Thomas M Kaffenberger, Ryan J Soose, B Tucker Woodson, Stuart G MacKay, Edward M Weaver, Charles W Atwood, Patrick J Strollo
{"title":"Modified uvulopalatopharyngoplasty in modern obstructive sleep apnea treatment: a narrative review.","authors":"Thomas M Kaffenberger, Ryan J Soose, B Tucker Woodson, Stuart G MacKay, Edward M Weaver, Charles W Atwood, Patrick J Strollo","doi":"10.5664/jcsm.11810","DOIUrl":"https://doi.org/10.5664/jcsm.11810","url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is a prevalent disorder associated with significant health risks, often managed with continuous positive airway pressure (CPAP). However, CPAP adherence remains suboptimal, prompting interest in surgical alternatives. Traditional uvulopalatopharyngoplasty (UPPP), introduced in 1981, has demonstrated limited success and notable side effects, leading to skepticism regarding its utility in OSA treatment. However, advancements in patient selection and surgical technique have led to the development of modified UPPP procedures, including expansion sphincter pharyngoplasty, barbed reposition pharyngoplasty, and the Australian modified UPPP.</p><p><strong>Methods: </strong>In this narrative review, we focus on the evolution of the palatal surgery field over the past two decades.</p><p><strong>Results: </strong>Recent randomized controlled trials and observational cohort studies have shown that modified UPPP variants can significantly reduce apnea-hypopnea index (AHI), improve symptoms, and even offer potential cardiovascular benefits. These reconstructive approaches have demonstrated consistently improved success rates, enhanced patient-reported outcomes, and reduced postoperative morbidity compared to traditional excisional UPPP.</p><p><strong>Conclusions: </strong>While controversies persist regarding patient selection, long-term durability, and the role of palate surgery in the era of hypoglossal nerve stimulation, emerging evidence supports modified UPPP as a viable alternative for appropriately selected OSA patients. This review underscores the evolution of palatal surgery, highlighting its role in a personalized, multimodal approach to OSA management, particularly for CPAP-intolerant patients seeking durable and effective treatment.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nathan C Nowalk, Maria Paola Arellano-Maric, Babak Mokhlesi
{"title":"Cutting the weight, restoring the breath: bariatric surgery in obesity hypoventilation syndrome.","authors":"Nathan C Nowalk, Maria Paola Arellano-Maric, Babak Mokhlesi","doi":"10.5664/jcsm.11830","DOIUrl":"https://doi.org/10.5664/jcsm.11830","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sleep apnea, how do we help thee? Let us count the ways.","authors":"Loretta Colvin, Nancy A Collop","doi":"10.5664/jcsm.11816","DOIUrl":"https://doi.org/10.5664/jcsm.11816","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The efficacy and safety of an intraoral negative air pressure device in patients with obstructive sleep apnea: a systematic review and meta-analysis.","authors":"Charoiboon Puvatanond, Navarat Kasemsuk, Wish Banhiran","doi":"10.5664/jcsm.11812","DOIUrl":"https://doi.org/10.5664/jcsm.11812","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the efficacy and safety of intraoral negative air pressure devices (INAP) in patients with obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>A systematic search without language restrictions was conducted in the Ovid Medline, Embase, and Scopus databases to identify all original studies on the effects of INAP devices in adult OSA patients who reported the apnea-hypopnea index (AHI). The final update was made on 7 December 2024. The risk-of-bias assessment tool for nonrandomized studies (RoBANS) was applied for quality assessment. RevMan was used to conduct statistical analysis.</p><p><strong>Results: </strong>Of the 72 originally retrieved articles, 9 studies were included that involved a total of 445 individuals. Meta-analysis of the pooled data showed that, following INAP treatment, the participants had a significant improvement in mean AHI with a mean difference (MD) of 12.4 (95%CI, 7.5 to 17.3), minimum oxygen saturation with MD of -3.6 (95%CI, -5.3 to -1.8), Epworth sleepiness scale with MD of 2.64 (95% CI, 0.23 to 5.05) and oxygen desaturation index (ODI) with MD of 10.8 (95%CI, 7.2 to 14.3). Participants also had a trend of improvement in the percentages of time spent with oxygen saturation ≥90% after treatment but did not reach statistical significance. The most common adverse events related to the device were oral tissue discomfort and irritation. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>Treatment with INAP devices significantly improved AHI and ODI. INAP may be a suitable treatment option for selected patients with OSA.</p><p><strong>Systematic review registration: </strong>Registry: PROSPERO; Identifier: CRD42024510535.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William H Noah, David P White, Bernard Hete, Ludovico Messineo
