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Adaptive servo-ventilation as treatment of persistent central sleep apnea in post-acute ischemic stroke patients.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Brill, Anne-Kathrin; Rösti, Regula; Hefti, Jacqueline Pichler; Bassetti, Claudio; Gugger, Matthias; Ott, Sebastian R
Project Sleep loss and sleep disorders and their impact on the short- and longterm outcome of stroke
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Original article (peer-reviewed)

Journal Sleep medicine
Volume (Issue) 15(11)
Page(s) 1309 - 13
Title of proceedings Sleep medicine
DOI 10.1016/j.sleep.2014.06.013

Abstract

Adaptive servo-ventilation (ASV) is a well-established treatment of central sleep apnea (CSA) related to congestive heart failure (CHF). Few studies have evaluated the effectiveness and adherence in patients with CSA of other etiologies, and even less is known about treatment of CSA in patients of post ischemic stroke. A single-centre retrospective analysis of ASV treatment for CSA in post-acute ischemic stroke patients without concomitant CHF was performed. Demographics, clinical data, sleep studies, ventilator settings, and adherence data were evaluated. Out of 154 patients on ASV, 15 patients had CSA related to ischemic stroke and were started on ASV a median of 11 months after the acute cerebrovascular event. Thirteen out of the 15 patients were initially treated with continuous positive airway pressure (11/15) and bilevel positive airway pressure (2/15) therapy with unsatisfactory control of CSA. ASV significantly improved AHI (46.7 ± 24.3 vs 8.5 ± 12/h, P = 0.001) and reduced ESS (8.7 ± 5.7 vs 5.6 ± 2.5, P = 0.08) with a mean nightly use of ASV of 5.4 ± 2.4 h at 3 months after the initiation of treatment. Results were maintained at 6 months. ASV was well tolerated and clinically effective in this group of patients with persistent CSA after ischemic stroke.
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