Adaptive servo-ventilation improves disease-specific life quality in central sleep apnea
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Key takeaways:
- Treatment with adaptive servo-ventilation for 12 months improved disease-specific quality of life scores.
- At 12 months, this treatment also contributed to less daytime sleepiness and better sleep quality.
WASHINGTON — Adults with central sleep apnea on adaptive servo-ventilation for 12 months had improved disease-specific quality of life, according to an abstract presented at the American Thoracic Society International Conference.
“Improvement of disease-specific quality of life is one major component of the indication for the therapy of adaptive servo-ventilation,” Michael Arzt, MD, of the department of Internal Medicine II at University Hospital Regensburg in Germany, told Healio.
In the prospective, multicenter and multinational READ-ASV European registry, Arzt and colleagues analyzed 801 adults (mean age, 67 years; 86% men; mean BMI, 31 kg/m2; mean apnea-hypopnea index, 49 events per hour) with central sleep apnea (CSA) newly prescribed adaptive servo-ventilation (ASV) treatment to see how 12 months of the therapy impacted disease-specific quality of life.
Researchers evaluated changes in this type of quality of life using the Functional Outcomes of Sleep Questionnaire (FOSQ) score.
In addition to measuring disease-specific quality of life 1 year after receiving ASV therapy, researchers looked at daytime sleepiness using the Epworth Sleepiness Scale (ESS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and general quality of life using the European Quality of Life 5 Dimensions (EQ-5D) index and EQ-5D-VAS.
The largest ASV indication observed was treatment-emergent CSA, which was found in more than half (56%) of the adults, Arzt told Healio. Notably, 31% of adults received ASV because of CSA in cardiovascular disease, according to the study poster.
When evaluating the prevalence of cardiovascular risk factors and comorbidities, Arzt told Healio the burden was elevated in this patient population, with hypertension observed in 79% of patients, atrial fibrillation in 32%, coronary artery disease in 29% and diabetes in 25% of patients.
Notably, 62% of patients had a FOSQ score less than 17.9 or an ESS score greater than 10 and 71% of patients had a PSQI score greater than 5, which both signal that patients are symptomatic, according to the poster.
Of the 499 adults who had a FOSQ score recorded at baseline and 12 months, researchers found that ASV treatment for 12 months improved this score by 0.8 points (IQR, –0.2 to 2.2; P < .001).
Improvements were also observed in daytime sleepiness, with a change in ESS score of –2 (IQR, –5 to 0; P < .001) in a cohort of 449 patients, as well as in sleep quality, with a change in PSQI score of –1 (n = 185; IQR, –3 to 1; P < .001) in a cohort of 185 patients, according to the abstract.
“The main message is that disease-specific quality of life and the leading symptom, daytime sleepiness, statistically and clinically significantly improves,” Arzt told Healio.
For the 288 patients with EQ-5D measurements, researchers did not observe a significant change with ASV; however, for the 480 patients with EQ-5D-VAS measurements, they found that ASV “modestly improved” the score (P < .001).
“If you look at the major randomized controlled trials, which is the evidence in the field, you always have the impression [that] these patients are not symptomatic,” Arzt told Healio. “Also, in the results from these trials, some do not find the improvement in quality of life, but of course, when you select patients who are not symptomatic, you cannot find the improvement of symptoms and quality of life. When we apply the therapy to a realistic sleep clinic population we see every day, we have an effective therapy for improvement of quality of life.”
Headshot Credit: University Hospital Regensburg