Techniques are provided for treating periodic breathing, such as
Cheyne-Stokes Respiration, using an implantable medical system. In one
technique, diaphragmatic stimulation is delivered during a hyperpnea
phase of periodic breathing via electrical stimulation of the phrenic
nerves. Diaphragmatic stimulation is synchronized with intrinsic
inspiration so as to increase the amplitude of diaphragmatic contraction
during inspiration. This tends to decrease intrathoracic pressure leading
to occlusion of the respiratory airway. Occlusion reduces actual
ventilation during hyperpnea, thus reducing the cyclic blood chemistry
imbalance that sustains periodic breathing so as to either mitigate
periodic breathing or eliminate it completely. In another technique,
respiration is instead inhibited during the hyperpnea phase of periodic
breathing by blocking phrenic nerve signals to the extent necessary to
reduce ventilation to terminate periodic breathing or at least mitigate
its severity. Techniques are also described for controlling the type of
therapy applied in response to periodic breathing.