{"title":"自适应伺服通气对中枢性睡眠呼吸暂停患者睡眠质量的影响：多中心法国faf - vaa队列6个月随访","authors":"Renaud Tamisier, Carole Philippe, Arnaud Prigent, Christelle Charley-Monaca, Marie-Pia d'Ortho, Thibaut Gentina, Frédéric Gagnadoux, Claire Launois, Vanessa Bironneau, Jean Pierre Mallet, Toufik Didi, Tiphaine Guy, Frédéric Goutorbe, Christophe Perrin, Sandrine Pontier-Marchandise, Jean-François Timsit, Jean-Louis Pépin, Jean-Claude Meurice","doi":"10.1016/j.chest.2024.12.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A large number of symptomatic individuals with central sleep apnea (CSA) in clinical practice have an indication for adaptive servoventilation (ASV) therapy.</p><p><strong>Research question: </strong>What are the effects of ASV therapy on sleep quality and patient-reported outcome measures in patients with CSA across a range of devices and indications?</p><p><strong>Study design and methods: </strong>This prospective, multicenter, observational cohort study was conducted in France and enrolled participants from June 2017 through February 2020. Adults with predominant CSA at diagnosis or OSA with central events not controlled with CPAP who had an indication for ASV were eligible. Participants attended clinic visits at baseline and after one, three, six, and 12 months of follow-up. The primary end point was the change in Pittsburgh sleep quality index (PSQI) score from baseline to six-month follow-up (evaluated using a Wilcoxon signed-rank test on paired data).</p><p><strong>Results: </strong>We included 526 individuals (median age, 69 years; 88.2% male). The indication for ASV included CSA with cardiovascular or neurologic cause (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%), or drug-induced CSA (11.4%). At the six-month follow-up, study participants were using ASV for a median of 6.1 h/night. The median change in the PSQI score from baseline to 6 months in the overall study population was -1 (interquartile range [IQR], -3 to 0; P < .001), with significant results across all indications for ASV except for drug-induced CSA, where the median change was similar to the overall results, but did not achieve statistical significance (-1 [IQR, -2 to 1]; P = .0866). Overall, 65% of participants showed a ≥ 1-point improvement in the PSQI.</p><p><strong>Interpretation: </strong>Individuals with a clinical indication for ASV therapy experienced improved sleep quality during real-world treatment, regardless of which ASV device was used.</p><p><strong>Clinical trial registry: </strong>ClinicalTrials.gov; No.: NCT02835638; URL: www.</p><p><strong>Clinicaltrials: </strong>gov.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":""},"PeriodicalIF":9.5000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Change in Sleep Quality Associated With Adaptive Servoventilation for Central Sleep Apnea: Six-Month Follow-up of the Multicenter Nationwide French Etude de Cohorte Observationnelle Multicentrique Française de Patients Ayant un Syndrome d'Apnées du Sommeil Central ou Combiné Avec SAS Central Prédominant, Traités par Ventilation Auto-asservie Cohort.\",\"authors\":\"Renaud Tamisier, Carole Philippe, Arnaud Prigent, Christelle Charley-Monaca, Marie-Pia d'Ortho, Thibaut Gentina, Frédéric Gagnadoux, Claire Launois, Vanessa Bironneau, Jean Pierre Mallet, Toufik Didi, Tiphaine Guy, Frédéric Goutorbe, Christophe Perrin, Sandrine Pontier-Marchandise, Jean-François Timsit, Jean-Louis Pépin, Jean-Claude Meurice\",\"doi\":\"10.1016/j.chest.2024.12.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A large number of symptomatic individuals with central sleep apnea (CSA) in clinical practice have an indication for adaptive servoventilation (ASV) therapy.</p><p><strong>Research question: </strong>What are the effects of ASV therapy on sleep quality and patient-reported outcome measures in patients with CSA across a range of devices and indications?</p><p><strong>Study design and methods: </strong>This prospective, multicenter, observational cohort study was conducted in France and enrolled participants from June 2017 through February 2020. Adults with predominant CSA at diagnosis or OSA with central events not controlled with CPAP who had an indication for ASV were eligible. Participants attended clinic visits at baseline and after one, three, six, and 12 months of follow-up. The primary end point was the change in Pittsburgh sleep quality index (PSQI) score from baseline to six-month follow-up (evaluated using a Wilcoxon signed-rank test on paired data).</p><p><strong>Results: </strong>We included 526 individuals (median age, 69 years; 88.2% male). The indication for ASV included CSA with cardiovascular or neurologic cause (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%), or drug-induced CSA (11.4%). At the six-month follow-up, study participants were using ASV for a median of 6.1 h/night. The median change in the PSQI score from baseline to 6 months in the overall study population was -1 (interquartile range [IQR], -3 to 0; P < .001), with significant results across all indications for ASV except for drug-induced CSA, where the median change was similar to the overall results, but did not achieve statistical significance (-1 [IQR, -2 to 1]; P = .0866). Overall, 65% of participants showed a ≥ 1-point improvement in the PSQI.</p><p><strong>Interpretation: </strong>Individuals with a clinical indication for ASV therapy experienced improved sleep quality during real-world treatment, regardless of which ASV device was used.</p><p><strong>Clinical trial registry: </strong>ClinicalTrials.gov; No.: NCT02835638; URL: www.</p><p><strong>Clinicaltrials: </strong>gov.</p>\",\"PeriodicalId\":9782,\"journal\":{\"name\":\"Chest\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":9.5000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chest\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.chest.2024.12.015\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chest","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.chest.2024.12.015","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Change in Sleep Quality Associated With Adaptive Servoventilation for Central Sleep Apnea: Six-Month Follow-up of the Multicenter Nationwide French Etude de Cohorte Observationnelle Multicentrique Française de Patients Ayant un Syndrome d'Apnées du Sommeil Central ou Combiné Avec SAS Central Prédominant, Traités par Ventilation Auto-asservie Cohort.
Background: A large number of symptomatic individuals with central sleep apnea (CSA) in clinical practice have an indication for adaptive servoventilation (ASV) therapy.
Research question: What are the effects of ASV therapy on sleep quality and patient-reported outcome measures in patients with CSA across a range of devices and indications?
Study design and methods: This prospective, multicenter, observational cohort study was conducted in France and enrolled participants from June 2017 through February 2020. Adults with predominant CSA at diagnosis or OSA with central events not controlled with CPAP who had an indication for ASV were eligible. Participants attended clinic visits at baseline and after one, three, six, and 12 months of follow-up. The primary end point was the change in Pittsburgh sleep quality index (PSQI) score from baseline to six-month follow-up (evaluated using a Wilcoxon signed-rank test on paired data).
Results: We included 526 individuals (median age, 69 years; 88.2% male). The indication for ASV included CSA with cardiovascular or neurologic cause (38.4%), treatment-emergent CSA (36.1%), idiopathic CSA (14.1%), or drug-induced CSA (11.4%). At the six-month follow-up, study participants were using ASV for a median of 6.1 h/night. The median change in the PSQI score from baseline to 6 months in the overall study population was -1 (interquartile range [IQR], -3 to 0; P < .001), with significant results across all indications for ASV except for drug-induced CSA, where the median change was similar to the overall results, but did not achieve statistical significance (-1 [IQR, -2 to 1]; P = .0866). Overall, 65% of participants showed a ≥ 1-point improvement in the PSQI.
Interpretation: Individuals with a clinical indication for ASV therapy experienced improved sleep quality during real-world treatment, regardless of which ASV device was used.
期刊介绍：
At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.
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