Effects of Adaptive Servo-Ventilation on Quality of Life: The READ-ASV Registry

Rationale: Adaptive servo-ventilation (ASV) effectively treats sleep-disordered breathing (SDB), including central (CSA) and coexisting obstructive (OSA) sleep apnea. Objectives: The prospective, multicenter European READ-ASV registry investigated the effects of first-time ASV therapy on disease-specific quality of life (QoL). Methods: The registry enrolled adults with CSA±OSA who had ASV therapy prescribed between September 2017 and March 2021. The primary endpoint was change in disease specific QoL (Functional Outcomes of Sleep Questionnaire [FOSQ]) score between baseline and 12-month follow-up. Sleepiness determined using the Epworth Sleepiness Scale (ESS) score was a key secondary outcome. For subgroup analysis, participants were classified as symptomatic (FOSQ score <17.9 and/or ESS score >10) or asymptomatic (FOSQ score ≥17.9 and/or ESS score ≤10). Results: 801 individuals (age 67±12 years, 14% female, body mass index 31±5 kg/m², apnea-hypopnea index 48±22/h) were enrolled; analyses include those with paired baseline and follow-up data. After 12±3 months on ASV, median [interquartile range] FOSQ score had increased significantly from baseline (+0.8 [–0.2; 2.2]; p<0.001 [n=499]). This was due to a significantly increased FOSQ score in symptomatic participants (+1.69 [0.38; 3.05]), with little change in asymptomatic individuals (+0.11 [–0.39; 0.54]). The median ESS score also improved significantly from baseline during ASV (–2.0 [–5.0, 0.0]; p<0.001). Conclusions: ASV treatment of CSA with or without coexisting OSA was associated with improvements in disease-specific QoL and daytime sleepiness, especially in individuals with SDB symptoms before therapy initiation. These improvements in patient-reported outcomes support the use of ASV in this population.