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

Hetzenecker, Andrea; Escourrou, P.; Kuna, Samuel T.; Sériès, Frédéric; Lewis, Keir; Birner, Christoph; Pfeifer, Michael; Arzt, Michael

doi:10.1016/j.sleep.2015.08.020

Cited by 34 publications

(22 citation statements)

References 40 publications

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“…Our analysis will provide a conceptual foundation for the use of the term “sleep disturbance” in diabetes. Evidence suggests that sleep disorders, particularly sleep apnoea, can cause sleep disturbance (i.e., sleep fragmentation and sleep loss) (Hetzenecker et al., ; Tasali, Mokhlesi, & Van Cauter, ). However, sleep apnoea was considered a characteristic of sleep disturbance in several studies included in this analysis.…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbance in people with diabetes: A concept analysis

Zhu

Vincent

Kapella

et al. 2017

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 99%

Sleep disturbance in people with diabetes: A concept analysis

Zhu

Vincent

Kapella

et al. 2017

Journal of Clinical Nursing

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“…In addition, ASV devices provide fixed or variable expiratory pressure to suppress obstructive events and apply mandatory breaths to avoid central apnoeas [38]. Therefore, ASV normalises obstructive and central SDB and is superior to CPAP, oxygen or other therapeutic approaches [15,37,[39][40][41][42][43][44] for suppressing sleep disturbances. However, the SERVE-HF trial, which compared optimum medical treatment for heart failure alone (control group) or in combination with adaptive servoventilation in severe CHF with reduced LVEF (<45%) and predominant CSA failed to show a prognostic benefit of ASV [45].…”

Section: Challenges In Managing Csa/periodic Breathing In Chf With Rementioning

confidence: 99%

Central sleep apnoea and periodic breathing in heart failure: prognostic significance and treatment options

et al. 2019

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Central sleep apnoea (CSA) including periodic breathing is prevalent in more than one-third of patients with heart failure and is highly and independently associated with poor outcomes. Optimal treatment is still debated and well-conducted studies regarding efficacy and impact on outcomes of available treatment options are limited, particularly in cardiac failure with preserved ejection fraction. While continuous positive airway pressure and oxygen reduce breathing disturbances by 50%, adaptive servoventilation (ASV) normalises breathing disturbances by to controlling the underlying mechanism of CSA. Results are contradictory regarding impact of ASV on hard outcomes. Cohorts and registry studies show survival improvement under ASV, while secondary analyses of the large SERVE-HF randomised trial showed an excess mortality in cardiac failure with reduced ejection fraction. The current priority is to understand which phenotypes of cardiac failure patients may benefit from treatment guiding individualised and personalised management.

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“…As a result of the evaluations made in this study, treatment interventions for CHF patients with OSA and CSA included mostly CPAP (7)(8)(9)12,18) and ASV (10)(11)(12)(13)(14)(15)(16)22), as well as BIPAP (8), overdrive pacing (21), oxygen therapy with nasal cannula (6,19), slow breathing training (17) and exercise training (20).…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Efficacy of Interventions for the Treatment of Sleep Respiratory Disorder in Chronic Heart Failure Patients: A Systematic Review

Uysal¹,

Oruçoğlu²

2019

Istanbul Med J

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One of the most important problems of heart failure (HF) patients is sleep disturbance. In HF patients with obstructive and central sleep apnea, hypoxia, hypercapnia and overexcitation of the sympathetic system are observed. As a result, negative intrathoracic pressure and left ventricular afterload increase. Treatment of sleep respiratory disorders in chronic HF patients is important for the prognosis of the disease. Therefore, in this systematic review, we aimed to evaluate the efficacy of interventions used for the treatment of sleep respiratory disorder in chronic HF patients. Cochrane Library, Scopus, Springer Link, Science Direct, Clinical Key, PubMed, Turkey Citation Index and EBSCO databases were searched for studies between June 2017-August 2018. When all studies were examined, out of 2.691.006 studies published between 2007-2017, 16 randomized controlled trials that met inclusion criteria were included in the study. In these studies, treatment interventions for treatment groups with sleep respiratory disorder included continuous positive airway pressure (CPAP), bi-level positive airway pressure, adaptive servo-ventilation (ASV), atrial overdrive pacing, home oxygen therapy, slow breathing exercise device and structured physical exercise. When the study results are examined, CPAP treatment improved daytime sleepiness and left ventricular ejection fraction (LVEF) but did not provide significant improvement on quality of life, and that ASV treatment reduced apneahypopnea index, provided improvement in LVEF and cardiac function, and reduced ventricular ejection fraction. However, further research is needed to fully demonstrate the efficacy of interventions for the treatment of sleep respiratory disorder in chronic HF patients.

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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: At home, ASV treatment modestly improves sleep fragmentation as well as sleep efficiency in CHF patients having either CSA or OSA.

Cited by 34 publications

References 40 publications

Sleep disturbance in people with diabetes: A concept analysis

Sleep disturbance in people with diabetes: A concept analysis

Central sleep apnoea and periodic breathing in heart failure: prognostic significance and treatment options

Assessment of the Efficacy of Interventions for the Treatment of Sleep Respiratory Disorder in Chronic Heart Failure Patients: A Systematic Review

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