• C Philippe, M Stoïca-Herman, X Drouot, B Raffestin, P Escourrou, L Hittinger, P-L Michel, S Rouault, and M-P d'Ortho.
• Service de Physiologie-Explorations Fonctionnelles, Hôpital Tenon, AP-HP, Paris, France.
• Heart. 2006 Mar 1; 92 (3): 337-42.

ObjectiveTo compare compliance with and effectiveness of adaptive servoventilation (ASV) versus continuous positive airway pressure (CPAP) in patients with the central sleep apnoea syndrome (CSA) with Cheyne-Stokes respiration (CSR) and with congestive heart failure in terms of the apnoea-hypopnoea index (AHI), quality of life, and left ventricular ejection fraction (LVEF) over six months.Methods25 patients (age 28-80 years, New York Heart Association (NYHA) class II-IV) with stable congestive heart failure and CSA-CSR were randomly assigned to either CPAP or ASV. At inclusion, both groups were comparable for NYHA class, LVEF, medical treatment, body mass index, and CSA-CSR.ResultsBoth ASV and CPAP decreased the AHI but, noticeably, only ASV completely corrected CSA-CSR, with AHI below 10/h. At three months, compliance was comparable between ASV and CPAP; however, at six months compliance with CPAP was significantly less than with ASV. At six months, the improvement in quality of life was higher with ASV and only ASV induced a significant increase in LVEF.ConclusionThese results suggest that patients with CSA-CSR may receive greater benefit from treatment with ASV than with CPAP.

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