Comparison of Modified With Conventional Adaptive Servoventilation Processes

Patients with cardiovascular disorders frequently suffer from sleep-related respiratory disorders (SRRD), such as obstructive sleep apnea (OSA) or a specific form of central sleep apnea, Cheyne-Stokes breathing (CSB, periodic breathing). However there is also a significant incidence of complex nocturnal breathing disorders, with both obstructive and central components. Sleep-related breathing disorders of this kind cause decreases in arterial oxygen saturation through brief hypopneas and apneas. Disturbed breathing also causes the patient to wake frequently during the night (arousals), usually during the hyperventilatory phase of CSB. Repeated arousals cause fragmentation of sleep, and therefore a deep sleep deficit. This leads to increased sleepiness during the day and impaired cognitive performance.

Previous studies have shown that Cheyne-Stokes breathing can be treated effectively with adaptive servoventilation. An enhancement to the routinely used algorithm (AutoSet CS2) has been created which allows the algorithm to differentiate between obstructive events and Cheyne-Stokes breathing, and better respond to apneas and hypopneas to eliminate the sleep-related breathing disorder and normalise breathing during sleep.

Inclusion criteria

• 18+ years of age
• consent in writing
• complex nocturnal breathing disorder with Cheyne-Stokes breathing and obstructive sleep apnoea
• AHI > 15/h

Exclusion criteria

• acute cardiac decompensation
• acute myocardial infarct within the last 3 months
• post-resuscitation condition within the last 3 months
• post-stroke condition with difficulty in swallowing or persisting hemiparesis
• abuse of medication, alcohol or drugs
• pregnancy
• known to be suffering from a tumour