Adaptive Servo-Ventilation for Treatment-Emergent Central Sleep Apnea: The READ-ASV Registry

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-naive adults with TE-CSA and an ASV prescription were included in this analysis of the READ-ASV (Registry on the Treatment of Central and Complex Sleep-Disordered Breathing with ASV). QoL (Functional Outcomes of Sleep Questionnaire [FOSQ]) and daytime sleepiness (Epworth Sleepiness Scale [ESS]) were assessed at baseline and 12-month follow up. Results: Of 452 patients with TE-CSA, 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 to +1.98], P < 0.001 and +0.90 [-0.12 to +2.29], P < 0.001, respectively), and the ESS score significantly decreased (-2.00 [-5.00 to 0.00], P < 0.001 and -3.00 [-6.75 to 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. Clinical trial registered with www.clinicaltrials.gov (NCT03032029).