Adaptive non-invasive ventilation treatment for sleep apnea.

The purpose of this study was to investigate the effectiveness of two non-invasive mechanical ventilation (NIV) modalities to treat sleep apnea: (1) Average Volume Assured Pressure Support (AVAPS) NIV, and (2) Pressure Support (PS) NIV with Continuously Calculated Average Required Ventilation (CCARV). Two detailed (previously developed and tested) simulation models were used to assess the effectiveness of the NIV modalities. One simulated subjects without chronic obstructive pulmonary disease (COPD), and the other simulated patients with COPD. Sleep apnea was simulated in each model (COPD and Non-COPD), and the ability of each NIV modality to normalize breathing was measured. In both NIV modalities, a low level continuous positive airway pressure was used and a backup respiratory rate was added to the algorithm in order to minimize the respiratory work rate. Both modalities could help normalize breathing in response to an episode of sleep apnea within about 5 min (during which time blood gases were within safe limits). AVAPS NIV and PS NIV with CCARV have potential value to be used for treatment of sleep apnea. Clinical evaluations are needed to fully assess the effectiveness of these NIV modalities.