Updated adaptive servo-ventilation recommendations for the 2012 AASM guideline: "The treatment of central sleep apnea syndromes in adults: Practice parameters with an evidence-based literature review and meta-analyses"

R. Nisha Aurora, Sabin R. Bista, Kenneth R. Casey, Susmita Chowdhuri, David A. Kristo, Jorge M. Mallea, Kannan Ramar, James A. Rowley, Rochelle S. Zak, Jonathan L. Heald

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

An update of the 2012 systematic review and meta-analyses were performed and a modified-GRADE approach was used to update the recommendation for the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea syndrome (CSAS) related to congestive heart failure (CHF). Metaanalyses demonstrated an improvement in LVEF and a normalization of AHI in all patients. Analyses also demonstrated an increased risk of cardiac mortality in patients with an LVEF of ≤ 45% and moderate or severe CSA predominant sleep-disordered breathing. These data support a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in patients with an LVEF of ≤ 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment CHF-associated CSAS in patients with an LVEF > 45% or mild CHF-related CSAS. The application of these recommendations is limited to the target patient populations; the ultimate judgment regarding propriety of any specific care must be made by the clinician.

Original languageEnglish (US)
Pages (from-to)757-761
Number of pages5
JournalJournal of Clinical Sleep Medicine
Volume12
Issue number5
DOIs
StatePublished - Jan 1 2016

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Keywords

  • Adaptive servo-ventilation
  • Central sleep apnea
  • Clinical practice guideline

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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