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Sleep Med. 2008 Dec;9(8):823-30. doi: 10.1016/j.sleep.2008.02.011. Epub 2008 Jul 21.

Adaptive servo-ventilation in patients with coexisting obstructive sleep apnoea/hypopnoea and Cheyne-Stokes respiration.

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  • 1Institute of Pneumology at the University Witten/Herdecke, Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, Solingen, Germany. randerath@klinik-bethanien.de

Abstract

OBJECTIVE:

The coexistence of obstructive (OSAS) and central sleep apnoea (CSA) and Cheyne-Stokes respiration (CSR) is common in patients with and without 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, but only few trials have considered patients with coexisting OSAS and CSA/CSR.

METHODS:

Prospective, observational pilot study to evaluate the efficacy of a new ASV device, the BiPAP AutoSV, in 10 male consecutive patients with coexisting OSAS and CSA/CSR with and without heart failure over eight weeks. Six had stable heart failure.

MEASUREMENTS AND RESULTS:

The total AHI improved from 48.9+/-20.6/h to 8.7+/-7.4, the obstructive AHI from 15.8+/-16.2/h to 2.6+/-2.5/h and the central AHI from 33.1+/-10.8/h to 6.1+/-5.9/h (all p<0.01). Furthermore, there was a significant improvement in sleep profile and respiratory related arousals. The six patients with cardiovascular disease, including three with congestive heart failure, showed similar improvements in all parameters.

CONCLUSIONS:

BiPAP AutoSV was effective in reducing all types of respiratory disturbances in coexisting OSAS and CSA/CSR with and without heart failure. Further studies comparing the long-term clinical efficacy of this device against CPAP are warranted.

PMID:
18640873
[PubMed - indexed for MEDLINE]
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