title: Comparison of two servo ventilator devices in the treatment of complex sleep apnea.
abstract: OBJECTIVE
  Servo ventilation (SV) devices generate positive airway pressure with a variable pressure support that changes in response to a patient's own respiratory output. Two currently available SV devices-VPAP-AdaptSV® and BIPAP-AutoSV®-have been used in treatment of complex sleep apnea (CompSAS), but no side-by-side comparisons are available.
  
  
  METHODS
  Data of 76 consecutive patients with complex sleep apnea, who were prescribed a VPAP-AdaptSV® or BIPAP-AutoSV® in a non-randomized parallel design, were retrospectively analyzed. Patients underwent a diagnostic polysomnogram followed by a continuous positive airway pressure (CPAP) titration and a SV titration study. Objective compliance with the device was assessed at the first visit at 4-6weeks of its use.
  
  
  RESULTS
  Thirty-five patients received a VPAP-AdaptSV® device, while 41 patients were treated with BIPAP-AutoSV®. Patients treated with BIPAP-AutoSV® had a significantly higher apnea-hypopnea index during their CPAP titration study than patients treated with VPAP-AdaptSV® [49/h (28-60) vs. 35/h (19.5-49.5), median (interquartile range), p<0.001]. On follow-up, 56 patients (73.7%) were using their device. Mean nightly use was 5.0h (2.8-6.4) for VPAP-AdaptSV® group and 6.0h (3.5-7.2) for BIPAP-AutoSV® group (p=0.081); an improvement in Epworth Sleepiness Scale score was higher in the BIPAP-AutoSV® group than in the VPAP-AdaptSV® group [4 (1-9) vs. 2.5 (0-5), p=0.02].
  
  
  CONCLUSIONS
  Our retrospective data indicate that the two servo-ventilation devices are comparable means of controlling complex sleep apnea, and the compliance with them is high.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, NorthShore University HealthSystem, Evanston, IL, USA. tkuzniar@northshore.org
authors.forename: Tomasz J
authors.initials: TJ
authors.lastname: Kuzniar
authors.forename: Smita
authors.initials: S
authors.lastname: Patel
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Nierodzik
authors.forename: Loretta C
authors.initials: LC
authors.lastname: Smith
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome