• Renaud Tamisier, Carole Philippe, Arnaud Prigent, Christelle Charley-Monaca, Marie-Pia d'Ortho, Thibaut Gentina, Frédéric Gagnadoux, Claire Launois, Vanessa Bironneau, Jean Pierre Mallet, Toufik Didi, Tiphaine Guy, Frédéric Goutorbe, Christophe Perrin, Sandrine Pontier-Marchandise, Jean-François Timsit, Jean-Louis Pépin, Jean-Claude Meurice, and Etude de Cohorte Observationnelle Multicentrique Française de Patients Ayant un Syndrome d’Apnées du Sommeil Central ou Combiné Avec SAS Central Prédominant, Traités par Ventilation Auto-asservie Investigators.
• Inserm 1300, HP2, University Grenoble Alpes, Grenoble; Service Hospitalo-Universitaire Pneumologie et Physiologie, Pole Thorax et Vaisseaux, CHU de Grenoble Alpes, Grenoble. Electronic address: rtamisier@chu-grenoble.fr.
• Chest. 2024 Dec 20.

BackgroundA large number of symptomatic individuals with central sleep apnea (CSA) in clinical practice have an indication for adaptive servoventilation (ASV) therapy.Research QuestionWhat are the effects of ASV therapy on sleep quality and patient-reported outcome measures in patients with CSA across a range of devices and indications?Study Design And MethodsThis prospective, multicenter, observational cohort study was conducted in France and enrolled participants from June 2017 through February 2020. Adults with predominant CSA at diagnosis or OSA with central events not controlled with CPAP who had an indication for ASV were eligible. Participants attended clinic visits at baseline and after one, three, six, and 12 months of follow-up. The primary end point was the change in Pittsburgh sleep quality index (PSQI) score from baseline to six-month follow-up (evaluated using a Wilcoxon signed-rank test on paired data).ResultsWe included 526 individuals (median age, 69 years; 88.2% male). The indication for ASV included CSA with cardiovascular or neurologic cause (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%), or drug-induced CSA (11.4%). At the six-month follow-up, study participants were using ASV for a median of 6.1 h/night. The median change in the PSQI score from baseline to 6 months in the overall study population was -1 (interquartile range [IQR], -3 to 0; P < .001), with significant results across all indications for ASV except for drug-induced CSA, where the median change was similar to the overall results, but did not achieve statistical significance (-1 [IQR, -2 to 1]; P = .0866). Overall, 65% of participants showed a ≥ 1-point improvement in the PSQI.InterpretationIndividuals with a clinical indication for ASV therapy experienced improved sleep quality during real-world treatment, regardless of which ASV device was used.Clinical Trial RegistryClinicalTrials.gov; No.: NCT02835638; URL: www.Clinicaltrialsgov.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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