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The following is a summary of “Change in Sleep Quality Associated With Adaptive Servoventilation for Central Sleep Apnea,” published in the April 2025 issue of CHEST Journal by Tamisier et al. 

Central sleep apnea (CSA) is frequently encountered in clinical practice, with a substantial proportion of patients requiring adaptive servoventilation (ASV) therapy to manage persistent symptoms and improve sleep-related outcomes. This study aimed to evaluate the impact of ASV therapy on sleep quality and patient-reported outcomes across a broad population of individuals with CSA, irrespective of underlying cause or device type.

A prospective, multicenter, observational cohort study was conducted across multiple sites in France, enrolling adult participants from June 2017 to February 2020. Eligible individuals had either predominant CSA at diagnosis or obstructive sleep apnea (OSA) with central events unresponsive to continuous positive airway pressure, and all had a clinical indication for ASV therapy. Participants were followed for 12 months, with scheduled evaluations at baseline and at 1, 3, 6, and 12 months. The primary outcome was the change in sleep quality, assessed by the Pittsburgh Sleep Quality Index, from baseline to 6 months. The Wilcoxon signed-rank test was applied to evaluate paired changes in PSQI scores.

The study enrolled 526 participants, with a median age of 69 years; 88.2% were male. The most common indications for ASV therapy included CSA associated with cardiovascular or neurologic conditions (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%), and drug-induced CSA (11.4%). At six months, participants reported a median ASV usage of 6.1 hours per night. The median PSQI score improved by –1 point ([IQR], –3 to 0; P < .001), reflecting a statistically significant improvement in sleep quality across the cohort. Subgroup analyses demonstrated consistent benefits across all CSA subtypes, except in the drug-induced CSA group where the median score change (–1; IQR, –2 to 1) did not reach statistical significance (P = .0866). Notably, 65% of all participants experienced at least a 1-point improvement in their PSQI score, indicating meaningful subjective sleep enhancement.

In this large, real-world cohort of patients with CSA receiving ASV therapy, significant improvements in sleep quality were observed over a six-month period. These benefits were consistent across a range of clinical indications and device types, underscoring the utility of ASV in managing CSA beyond traditional etiologies. The findings support the integration of ASV therapy into routine care for patients with CSA, with favorable patient-reported outcomes and high adherence to therapy.

Source: journal.chestnet.org/article/S0012-3692(24)05717-9/fulltext