Source: Annual Congress 2008 - Outcome of adaptive servo ventilation in sleep apnoea
Disease area: Sleep and breathing disorders

Abstract

Objective Nasal continuous positive airway pressure (nCPAP) usually reduces sleepiness in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). However, even with regular use of nCPAP, some OSAHS patients experience residual sleepiness (RS). The aim of this study was to evaluate the efficacy of adaptive servo-ventilation (ASV) on RS in OSAHS patients. Methods The Epworth Sleepiness Scale (ESS) score was used for assessment of RS. Following correct application of one month‘s autoCPAP (APAP) treatment and exclusion for other sleepiness-associated disorders, 42 RS patients with moderate-to-severe OSAS were recruited. All of them received one week‘s ASV treatment with auto CS2 ventilator. Comparisons between APAP and ASV treatments were made for the following data: polysomnographic parameters including apnea hypopnea index (AHI), central sleep apnea index (CSAI), micro-arousal index (MAI), minimal pulse oxygen saturation (mini SpO₂), etc; daytime ESS score; and plasma tumor necrosis factor-α (TNF-α). Plasma TNF-α levels were measured by enzyme linked immunosorbent assay (ELISA). Results Compared with the parameters on day 30 of APAP treatment, there was a further significant decrease in AHI, CSAI, MAI, daytime ESS score and plasma TNF-α levels(P <0.01) on day 7 of ASV treatment. ESS score before ASV treatment (10.89±0.40) reduced to normal range (3.98±1.26) on day 7 of ASV treatment (P <0.01). Conclusions ASV treatment could significantly improved RS in OSAS patients, the mechanism of such an efficacy might be associated with further declined levels of AHI, CSAI, arousal index and plasma tumor necrosis factor-α.

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Citations should be made in the following way:
Z. Xilong, Y. Kaisheng, Y. Sumei (Nanjing/Jiangsu, China). Efficacy of adaptive servo-ventilation on residual sleepiness in patients with obstructive sleep apnea syndrome. Eur Respir J 2008; 32: Suppl. 52, 4211

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