Hetzenecker, Andrea and Escourrou, Pierre and Kuna, Samuel T. and Series, Frederic and Lewis, Keir and Birner, Christoph and Pfeifer, Michael and Arzt, Michael (2016) Treatment of sleep apnea in chronic heart failure patients with auto-servo ventilation improves sleep fragmentation: a randomized controlled trial. SLEEP MEDICINE, 17. pp. 25-31. ISSN 1389-9457, 1878-5506
Full text not available from this repository. (Request a copy)Abstract
Background: Impaired sleep efficiency is independently associated with worse prognosis in patients with chronic heart failure (CHF). Therefore, a test was conducted on whether auto-servo ventilation (ASV, biphasic positive airway pressure [BiPAP]-ASV, Philips Respironics) reduces sleep fragmentation and improves sleep efficiency in CHF patients with central sleep apnea (CSA) or obstructive sleep apnea (OSA). Methods: In this multicenter, randomized, parallel group trial, a study was conducted on 63 CHF patients (age 64 +/- 10 years; left ventricular ejection fraction 29 +/- 7%) with CSA or OSA (apnea-hypopnea Index, AHI 47 +/- 18/h; 46% CSA) referred to sleep laboratories of the four participating centers. Participants were randomized to either ASV (n = 32) or optimal medical treatment alone (control, n = 31). Results: Polysomnography (PSG) and actigraphy at home (home) with centralized blinded scoring were obtained at baseline and 12 weeks. ASV significantly reduced sleep fragmentation (total arousal indexpsc: -16.4 +/- 20.6 vs.-0.6 13.2/h, p = 0.001; sleep fragmentation index(home):-7.6 +/- 15.6 versus 4.3 +/- 13.9/h, p = 0.003, respectively) and significantly increased sleep efficiency assessed by actigraphy (SEhome) compared to controls (2.3 +/- 10.1 vs.-2.1 +/- 6.9%, p = 0.002). Effects of ASV on sleep fragmentation and efficiency were similar in patients suffering from OSA and CSA. Conclusions: At home, ASV treatment modestly improves sleep fragmentation as well as sleep efficiency in CHF patients having either CSA or OSA. (C) 2015 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITIVE AIRWAY PRESSURE; CHEYNE-STOKES RESPIRATION; PROGNOSTIC IMPACT; ADAPTIVE SERVOVENTILATION; HYPOPNEA SYNDROME; WRIST ACTIGRAPHY; PREVALENCE; DIAGNOSIS; SYMPTOMS; EPIDEMIC; Heart failure; Sleep disordered breathing; Auto-servo ventilation; Sleep quality; NT-pro BNP |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Mar 2019 15:10 |
| Last Modified: | 21 Mar 2019 15:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2763 |
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