{"title":"Rebreathing during CPAP therapy and its implications in obstructive sleep apnea.","authors":"William H Noah, David P White, Bernard Hete, Ludovico Messineo","doi":"10.5664/jcsm.11802","DOIUrl":"https://doi.org/10.5664/jcsm.11802","url":null,"abstract":"<p><p>Elevated environmental CO<sub>2</sub> levels can have important health impacts, including increased anxiety, impaired high-level cognitive performance, reduced sleep quality, and decreased next-day alertness, especially in children. Bedrooms, where people spend a third of their lives, are often poorly ventilated, further exacerbating CO<sub>2</sub> exposure during sleep. These symptoms may be of particular concern for individuals with obstructive sleep apnea (OSA) treated with continuous positive pressure (CPAP) as a result of CO<sub>2</sub> trapping within the mask, which is dependent on environmental levels, and circuit CO<sub>2</sub> rebreathing<sub>.</sub> Additionally, lower inhaled oxygen concentrations may be encountered when exhaled gases are rebreathed from the circuit. Low expiratory PAP, high ventilation levels (e.g., in large individuals or at altitude), and small exhaust valves increase rebreathing risk, which can self-propagate due to patient attempts to compensate by increasing tidal volume. Elevated environmental CO<sub>2</sub> may further exacerbate the clinical consequences of rebreathing, including reduced CPAP adherence. While strategies including higher expiratory PAP or larger exhaust valves help mitigate CO<sub>2</sub> buildup, they can also lead to increased noise which may potentially affect adherence. With this work, we review the available evidence on the thresholds and effects of classroom, office, bedroom and rebreathed CO<sub>2</sub> levels, in healthy and OSA individuals, both adults and children. Importantly, we provide the often-overlooked link between environmental CO<sub>2</sub> concentrations and circuit rebreathing for OSA patients, underscoring the need to optimize current indoor ventilation standards and thresholds for mask-based CO<sub>2</sub> inhalation, as well as CPAP technology to maximize adherence, abate CO<sub>2</sub>/hypoxic exposure, and improve health outcomes.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amee Revana, Rakesh Bhattacharjee, Jennifer L Miller, Aaron Chidekel, Priya Khanna, Sarayu Ratnam, Grant Runyan, Eric Bauer, Krystle Davis Rapchak, David Seiden, Kumar Budur, Jeffrey M Dayno
{"title":"A proof-of-concept study of pitolisant for excessive daytime sleepiness in patients with Prader-Willi syndrome.","authors":"Amee Revana, Rakesh Bhattacharjee, Jennifer L Miller, Aaron Chidekel, Priya Khanna, Sarayu Ratnam, Grant Runyan, Eric Bauer, Krystle Davis Rapchak, David Seiden, Kumar Budur, Jeffrey M Dayno","doi":"10.5664/jcsm.11800","DOIUrl":"https://doi.org/10.5664/jcsm.11800","url":null,"abstract":"<p><strong>Study objectives: </strong>The majority of patients with Prader-Willi syndrome (PWS) experience excessive daytime sleepiness (EDS). This study evaluated the effects of pitolisant, a histamine 3 (H<sub>3</sub>)-receptor antagonist/inverse agonist that promotes wakefulness, in patients with PWS and EDS.</p><p><strong>Methods: </strong>In this phase 2, randomized, double-blind, placebo-controlled, proof-of-concept study, patients ages 6-65 years with a confirmed diagnosis of PWS with EDS were randomized 1:1:1 to receive lower-dose pitolisant (children/adolescents/adults, 8.9/13.35/17.8 mg), higher-dose pitolisant (children/adolescents/adults, 17.8/26.7/35.6 mg), or matching placebo for 11 weeks (3-week titration/8-week maintenance). The primary endpoint was change from baseline to Week 11 in Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD; parent/caregiver version) score. Other measures included the Caregiver Global Impression of Severity for EDS, Aberrant Behavior Checklist-C (ABC-C), and Hyperphagia Questionnaire for Clinical Trials (HQ-CT).</p><p><strong>Results: </strong>Of 65 patients randomized and treated, 59 (90.8%) completed the double-blind phase. Least-squares (LS) mean improvement from baseline to Week 11 in ESS-CHAD score was greater for higher-dose pitolisant (-5.0) versus placebo (-3.9; LS mean [SE] difference, -1.1 [1.52]), but not for lower-dose pitolisant (-3.5) versus placebo (LS mean [SE] difference, 0.5 [1.6].The largest effect of pitolisant was seen in children (ages 6 to <12 years; LS mean [SE] difference for higher-dose pitolisant versus placebo, -3.5 [1.90]). Improvements were observed across other measures, especially in the higher-dose pitolisant group, including LS mean (SE) change of -5.5 (1.2) on the irritability domain of the ABC-C and -3.1 (1.0) on the HQ-CT. The most common AEs in pitolisant-treated patients (doses pooled) were anxiety, irritability, and headache (11.9% each), consistent with the known safety profile of pitolisant.</p><p><strong>Conclusions: </strong>Results of this proof-of-concept study support further evaluation of pitolisant in patients with PWS and EDS.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Identifier: NCT04257929.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Yoo, Amit Shah, Haitham Shahrour, Hong Li, Ajay S Kasi
