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

Abstract

Complex sleep apnoea, combining central and obstructive events, does not seem to be well characterized. Alveolar hypoventilation disorders, heart failure, neurological disorders with stroke and idiopathic forms are suggested as reasons for central sleep apnea (CSA) (Wisskirchen & Teschler, 2000, Rochester & Mohsenin, 2002, Badr, 2005).
CPAP is an appropriate means for the treatment of OSAS, but may lead to accumulation of central apnoeas instead (Morgenthaler et al., 2007). Because of that, the optimal treatment of patients with complex apnea often require alternative ventilatory modalities. Adaptive servoventilation (ASV) seems to be more effective than CPAP in patients with CSA, mixed apnea or complex sleep apnea (Morgenthaler et al., 2007).
We examined nine patients with a complex sleep apnea in a polysomnography. Four patients had pulmonary hypertension (verified with right heart catheterization and follow-up), two patients intracerebral hemorrhage, three with chronic heart failure and one with minor stroke in addition. We detected a diagnostic AHI 29.3/h SD ± 19.3. CPAP and bilevel ST, respectively, was attempted without success in all patients. After this we observed a slight reduction of the obstructive pattern, but an increase of central apnoea (AHI 22 SD ± 12.8). In con-trast, ASV was very effective in both complex sleep apnea and CSA/Cheyne Stokes breathing (CSR) (residual AHI 3.0 ± 2.7).
In patients with CSA/CSR, mixed apneas and in particular complex sleep apnea of different causes ASV is very effective in normalizing breathing and sleep parameters.

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Citations should be made in the following way:
M. Becker, N. Tröster, S. Scheidl, R. Wurm, M. Dominco, H. Olschewski (Graz, Austria). Adaptive servoventilation for complex sleep apnea in patients with different underlying diseases. Eur Respir J 2008; 32: Suppl. 52, 4212

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