between the torso section and an inflatable leg section, wherein the knee gatch section has no lateral tilt and has a knee gatch bladder that is inflatable to control an amount of rounded contour in an upper surface of the knee gatch section; and

an inflatable bolster extending along a side of person support apparatus and extending above at least one of a side and an end of the person support apparatus.
The person support apparatus as recited in claim 1, wherein the bolster does not extend along at least a portion of a side of the head section.
The person support apparatus as recited in either claim 1 or claim 2, wherein the bolster extends above the foot end of the person support apparatus.
The person support apparatus as recited in any preceding claim, wherein the head support surface (2121a) is sloped at an angle of from about 10 to about 30 degrees, and the torso support surface (2121b) is sloped at an angle of from about 1 to about 20 degrees.
The person support apparatus as recited in any preceding claim, wherein at least one of the head section and torso section comprises an air bladder (2118a, 2118b) configured to inflate to create at least a portion of the slope of the section.
The person support apparatus as recited in any preceding claim, further comprising a transition surface sloping between the head section and the torso section.
The person support apparatus as recited in any preceding claim wherein the head section has a height when the person support apparatus is in a generally horizontal position, wherein the torso section has a height when the person support apparatus is in the generally horizontal position, and wherein the height of the head support section is greater than the height of the torso support section.
The person support apparatus as recited in claim 7, wherein 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.
The person support apparatus as recited in either claim 7 or claim 8, wherein the angle of the head section is the average angle of slope of tangents to horizontal cross sections of the head section, and the angle of the torso section is the average angle of slope of tangents to horizontal cross sections of the torso section.
The person support apparatus as recited in any one of claims 7 to 9, wherein the leg section is sized to support a person's legs, wherein the leg section is generally laterally sloped moving from the first side toward the second side, wherein the leg section has a height when the sleeping apparatus is in the generally horizontal position; wherein the height of the torso section is greater than the height of the leg section.
The person support apparatus as recited in any preceding claim wherein the head section and/or the torso section forms part of 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, wherein the support section allows the person's head to turn substantially in at least one direction; wherein the support section urges 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, wherein the first angle is equal to or greater than about 35 degrees from the upwardly extending vertical plane.
The person support apparatus as recited in any preceding claim wherein the torso support surface (2121b) is generally laterally sloped moving from the first side toward the second side; wherein the person support apparatus is generally longitudinally sloped moving from the head end to the foot end.
The person support apparatus as recited in any preceding claim, wherein the leg section has a leg support surface (2121d) to support at least a portion of a person's leg, wherein the leg support surface (2121d) 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 (2121b).
The person support apparatus as recited in claim 13, wherein the bolster extends along at least a portion of the leg section.
The person support apparatus as recited in any of the claims 1-12, wherein the leg section has a leg support surface (2121d) to support at least a portion of a person's leg, wherein the leg support surface (2121d) is flat or is generally downwardly sloped in the lateral direction at an angle relative to the plane that is less than the angle of the head support surface (2121a).