{"title":"Images: Atypical resolution of sleep-related hypoventilation in congenital central hypoventilation syndrome.","authors":"Michelle Yoo, Amit Shah, Haitham Shahrour, Hong Li, Ajay S Kasi","doi":"10.5664/jcsm.11644","DOIUrl":"10.5664/jcsm.11644","url":null,"abstract":"<p><p>Paired-like homeobox 2B gene variants cause congenital central hypoventilation syndrome (CCHS) characterized by abnormal ventilatory control necessitating lifelong assisted ventilation (AV). We report a 3-year-old female who presented with apnea, hypoxemia, hypoventilation requiring AV, and Hirschsprung's disease during infancy followed by resolution of hypoventilation. At 3 weeks, polysomnography showed obstructive and central sleep apnea, oxygen desaturations, and hypoventilation. A novel, heterozygous, paternal-inherited 2.77-Mb deletion in chromosome 4p14-p13 resulted in deletion of the entire paired-like homeobox 2B gene, confirming the diagnosis of CCHS. Paired-like homeobox 2B whole-gene deletions are categorized as nonpolyalanine repeat mutations. AV via tracheostomy was utilized during sleep. At 2.8 years, diagnostic polysomnography was performed due to suboptimal adherence to AV that demonstrated central sleep apnea without hypoxemia or hypoventilation. There were no signs of chronic hypoventilation such as polycythemia, elevated serum bicarbonate, or pulmonary hypertension. CCHS is characterized by lifelong hypoventilation requiring AV. Despite a classic presentation of CCHS requiring early tracheostomy, polysomnography at 3 years of age indicated an absence of hypoventilation that represents a unique and atypical presentation in CCHS.</p><p><strong>Citation: </strong>Yoo M, Shah A, Shahrour H, Li H, Kasi AS. Images: Atypical resolution of sleep-related hypoventilation in congenital central hypoventilation syndrome. <i>J Clin Sleep Med</i>. 2025;21(7):1327-1331.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1327-1331"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily A Commesso, Cyrus Haghighian, Eric J Kezirian
{"title":"Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores.","authors":"Emily A Commesso, Cyrus Haghighian, Eric J Kezirian","doi":"10.5664/jcsm.11620","DOIUrl":"10.5664/jcsm.11620","url":null,"abstract":"<p><strong>Study objectives: </strong>Effective treatment of obstructive sleep apnea depends on efficacy and adherence. The objective of this analysis was to examine the association between adherence to unilateral hypoglossal nerve stimulation (Inspire upper airway stimulation) and changes in daytime sleepiness.</p><p><strong>Methods: </strong>Participants were adults treated with unilateral hypoglossal nerve stimulation enrolled in the ADHERE Registry. All participants included in the analysis completed a final visit 1-2 years following implantation. Outcomes were the change in Epworth Sleepiness Scale (ESS) score and normalization of a baseline abnormal ESS score (baseline ESS > 10 and final ESS ≤ 10). Statistical analyses examined the association between objective therapy adherence and ESS outcomes, with multiple regression including adjustment for age, sex, race, ethnicity, body mass index, and apnea-hypopnea index-defined responder status.</p><p><strong>Results: </strong>The analysis included 1,147 participants who were primarily middle-aged (59.7 ± 10.5 years), overweight (body mass index: 29.1 ± 3.7), White (95.8%), male (76.8%), and with severe obstructive sleep apnea (apnea-hypopnea index: 35.12 ± 14.81). ESS scores decreased from 11.3 ± 5.5 at baseline to 6.9 ± 4.6 at the final visit. Of those with baseline ESS > 10, 68% (441/644) achieved normalized ESS scores at the final visit. Multiple regression analyses showed that each additional hour/night of therapy use was associated with a decrease in ESS score (0.17, <i>P</i> = .045) and increased odds of normalized ESS (odds ratio: 1.13; 95% confidence interval: 1.03-1.25). Apnea-hypopnea index response was also associated with a decrease in ESS score (1.29, <i>P</i> < .001) and increased odds of a normalized ESS (odds ratio: 2.29; 95% confidence interval: 1.55-3.4).</p><p><strong>Conclusions: </strong>Adherence to hypoglossal nerve stimulation is associated with improvement in daytime sleepiness symptoms and increased odds of achieving normalization of daytime sleepiness.</p><p><strong>Citation: </strong>Commesso EA, Haghighian C, Kezirian EJ. Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores. <i>J Clin Sleep Med</i>. 2025;21(7):1175-1183.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1175-1183"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Onyekachi S Ezeokeke, Janelle M Fine, Jennifer L Martin, Prerna Gupta, Atul Malhotra, Melissa P Knauert, Erica B Feldman, Biren B Kamdar
