The May issue of the Journal of Clinical Sleep Medicine includes updated recommendations from the AASM pertaining to the use of adaptive servo-ventilation (ASV) to treat central sleep apnea syndrome (CSAS) associated with congestive heart failure. Since the 2012 publication of the AASM practice parameters for the Treatment of Central Sleep Apnea Syndromes in Adults, concerns have been raised about the potential for increased cardiovascular mortality in heart failure patients with a reduced ejection fraction using ASV.
Based on a systematic review and meta-analyses, the AASM update comprises a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in adult patients with an LVEF of less than or equal to 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment of CHF-associated CSAS in adult patients with an LVEF greater than 45% or mild CHF-related CSAS.
Read the complete update in JCSM: Updated Adaptive Servo-Ventilation Recommendations for the 2012 AASM Guideline: “The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses”