First experience of using new adaptive servo-ventilation device for Cheyne-Stokes respiration with central sleep apnea among Japanese patients with congestive heart failure: report of 4 clinical cases.
BACKGROUND
Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) in congestive heart failure (CHF) is generally considered a poor prognostic indicator, but treatment of CSR-CSA using an adaptive servo-ventilation (ASV) device has been developed. This is the first evaluation of its use in the management of CSR-CSA in Japanese CHF patients.


RESULTS
Four CHF patients with CSR-CSA that was unresponsive to conventional positive airway pressure (CPAP) underwent 3 nights of polysomnography: baseline, CPAP or bi-level PAP, and on the ASV. The apnea - hypopnea index (AHI) and central-AHI (CAHI) were markedly improved on ASV (AHI 62.7+/-10.1 to 5.9+/-2.2 /h, p=0.0006, CAHI 54.5+/-6.7 to 5.6+/-2.3 /h, p=0.007). In addition, the sleep quality improved significantly on ASV, including arousal index (62.0+/-10.5 to 18.7 +/-6.2 /h, p=0.012), percentage of slow-wave sleep (2.6+/-2.6 to 19.4+/-4.8 %, p=0.042).


CONCLUSIONS
ASV markedly improved CSR-CSA in patients with CHF. It is a promising treatment for Japanese patients with CHF.
Kasai
Takatoshi
T
Sleep Center, Toranomon Hospital, Japan. kasai-t@mx6.nisiq.net
Narui
Koji
K
Dohi
Tomotaka
T
Takaya
Hisashi
H
Yanagisawa
Naotake
N
Dungan
George
G
Ishiwata
Sugao
S
Ohno
Minoru
M
Ymaguchi
Tetsu
T
Momomura
Shin-ichi
S
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002639:Cheyne-Stokes Respiration / Q000150:complications / Q000628:therapy*; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D007564:Japan; D008297:Male; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods; D020182:Sleep Apnea, Central / Q000150:complications / Q000628:therapy*; D012122:Ventilators, Mechanical