Came across these while doing some data gathering & thought some among us would enjoy reading them.
DSM
The Role of Noninvasive Adaptive Servo-ventilation for Heart Failure-Related Central Sleep Apnea
http://chestjournal.chestpubs.org/conte ... ull?ck=nck
Efficacy of Adaptive Servoventilation in Treatment of Complex and Central Sleep Apnea Syndromes
(this article in particular is an excellent read and is quite readable)
http://chestjournal.chestpubs.org/conte ... /1839.full
Auto servo-ventilation in patients with obstructive sleep apnea syndrome and periodic breathing – a pilot study
http://www.ersnet.org/learning_resource ... es/168.pdf
Adaptive Pressure Support Servoventilation: A New Spin on the
Treatment of Heart Failure Patients with Central Sleep Apnea
http://www.sleepdt.com/_journal/bottom2 ... T24-25.pdf
Some interesting papers on using ASV machines for therapy
2 posts
• Page 1 of 1
Some interesting papers on using ASV machines for therapy
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
Re: Some interesting papers on using ASV machines for therapy
In this post I will put some extracts from the 1st set of papers as these little extracts can be quite interesting.
From link 1 ...
>>
Given the combination of mechanisms leading to these various respiratory events, many investigators have concluded that some sort of adaptive noninvasive ventilator (eg, rate-targeted, flow-targeted, volume-targeted, or some combination) holds promise for treating central sleep apnea (CSA)/Cheyne-Stokes respiration (CSR) alone or for simultaneously treating the central and obstructive components of CompSAS.
<<
From link 2 (the synopsis) ...
>>
Background: Complex sleep apnea syndrome (CompSAS) is recognized by the concurrence of mixed or obstructive events with central apneas, the latter predominating on exposure to continuous positive airway pressure (CPAP). Treatment of CompSAS or central sleep apnea (CSA) syndrome with adaptive servoventilation (ASV) is now an option, but no large series exist describing the application and effectiveness of ASV.
Methods: Retrospective chart review of the first 100 patients who underwent polysomnography using ASV at Mayo Clinic Sleep Center.
Results: ASV titration was performed for CompSAS (63%), CSA (22%), or CSA/Cheyne Stokes breathing patterns (15%). The median diagnostic sleep apnea hypopnea index (AHI) was 48 events per hour (range, 24 to 62). With CPAP, obstructive apneas decreased, but the appearance of central apneas maintained the AHI at 31 events per hour (range, 17 to 47) [p = 0.02]. With bilevel positive airway pressure (BPAP) in spontaneous mode, AHI trended toward worsening vs baseline, with a median of 75 events per hour (range, 46 to 111) [p = 0.055]. BPAP with a backup rate improved the AHI to 15 events per hour (range, 11 to 31) [p = 0.002]. Use of ASV dramatically improved the AHI to a mean of 5 events per hour (range, 1 to 11) vs baseline and vs CPAP (p < 0.0001). ASV also resulted in an increase in rapid eye movement sleep vs baseline and CPAP (18% vs 12% and 10%, respectively; p < 0.0001). Overall, 64 patients responded to the ASV treatment with a mean AHI < 10 events per hour. Of the 44 successful survey follow-up patients contacted, 32 patients reported some improvement in sleep quality.
Conclusion: The ASV device appears to be an effective treatment of both CompSAS and CSA syndromes that are resistant to CPAP.
<<
From link 3 ...
>>
Objectives: To evaluate auto servo-ventilation in patients with obstructive sleep
apnea and periodic breathing.
Design: Pilot study
Material and Methods: Patients with a combination of obstructive sleep apnea
and periodic breathing, defined as > 20% of all respiratory events, were eligible
for this study. After a diagnostic polysomnography patients were treated for one
night with auto servo-ventilation (BiPAP auto SV, Respironics, Murrysville, PA)
and then discharged. After six weeks of treatment at home a full - in laboratory
reevaluation was performed.
Results: Fifteen male patients were enrolled (age 65.0±11.9 years, body mass
index 27.7±6.9 kg/m2). Baseline apnea / hypopnea index (AHI) was 43.1±21.2
/h, arousal index 27.8±23.7 /h, snoring 99.7±72.1 minutes / night and time <
90% oxygen saturation 38.0±37.7 minutes.With auto servo - ventilation AHI was
8.6±5.7 / h at the first night and 7.4±5.3 /h after six weeks (p<0.001 vs.baseline).
