Adaptive Servo-ventilation for Treatment-emergent Central Sleep Apnea: The READ-ASV Registry

Abstract

Rationale: Treatment-emergent central sleep apnea (TE-CSA) is the most common indication for adaptive servo-ventilation (ASV). Evidence on the effects of TE-CSA treatment on quality of life (QoL) is limited.

Objectives: To test the hypotheses that patients with TE-CSA who have cardiovascular disease (CVD) would be less symptomatic than those with CVD, and that the beneficial effects of ASV on QoL/sleepiness might be smaller in individuals with versus without CVD.

Methods: ASV-naïve adults with TE-CSA and an ASV prescription were included in this analysis of the Registry on the Treatment of Central and Complex Sleep-Disordered Breathing with ASV (READ-ASV). QoL (Functional Outcomes of Sleep Questionnaire [FOSQ] and daytime sleepiness (Epworth Sleepiness Scale [ESS]) were assessed at baseline and 12-month follow-up.

Measurements and main results: Of 452 TE-CSA patients, 81% had CVD. Before treatment initiation FOSQ and ESS scores were better in those with versus without CVD. On ASV, in the CVD and no CVD subgroups, median [interquartile range] FOSQ score significantly increased (+0.72 [-0.20; +1.98], p<0.001 and +0.90 [-0.12; +2.29], p<0.001, respectively) and the ESS score significantly decreased (-2.00 [-5.00; 0.00], p<0.001 and -3.00 [-6.75; 0.00], p<0.001); improvement magnitude was similar in both subgroups (p=0.454 and p=0.120).

Conclusions: The majority of individuals with TE-CSA and an ASV therapy prescription had CVD. Although those with TE-CSA and CVD were less symptomatic than those without CVD, ASV had a positive effect on QoL and sleepiness in these individuals, as well as those without CVD.