Comparison of two servo ventilator devices in the treatment of complex sleep apnea

Objective: Servo ventilation (SV) devices generate positive airway pressure with a variable pressure support that changes in response to a patient's own respiratory output. Two currently available SV devices-VPAP-AdaptSV® and BIPAP-AutoSV®-have been used in treatment of complex sleep apnea (CompSAS), but no side-by-side comparisons are available.

Methods: Data of 76 consecutive patients with complex sleep apnea, who were prescribed a VPAP-AdaptSV® or BIPAP-AutoSV® in a non-randomized parallel design, were retrospectively analyzed. Patients underwent a diagnostic polysomnogram followed by a continuous positive airway pressure (CPAP) titration and a SV titration study. Objective compliance with the device was assessed at the first visit at 4-6weeks of its use.

Results: Thirty-five patients received a VPAP-AdaptSV® device, while 41 patients were treated with BIPAP-AutoSV®. Patients treated with BIPAP-AutoSV® had a significantly higher apnea-hypopnea index during their CPAP titration study than patients treated with VPAP-AdaptSV® [49/h (28-60) vs. 35/h (19.5-49.5), median (interquartile range), p<0.001]. On follow-up, 56 patients (73.7%) were using their device. Mean nightly use was 5.0h (2.8-6.4) for VPAP-AdaptSV® group and 6.0h (3.5-7.2) for BIPAP-AutoSV® group (p=0.081); an improvement in Epworth Sleepiness Scale score was higher in the BIPAP-AutoSV® group than in the VPAP-AdaptSV® group [4 (1-9) vs. 2.5 (0-5), p=0.02].

Conclusion: Our retrospective data indicate that the two servo-ventilation devices are comparable means of controlling complex sleep apnea, and the compliance with them is high.