Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
ResMed Science Centre, Martinsried, Germany.
Ann Am Thorac Soc. 2024 Apr;21(4):651-657. doi: 10.1513/AnnalsATS.202310-908OC.
Adaptive servo-ventilation (ASV) effectively treats sleep-disordered breathing, including central sleep apnea (CSA) and coexisting obstructive sleep apnea (OSA). The prospective, multicenter European READ-ASV (Registry on the Treatment of Central and Complex Sleep-Disordered Breathing with Adaptive Servo-Ventilation) registry investigated the effects of first-time ASV therapy on disease-specific quality of life (QoL). The registry enrolled adults with CSA with or without OSA who had ASV therapy prescribed between September 2017 and March 2021. The primary endpoint was change in disease-specific QoL (Functional Outcomes of Sleep Questionnaire [FOSQ]) score between baseline and 12-month follow-up. Sleepiness determined using the Epworth Sleepiness Scale (ESS) score was a key secondary outcome. For subgroup analysis, participants were classified as symptomatic (FOSQ score < 17.9 and/or ESS score > 10) or asymptomatic (FOSQ score ⩾ 17.9 and/or ESS score ⩽ 10). A total of 801 individuals (age, 67 ± 12 yr; 14% female; body mass index, 31 ± 5 kg/m; apnea-hypopnea index, 48 ± 22/h) were enrolled; analyses include those with paired baseline and follow-up data. After 12 ± 3 months on ASV, median (interquartile range) FOSQ score had increased significantly from baseline (+0.8 [-0.2 to 2.2]; < 0.001; = 499). This was due to a significantly increased FOSQ score in symptomatic participants (+1.69 [0.38 to 3.05]), with little change in asymptomatic individuals (+0.11 [-0.39 to 0.54]). The median ESS score also improved significantly from baseline during ASV (-2.0 [-5.0 to 0.0]; < 0.001). ASV treatment of CSA with or without coexisting OSA was associated with improvements in disease-specific QoL and daytime sleepiness, especially in individuals with sleep-disordered breathing symptoms before therapy initiation. These improvements in patient-reported outcomes support the use of ASV in this population.
适应性伺服通气（ASV）有效地治疗睡眠呼吸障碍，包括中枢性睡眠呼吸暂停（CSA）和并存的阻塞性睡眠呼吸暂停（OSA）。前瞻性、多中心欧洲 READ-ASV（使用适应性伺服通气治疗中枢和复杂睡眠呼吸障碍登记处）登记处研究了首次 ASV 治疗对疾病特异性生活质量（QoL）的影响。该登记处招募了 2017 年 9 月至 2021 年 3 月期间被处方 ASV 治疗的伴有或不伴有 OSA 的 CSA 成年患者。主要终点是基线至 12 个月随访时疾病特异性 QoL（睡眠功能结果问卷[FOSQ]）评分的变化。使用 Epworth 嗜睡量表（ESS）评分确定的嗜睡是关键次要结局。对于亚组分析，参与者分为有症状（FOSQ 评分<17.9 和/或 ESS 评分>10）或无症状（FOSQ 评分≥17.9 和/或 ESS 评分≤10）。共纳入 801 名个体（年龄 67±12 岁；14%女性；体重指数 31±5kg/m；呼吸暂停低通气指数 48±22/h）；分析包括具有配对基线和随访数据的个体。在接受 ASV 治疗 12±3 个月后，FOSQ 评分中位数（四分位距）从基线显著增加（+0.8[-0.2 至 2.2]；<0.001； = 499）。这是由于有症状参与者的 FOSQ 评分显著增加（+1.69[0.38 至 3.05]），而无症状个体的变化较小（+0.11[-0.39 至 0.54]）。在接受 ASV 治疗期间，ESS 评分中位数也从基线显著改善（-2.0[-5.0 至 0.0]；<0.001）。伴有或不伴有并存 OSA 的 CSA 的 ASV 治疗与疾病特异性 QoL 和白天嗜睡的改善相关，尤其是在治疗开始前存在睡眠呼吸障碍症状的个体中。这些患者报告结局的改善支持在该人群中使用 ASV。
