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01-05-2018 | Original Paper

Adaptive servo-ventilation and sleep quality in treatment emergent central sleep apnea and central sleep apnea in patients with heart disease and preserved ejection fraction

Authors: Katharina Heider, Michael Arzt, Christoph Lerzer, Leonie Kolb, Michael Pfeifer, Lars S. Maier, Florian Gfüllner, Maximilian Valentin Malfertheiner

Published in: Clinical Research in Cardiology | Issue 5/2018

Abstract

Background

Reduced sleep quality is associated with impaired quality of life and increased mortality in patients with heart failure. The aim of this study was to observe changes in sleep fragmentation and sleep quality in patients with heart disease and preserved left ventricular ejection fraction (pEF) treated with adaptive servo-ventilation (ASV) therapy for treatment of emergent central sleep apnea (TECSA) or central sleep apnea (CSA).

Methods

114 patients with structural heart disease and pEF introduced to ASV therapy between 2010 and 2015 were retrospectively analyzed. Patients were stratified into two groups; TECSA (n = 60) or CSA (n = 54). Changes of sleep fragmentation and sleep quality from baseline to ASV initiation were compared.

Results

ASV therapy leads to a significant reduction of apnea–hypopnea index (AHI) and arousal index in patients with TECSA and CSA (∆AHI: − 43 ± 21 vs. − 47 ± 22/h; ∆arousal index − 11 ± 15, vs. − 11 ± 21/h). ASV treatment leads to a significant increase in sleep efficiency in TECSA compared to CSA (∆SE: 10 ± 19 vs. 1 ± 18%, p = 0.019). Both groups had significantly longer stage N3 (N3) and rapid eye movement sleep (REM) on ASV (∆N3: 8 ± 11 vs. 9 ± 13%; ∆REM 7 ± 9 vs. 3 ± 8%; p < 0.05 for all comparisons baseline vs. ASV).

Conclusions

In patients with heart disease and pEF, whose TECSA and CSA were treated with ASV, a significant reduction of AHI and arousal index as well as an increase of N3 and REM sleep was observed. Increase of sleep efficiency was significantly greater in TECSA compared to CSA. Hence, improvements of sleep quality were modestly greater in patients with TECSA compared to those with CSA.

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Title: Adaptive servo-ventilation and sleep quality in treatment emergent central sleep apnea and central sleep apnea in patients with heart disease and preserved ejection fraction
Authors: Katharina Heider
Michael Arzt
Christoph Lerzer
Leonie Kolb
Michael Pfeifer
Lars S. Maier
Florian Gfüllner
Maximilian Valentin Malfertheiner
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 5/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1203-9

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Adaptive servo-ventilation and sleep quality in treatment emergent central sleep apnea and central sleep apnea in patients with heart disease and preserved ejection fraction

Abstract

Background

Methods

Results

Conclusions

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Abstract

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Conclusions

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