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

Abstract

Objective: The coexistence of obstructive (OSAS) and central sleep apnoea (CSA), and Cheyne-Stokes respiration (CSR) is common in patients with underlying heart diseases. CPAP has been shown to improve CSA/CSR by about 50%, but recent data suggest maximal suppression of CSA is important in improving clinical outcomes in heart failure patients. Adaptive servo-ventilation (ASV) effectively suppresses CSA/CSR in heart failure. However, there are insufficient data from CPAP controlled trials in coexisting OSAS and CSA/CSR.
Methods: Prospective, randomized, CPAP controlled study over three months on the efficacy of a new ASV device, the BiPAP AutoSV (BSV), in 26 patients (24 m, 2 f) with coexisting OSAS and CSA/CSR. The patients suffered of arterial hypertension, coronary heart disease or cardiomyopathy and clinical signs of heart failure NYHA II-III. CPAP n=12, BSV n=14. Primary outcome parameter was the number of central respiratory disturbances.
Measurements and Results: Under BSV the total AHI improved from 46.8±19.4/h to 7.8±12.7, the central AHI from 25.7±17.1/h to 7.1±12.6/h and the obstructive AHI from 14.2±8.4/h to 0.7±0.7/h (all p<0.01). Under CPAP total AHI improved from 38.8±10.6/h to 11.9±8.0/h, the central AHI from 23.7±11.3/h to 10.5 ±7.7/h and the obstructive AHI from 8.4±4.0/h to 0.8±1.3/h (all p<0.01). The central AHI was significantly improved with BSV as compared with CPAP (p<0.05). Furthermore, there was a significant improvement in quality of sleep under both modes.
Conclusions: BiPAP AutoSV was superior in improving the central AHI in coexisting OSAS and CSA/CSR and underlying cardiovascular diseaeses compared with CPAP over a three-month treatment period.

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Citations should be made in the following way:
W. Randerath, W. Galetke, S. Stieglitz, C. Priegnitz, T. Schäfer (Solingen, Germany). Adaptive servoventilation in coexisting obstructive sleep apnoea/hypopnoea and Cheyne-Stokes respiration. Eur Respir J 2008; 32: Suppl. 52, 4215

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