Sleep Function Feature

The Sleep Function suspends the programmed Lower Rate and replaces it with a Sleep Rate (slower than the Lower Rate) during a specified sleep period. The slower pacing rate during the sleep period is intended to reduce the paced rhythm during sleep.

This feature can be found in some Medtronic Pacemaker, ICD, CRT-P, and CRT-D devices. Please go to manuals.medtronic.com or consult with your local Medtronic representative regarding device models available in your geography.

Sleep function is available in all pacing modes and is nominally Off.

Additional programming parameters include (nominal settings are shown in image below):

  • Sleep Rate – Device gradually reduces the operating pacing rate from the Lower Rate to this rate. This rate remains in effect as the operating pacing rate until the programmed Wake Time.
  • Bed Time – Time at which rate will gradually decrease to the Sleep Rate.
  • Wake Time – Time at which rate will gradually increase to the Lower Rate.

To program this feature in Adapta™/Versa™/Sensia™ pacemakers, go to Params -> Additional Features -> Sleep.

To program this feature in Advisa™ pacemakers, ICDs and CRTs, go to Pacing -> Params -> Additional Features -> Sleep.

Sleep Function Programming for Adapta/Versa/Sensia

Sleep Feature Programming for Advisa pacemakers, ICDs, and CRTS

Considerations: 

  • When setting Bed Time and Wake Time, consider time zone changes resulting from travel, daylight savings time, and variations in the patient’s sleep patterns (such as variable work shifts).
  • Bed Time and Wake Time must differ by: 
    • Minimum of one hour in Adapta/Versa/Sensia pacemakers, less than one hour is not programmable.
    • Minimum of two hours in all other device, less than two hours in not programmable.
  • In rate responsive modes, the sensor-indicated rate drops to the Sleep Rate, but increases in the presence of sensor-indicated activity.​
In Adapta/Versa/Sensia pacemakers:
  • The 2090 programmer clock is used to set and display Bed Time and Wake Time. To ensure that the Bed Time and Wake Time parameters are accurate, keep your programmer set to the correct time.
  • Atrial Preference Pacing and Sleep Function cannot be enabled concurrently.
  • When Sleep Function is active, Rate Drop Response therapy intervention is temporarily disabled.
  • Applying a magnet or the programming head over the pacemaker during the sleep period causes the device to abandon Sleep operation and restores the programmed Lower Rate upon magnet removal. The Sleep Function resumes at the next scheduled Bed Time.
In Advisa pacemakers, ICDs, and CRT devices:
  • The device’s internal clock is used to set and display Bed Time and Wake Time and can be programmed by going PARAMS -> Data Collection Setup.  To ensure that the Bed Time and Wake Time parameters are accurate, keep the device clock set to the correct time.
  • If the patient experiences an AT/AF episode and the Mode Switch feature is operating during the Sleep period, the device does not pace below the Lower Rate until the AT/AF episode has ended.
  • If a magnet is applied to the device during Sleep operation, sleep rate is restored once the magnet is removed.

At the programmed Bed Time, the pacemaker gradually reduces the pacing rate: the rate goes from the Lower Rate Limit (LRL) to the programmed Sleep Rate.

The device will pace at the Sleep Rate until Wake Time is reached, and then it will switch back to the Lower rate from the Sleep Rate. Each change in rate will take about 30 minutes to complete.

The diagram below demonstrates sleep function operation:

References

Sources: Medtronic Adapta/Versa/Sensia Reference Guide; Medtronic Consulta CRT-P Clinician Manual;Medtronic Protecta XT DR Clinician Manual; Medtronic Protecta XT CRT-D Clinician Manual.

Last updated: 
05 Dec 2016