RT Journal Article
SR Electronic
T1 Treatment of central and obstructive sleep apnea in stable heart failure patients with auto-servo ventilation reduces sleep fragmentation - A randomized controlled trial
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3289
VO 40
IS Suppl 56
A1 Michael Arzt
A1 Frederic Series
A1 Keir Lewis
A1 Amit Benjamin
A1 Pierre Escourrou
A1 Ruth Luigart
A1 Christoph Birner
A1 Michael Pfeifer
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3289.abstract
AB Background: It is of debate, whether treatment of central sleep apnea (SA) reduces sleep fragmentation. Therefore, we tested, whether auto-servo ventilation (ASV, BiPAP-ASV, Philips Respironics) reduces sleep fragmentation in heart failure (HF) patients with severe central or obstructive SA.Methods: 42 patients with HF (age 66±9y, LVEF <40%) and SDB (apnea-hypopnea index, AHI 48±19/h, 51% central SA) were randomized to either ASV (n=21) or optimal medical treatment alone (control, n=21). Polysomnography (PSG) and 5 days of actigraphy with centralized scoring by blinded raters were obtained at baseline and 12 weeks.Results: In the ASV-group AHI and central AHI were significantly suppressed compared to the control-group (-40±16 versus -1±13/h, p<0.001 and -24±14 versus +1.7±10/h, p<0.001, respectively). The arousalindex (ArI), sleep stage 1 (S1, PSG) and the fragmentation index (actigraphy) were significantly reduced (-14.7±21.3 versus 2.6±13.3/h, p=0.032 and 36±47 versus -6±41 min, p=0.005, and -11.4±16.0 versus -2.9±9.4/h, p=0.002, respectively) and sleep efficiency (SE) and daytime activity duration (actigraphy) significantly increased in the ASV-group compared to controls (5.5±10 vs. 1.6±6.9/h, p=0.021 and 14±54 vs. -24±41 min, p=0.009, respectively). Effects of ASV on ArI, S1, SE and daytime activity duration were similar in HF patients with obstructive and central SA (p>0.05 for all comparisons).Conclusions: ASV-treatment significantly improves sleep fragmentation similarly in HF-patients with either central or obstructive SA. These effects were associated with a modest increase of daytime activity duration.