• Takatoshi Kasai, Koji Narui, Tomotaka Dohi, Hisashi Takaya, Naotake Yanagisawa, George Dungan, Sugao Ishiwata, Minoru Ohno, Tetsu Ymaguchi, and Shin-ichi Momomura.
• Sleep Center, Toranomon Hospital, Japan. kasai-t@mx6.nisiq.net
• Circ. J. 2006 Sep 1;70(9):1148-54.

BackgroundCheyne-Stokes respiration with central sleep apnea (CSR-CSA) in congestive heart failure (CHF) is generally considered a poor prognostic indicator, but treatment of CSR-CSA using an adaptive servo-ventilation (ASV) device has been developed. This is the first evaluation of its use in the management of CSR-CSA in Japanese CHF patients.Methods And ResultsFour CHF patients with CSR-CSA that was unresponsive to conventional positive airway pressure (CPAP) underwent 3 nights of polysomnography: baseline, CPAP or bi-level PAP, and on the ASV. The apnea - hypopnea index (AHI) and central-AHI (CAHI) were markedly improved on ASV (AHI 62.7+/-10.1 to 5.9+/-2.2 /h, p=0.0006, CAHI 54.5+/-6.7 to 5.6+/-2.3 /h, p=0.007). In addition, the sleep quality improved significantly on ASV, including arousal index (62.0+/-10.5 to 18.7 +/-6.2 /h, p=0.012), percentage of slow-wave sleep (2.6+/-2.6 to 19.4+/-4.8 %, p=0.042).ConclusionsASV markedly improved CSR-CSA in patients with CHF. It is a promising treatment for Japanese patients with CHF.

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