Snoring was0.2±0.2 minutes and 1.0±0.9 minutes, respectively (p<0.001 vs.
baseline). Arousal index decreased to3.6±1.8 /h after six weeks(p <0.001 vs.
baseline). Mean EPAP was 7.8±2.3, mean IPAP mininum 8.7±2.7 and mean IPAP
maximum 16.1±2.2 cmH2O.
Conclusion: Auto servo-ventilation (BiPAP autoSV) is a suitable treatment
option for patients with obstructive sleep apnea syndrome and attendant periodic
breathing.
<<
DSM
From link 1 ...
>>
Given the combination of mechanisms leading to these various respiratory events, many investigators have concluded that some sort of adaptive noninvasive ventilator (eg, rate-targeted, flow-targeted, volume-targeted, or some combination) holds promise for treating central sleep apnea (CSA)/Cheyne-Stokes respiration (CSR) alone or for simultaneously treating the central and obstructive components of CompSAS.
<<
From link 2 (the synopsis) ...
>>
Background: Complex sleep apnea syndrome (CompSAS) is recognized by the concurrence of mixed or obstructive events with central apneas, the latter predominating on exposure to continuous positive airway pressure (CPAP). Treatment of CompSAS or central sleep apnea (CSA) syndrome with adaptive servoventilation (ASV) is now an option, but no large series exist describing the application and effectiveness of ASV.
Methods: Retrospective chart review of the first 100 patients who underwent polysomnography using ASV at Mayo Clinic Sleep Center.
Results: ASV titration was performed for CompSAS (63%), CSA (22%), or CSA/Cheyne Stokes breathing patterns (15%). The median diagnostic sleep apnea hypopnea index (AHI) was 48 events per hour (range, 24 to 62). With CPAP, obstructive apneas decreased, but the appearance of central apneas maintained the AHI at 31 events per hour (range, 17 to 47) [p = 0.02]. With bilevel positive airway pressure (BPAP) in spontaneous mode, AHI trended toward worsening vs baseline, with a median of 75 events per hour (range, 46 to 111) [p = 0.055]. BPAP with a backup rate improved the AHI to 15 events per hour (range, 11 to 31) [p = 0.002]. Use of ASV dramatically improved the AHI to a mean of 5 events per hour (range, 1 to 11) vs baseline and vs CPAP (p < 0.0001). ASV also resulted in an increase in rapid eye movement sleep vs baseline and CPAP (18% vs 12% and 10%, respectively; p < 0.0001). Overall, 64 patients responded to the ASV treatment with a mean AHI < 10 events per hour. Of the 44 successful survey follow-up patients contacted, 32 patients reported some improvement in sleep quality.
Conclusion: The ASV device appears to be an effective treatment of both CompSAS and CSA syndromes that are resistant to CPAP.
<<
From link 3 ...
>>
Objectives: To evaluate auto servo-ventilation in patients with obstructive sleep
apnea and periodic breathing.
Design: Pilot study
Material and Methods: Patients with a combination of obstructive sleep apnea
and periodic breathing, defined as > 20% of all respiratory events, were eligible
for this study. After a diagnostic polysomnography patients were treated for one
night with auto servo-ventilation (BiPAP auto SV, Respironics, Murrysville, PA)
and then discharged. After six weeks of treatment at home a full - in laboratory
reevaluation was performed.
Results: Fifteen male patients were enrolled (age 65.0±11.9 years, body mass
index 27.7±6.9 kg/m2). Baseline apnea / hypopnea index (AHI) was 43.1±21.2
/h, arousal index 27.8±23.7 /h, snoring 99.7±72.1 minutes / night and time <
90% oxygen saturation 38.0±37.7 minutes.With auto servo - ventilation AHI was
8.6±5.7 / h at the first night and 7.4±5.3 /h after six weeks (p<0.001 vs.baseline).
Snoring was0.2±0.2 minutes and 1.0±0.9 minutes, respectively (p<0.001 vs.
baseline). Arousal index decreased to3.6±1.8 /h after six weeks(p <0.001 vs.
baseline). Mean EPAP was 7.8±2.3, mean IPAP mininum 8.7±2.7 and mean IPAP
maximum 16.1±2.2 cmH2O.
Conclusion: Auto servo-ventilation (BiPAP autoSV) is a suitable treatment
option for patients with obstructive sleep apnea syndrome and attendant periodic
breathing.
<<
DSM
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
2 posts
• Page 1 of 1