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Automated device effectively treats sleep disordered breathing

An automated adaptive servo-ventilation device effectively treated sleep disordered breathing among a cohort of patients with mixed sleep apnea, according to the results of a recent study.

“Suppression of [Hunter-Cheyne Stokes breathing, continuous positive airway pressure emergent central apnea and central apnea associated with opioids acutely and chronically] over the course of 3 months use at home resulted in improvement in apnea hypopnea index and subjective assessment of excessive day time sleepiness in the study participants,” Shahrokh Javaheri, MD, of Sleepcare Diagnostics in Cincinnati, Ohio, and colleagues wrote.

For the prospective, multicenter, observational trial, Javaheri and colleagues hypothesized that the automatic adaptive servo-ventilation device would lead to significant reductions in the frequency of breathing events in 27 patients with mixed sleep apnea who underwent 3 nights of polysomnography and 3 months of treatment.

The 27 patients had an apnea hypopnea index greater than or equal to 15 and a central apnea index greater than or equal to 5 per hour. They underwent automated adaptive servo-ventilation titration without technician intervention. Twenty-six patients used adaptive servo-ventilation at home for 3 months.

Mean baseline apnea hypopnea index was 55 and central apnea index was 23. Overnight adaptive servo-ventilation titration significantly improved apnea hypopnea index, central apnea index, obstructive apnea and arousal index, according to the study results. 

Compared with continuous positive airway pressure, patients reported better sleep quality with the device. Mean adherence to device use was 4.2 hours per night. Researchers observed a decrease in Epworth Sleepiness Scale from 12.8 to 7.8 (P = .001). During the 3 months of treatment, adaptive servo-ventilation remained effective with a median apnea hypopnea index of 11 vs. 4 during polysomnography.

“Given the present circumstances of widespread use of home sleep testing as well as auto-titrating continuous positive airway pressure for treatment of obstructive sleep apnea, home titration with Adaptive Servo-Ventilation devices may also prove to be both effective and cost saving,” Javaheri and colleagues wrote. “However, practitioners should confirm that efficacy and adherence are acceptable in patients prescribed adaptive servo-ventilation, since not all devices use the same algorithms.”

Disclosure: The study was sponsored by Philips Respironics. The researchers report speakers bureau and consulting roles for and research funding from Inspire, Medtronic, Merck, Philips-Respironics, Res-Med and Respicardia.