Stimulation for treating sleep disordered breathing

1. A device for treating obstructive sleep apnea, comprising:

a non-cardiac stimulation element to engage and to stimulate an upper-airway-patency-related nerve, according to a first stimulation therapy protocol not synchronized relative to actively-sensed respiratory information, wherein the first stimulation therapy protocol comprises a series of repeating stimulation cycles in which each stimulation cycle includes a stimulation period and a non-stimulation period,

wherein each stimulation period includes continuous stimulation and has a minimum duration equal to or greater than an inspiratory reference of a reference respiratory cycle, wherein the inspiratory reference corresponds to a duration of an inspiratory phase of the reference respiratory cycle, and wherein the reference respiratory cycle comprises at least one of:

a historical patient-specific average respiratory cycle for stable respiration; and

a multi-patient average respiratory cycle for stable respiration, and

wherein each stimulation period of each respective stimulation cycle has a duration greater than a duration of the inspiratory reference of the reference respiratory cycle and the stimulation period is followed by the non-stimulation period of the respective stimulation cycle comprising a duration less than the duration of the stimulation period.

2. The device of claim 1 , wherein the non-cardiac stimulation element comprises an implantable electrode and a pulse generator electrically connected to the implantable electrode.

3. The device of claim 2 ,

wherein the implantable electrode comprises a cuff electrode including at least one operative contact group through which the stimulation is deliverable non-selectively to the upper-airway-patency-related nerve.

4. The device of claim 1 , wherein a total duration of stimulation via the first stimulation protocol during a treatment period is greater than 30 percent of the total duration of the treatment period.

5. The device of claim 1 , wherein the duration of the stimulation period comprises

at least 50 percent of a duration of the stimulation cycle.

6. The device of claim 1 , wherein the duration of the stimulation period comprises

at least 50 percent of a duration of the reference respiratory cycle.

7. The device of claim 1 , wherein the duration of each respective stimulation cycle is less than the duration of the reference respiratory cycle, and a duration of the stimulation period exceeds the duration of the non-stimulation period by a factor of at least 3.

8. The device of claim 1 , wherein the duration of each respective stimulation cycle is greater than the duration of the reference respiratory cycle.

9. The device of claim 8 , wherein the stimulation period and the non-stimulation period are in a proportion of at least 1.5 to 1.

10. The device of claim 8 , wherein the duration of the stimulation cycle is less than a duration of two consecutive reference respiratory cycles.

11. The device of claim 1 , wherein the duration of each respective stimulation cycle is equal to the duration of the reference respiratory cycle, and wherein the duration of the reference respiratory cycle differs from a duration of a real time respiratory cycle from actively-sensed respiration information by an amount exceeding a duration variability criteria.

12. The device of claim 1 , comprising:

a processor; and

a non-volatile computer readable medium storing instructions, executable on the processor, to implement the non-cardiac stimulation element and to perform the first stimulation therapy protocol.

13. The device of claim 1 , comprising:

a sensing element to at least periodically actively sense respiratory information to obtain the actively-sensed respiratory information unrelated to stimulation synchronization,

wherein the non-cardiac stimulation element is activated for stimulation upon the sensing element identifying, via at least the actively-sensed respiratory information, obstructive sleep apnea behavior which meets or exceeds a severity threshold and wherein the non-cardiac stimulation element is deactivated upon the sensing element identifying, via at least the actively-sensed respiratory information, that the obstructive sleep apnea behavior is less than the severity threshold.

14. The device of claim 1 , comprising:

a sensing element to obtain the actively-sensed respiratory information; and

a control portion including:

a processor; and

a non-volatile memory storing instructions, executable via the processor, to:

provide convertible operation via a therapy manager between:

a first stimulation mode implementing the first stimulation therapy protocol; and

a second stimulation mode of stimulating the upper-airway-patency-related nerve synchronous with a characteristic of the actively-sensed respiratory information.

15. The device of claim 1 , wherein the stimulation period and the non-stimulation period are in a proportion of at least 1.5 to 1.