Adaptive servo-ventilation (ASV) in patients with central or complex sleep apnoea and associated cardiovascular comorbidities: the READ-ASV registry

<bold>Background and objectives:</bold> Adaptive servo-ventilation (ASV) treats central sleep apnoea (CSA) and improves disease specific quality of life (QoL) and sleepiness, especially in individuals with CSA symptoms. Patients with cardio– and cerebrovascular disease (CCD) and sleep apnoea usually report less daytime sleepiness compared to those without CCD. Therefore, the aim of the present analysis was to describe the effects of ASV on QoL and sleepiness in those with and without CCD. <bold>Methods:</bold> 801 patients were enrolled between Sept 2017 and March 2021 in the prospective, multi-centre READ-ASV registry. In the present analysis patients were stratified in the following groups: “no CCD”, “CCD risk” (hypertension or atrial fibrillation) or “overt CCD” (heart failure, stroke or coronary artery disease). QoL and sleepiness were assessed with the Functional Outcomes of Sleep Questionnaire (FOSQ) and the Epworth Sleepiness Scale (ESS). Symptomatic was defined as FOSQ<17.9 and/or ESS >10. <bold>Results:</bold> The no CCD group had significantly lower FOSQ and higher ESS scores compared to the CCD risk group and the overt CCD group (p<0.001; p=0.001). Nevertheless, the significant improvement of FOSQ and ESS scores on ASV was similar between the no CCD, CCD risk and overt CCD groups (FOSQ: 0.97 [−0.10;2.33] vs. 0.73 [−0.20;1.69] vs. 0.78 [−0.20;2.39], p=0.554; ESS: -2.0 [−6.0;0.0] vs. -2.0 [−5.0;0.0] vs. -2.0 [−5.0;0.0], p=0.684). <bold>Conclusions:</bold> ASV users with CCD risk factors or CCD were less symptomatic than those without. ASV significantly improved disease-specific QoL and daytime sleepiness independent of the presence of CCD risk or overt CCD.