Adaptive Servo-Ventilation: A Comprehensive Descriptive Study in the Geneva Lake Area

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Cardiology

Background:

• Adaptive servo-ventilation (ASV) use has faced scrutiny in patients with central sleep apnea (CSA) and chronic heart failure (CHF).
• Current clinical practice patterns for ASV require detailed examination.
• Understanding ASV's evolving role is crucial for patient management.

Purpose of the Study:

• To describe the current utilization of ASV in clinical practice.
• To characterize the patient population receiving long-term ASV therapy.
• To assess the indications and outcomes of ASV use.

Main Methods:

• A descriptive, cross-sectional, multicentric study was conducted.
• Included patients (n=458) received long-term ASV (≥3 months) in Geneva or Vaud, Switzerland.
• Data collected included patient demographics, prior treatments, ASV indications, and device usage.

Main Results:

• The study population was predominantly male (85.6%), overweight (median BMI 29 kg/m²), and comorbid, with a median age of 71 years.
• Primary indications for ASV were emergent sleep apnea (ESA; 73.6%) and central sleep apnea (CSA; 23.6%).
• CSA in chronic heart failure (CHF) represented only 6.5% of cases; ASV normalized the apnea-hypopnea index in 94% of patients.

Conclusions:

• ASV use has expanded beyond its initial indication (CSA in CHF) to a heterogeneous population, mainly for ESA and CSA.
• The study population comprised older, male, comorbid, and overweight individuals.
• ASV demonstrated satisfactory compliance and effective respiratory event normalization.