Holger Woehrle.

These total results were seen despite effective control of central sleep apnea during adaptive servo-ventilation therapy.. Martin R. Cowie, M.D., Holger Woehrle, M.D., Karl Wegscheider, Ph.D., Christiane Angermann, M.D.D., Ph.D., Erland Erdmann, M.D., Patrick Levy, M.D., Ph.D., Anita K. Simonds, M.D., Virend K. Somers, M.D., Ph.D., Faiez Zannad, M.D., Ph.D., and Helmut Teschler, M.D.: Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure Sleep-disordered breathing is common in patients who have heart failure with minimal ejection fraction, with reported prevalence rates of 50 to 75 percent.1 Obstructive sleep apnea takes place more in patients with heart failure than in the general population often.2 The prevalence of central sleep apnea increases in parallel with increasing severity of heart failure1 and worsening cardiac dysfunction.3 There are always a true number of mechanisms where central sleep apnea could be detrimental to cardiac function, including increased sympathetic nervous system activity and intermittent hypoxemia.4-6 Central sleep apnea can be an independent risk marker for poor prognosis and death in patients with heart failure.4,7,8 In the Canadian Continuous Positive Airway Pressure for Sufferers with Central Sleep Apnea and Cardiovascular Failure study, patients with heart failure and central sleep apnea were randomly assigned to get continuous positive airway pressure or no CPAP.9 The trial was halted prematurely and did not show a beneficial aftereffect of CPAP on morbidity or mortality.10 Adaptive servo-ventilation is a non-invasive ventilatory therapy that effectively alleviates central sleep apnea by delivering servo-controlled inspiratory pressure support on top of expiratory positive airway pressure.11,12 The treating Sleep-Disordered Breathing with Predominant Central Rest Apnea by Adaptive Servo Ventilation in Individuals with Heart Failure trial investigated the effects of adding adaptive servo-ventilation to guideline-based medical treatment on survival and cardiovascular outcomes in patients who had heart failure with reduced ejection fraction and predominantly central sleep apnea.Post hoc testing showed significant differences between your intervention group and the control group on the SCL-20 score alone and the joint 12-month glycated hemoglobin, LDL cholesterol, and systolic blood-pressure outcomes, in addition to significant between-group distinctions on three of the four disease-control steps. Post hoc analyses also showed that sufferers in the intervention group had significant improvement on the joint major outcome in comparison with controls with each one of the three nurses who offered the intervention .