{"title":"An approach to improving efficiency of actigraphy data in research: use of statistical software to facilitate batch import.","authors":"Onyekachi S Ezeokeke, Janelle M Fine, Jennifer L Martin, Prerna Gupta, Atul Malhotra, Melissa P Knauert, Erica B Feldman, Biren B Kamdar","doi":"10.5664/jcsm.11612","DOIUrl":"10.5664/jcsm.11612","url":null,"abstract":"<p><p>Despite the recent discontinuation of Philips Actiwatch devices, volumes of actigraphy data remain unanalyzed, and these and similar devices continue to be used for clinical and research applications. In this report, we present a Stata \"do\"-file that automates the process of importing and appending raw data files downloaded from Philips Actiware software. For example, in less than 60 seconds, our do-file imported, appended, and cleaned 189,596 epochs of data from raw 48-hour actigraphy data files of 35 critically ill patients, yielding a single unified dataset with usable variables ready for analysis. Portable and scalable, this approach can facilitate error-free generation of single- or multi-day actigraphy datasets from an unlimited number of patients. Although designed for Stata, this simple executable file can be adapted for other data platforms and applied to new and existing actigraphy data files and modified as needed for other actigraphy-based efforts.</p><p><strong>Citation: </strong>Ezeokeke OS, Fine JM, Martin JL, et al. An approach to improving efficiency of actigraphy data in research: use of statistical software to facilitate batch import. <i>J Clin Sleep Med</i>. 2025;21(7):1293-1296.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1293-1296"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean-Louis Pepin, Adam V Benjafield, Oliver Munt, Holger Woehrle, Raphael Heinzer, Michael Arzt
{"title":"Treatment of sleep-disordered breathing in opioid users with adaptive servo-ventilation: a subgroup analysis of the European READ-ASV registry.","authors":"Jean-Louis Pepin, Adam V Benjafield, Oliver Munt, Holger Woehrle, Raphael Heinzer, Michael Arzt","doi":"10.5664/jcsm.11652","DOIUrl":"10.5664/jcsm.11652","url":null,"abstract":"<p><strong>Study objectives: </strong>Central sleep-disordered breathing (SDB) is associated with negative health outcomes. Intake of opioids influences stability of breathing and can cause central apneas. Screening for and treatment of SDB is recommended for individuals who use opioids. This subanalysis of the READ-ASV (Registry on the Treatment of Central and Complex Sleep-Disordered Breathing with Adaptive Servo-Ventilation) investigated the effects of adaptive servo-ventilation therapy (ASV) on SDB symptoms in people using opioids.</p><p><strong>Methods: </strong>Patients initiated on ASV who reported intake of opioids at baseline were included in this analysis of real-world registry data. Patients were prospectively followed-up for 12 months. Disease-specific quality of life was assessed with the Functional Outcomes of Sleep Questionnaire. Sleepiness was measured with the Epworth Sleepiness Scale. Symptomatic patients were defined as having a Functional Outcomes of Sleep Questionnaire score of < 17.9 and an Epworth Sleepiness Scale score of > 10.</p><p><strong>Results: </strong>Eighty-six patients who reported opioid use were included. The population had severe SDB (median apnea-hypopnea index: 55 events/h), the majority (n = 75 [87%]) had comorbidities, and 81.6% (40/49 with follow-up available questionnaires) were symptomatic at baseline. ASV effectively treated SDB (residual median apnea-hypopnea index from device data [apnea-hypopnea index flow]: 1.5 events/h). The Functional Outcomes of Sleep Questionnaire (+1.4 points; <i>P</i> = .003) and Epworth Sleepiness Scale (-3 points; <i>P</i> = .029) scores improved significantly at follow-up compared with baseline, and improvements in disease-specific quality of life were more pronounced in symptomatic patients.</p><p><strong>Conclusions: </strong>ASV treatment of central breathing disorders in individuals using opioids resolved SDB and was associated with significant improvements in disease-specific quality of life and sleepiness. ASV treatment may therefore be an actionable intervention to counteract the negative effects of opioids on SDB and quality of life.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Registry on the Treatment of Central and Complex Sleep-Disordered Breathing With Adaptive Servo-Ventilation (READ-ASV); URL: https://www.clinicaltrials.gov/study/NCT03032029; Identifier: NCT03032029.</p><p><strong>Citation: </strong>Pepin J-L, Benjafield AV, Munt O, Woehrle H, Heinzer R, Arzt M; for the READ-ASV Investigators. Treatment of sleep-disordered breathing in opioid users with adaptive servo-ventilation: a subgroup analysis of the European READ-ASV registry. <i>J Clin Sleep Med</i>. 2025;21(7):1227-1232.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1227-1232"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}