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Treatment of sleep apnea in chronic heart failure patients with auto-servo ventilation improves sleep fragmentation: a randomized controlled trial.

Abstract：

BACKGROUND:Impaired sleep efficiency is independently associated with worse prognosis in patients with chronic heart failure (CHF). Therefore, a test was conducted on whether auto-servo ventilation (ASV, biphasic positive airway pressure [BiPAP]-ASV, Philips Respironics) reduces sleep fragmentation and improves sleep efficiency in CHF patients with central sleep apnea (CSA) or obstructive sleep apnea (OSA). METHODS:In this multicenter, randomized, parallel group trial, a study was conducted on 63 CHF patients (age 64 ± 10 years; left ventricular ejection fraction 29 ± 7%) with CSA or OSA (apnea-hypopnea Index, AHI 47 ± 18/h; 46% CSA) referred to sleep laboratories of the four participating centers. Participants were randomized to either ASV (n = 32) or optimal medical treatment alone (control, n = 31). RESULTS:Polysomnography (PSG) and actigraphy at home (home) with centralized blinded scoring were obtained at baseline and 12 weeks. ASV significantly reduced sleep fragmentation (total arousal indexPSG: -16.4 ± 20.6 vs. -0.6 ± 13.2/h, p = 0.001; sleep fragmentation indexhome: -7.6 ± 15.6 versus 4.3 ± 13.9/h, p = 0.003, respectively) and significantly increased sleep efficiency assessed by actigraphy (SEhome) compared to controls (2.3 ± 10.1 vs. -2.1 ± 6.9%, p = 0.002). Effects of ASV on sleep fragmentation and efficiency were similar in patients suffering from OSA and CSA. CONCLUSIONS:At home, ASV treatment modestly improves sleep fragmentation as well as sleep efficiency in CHF patients having either CSA or OSA.

journal_name

Sleep Med

journal_title

Sleep medicine

authors

Hetzenecker A,Escourrou P,Kuna ST,Series F,Lewis K,Birner C,Pfeifer M,Arzt M

doi

10.1016/j.sleep.2015.08.020

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

25-31

eissn

1389-9457

issn

1878-5506

pii

S1389-9457(15)00924-7

journal_volume

17

pub_type

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