Updated Adaptive Servo-Ventilation Recommendations for the 2012 AASM Guideline: "The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses"

J Clin Sleep Med. 2016 May 15;12(5):757-61. doi: 10.5664/jcsm.5812.


An update of the 2012 systematic review and meta-analyses were performed and a modified-GRADE approach was used to update the recommendation for the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea syndrome (CSAS) related to congestive heart failure (CHF). Meta-analyses demonstrated an improvement in LVEF and a normalization of AHI in all patients. Analyses also demonstrated an increased risk of cardiac mortality in patients with an LVEF of ≤ 45% and moderate or severe CSA predominant sleep-disordered breathing. These data support a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in patients with an LVEF of ≤ 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment CHF-associated CSAS in patients with an LVEF > 45% or mild CHF-related CSAS. The application of these recommendations is limited to the target patient populations; the ultimate judgment regarding propriety of any specific care must be made by the clinician.

Keywords: adaptive servo-ventilation; central sleep apnea; clinical practice guideline.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Academies and Institutes
  • Adult
  • Evidence-Based Medicine / methods*
  • Humans
  • Practice Guidelines as Topic*
  • Respiration, Artificial / methods*
  • Sleep Apnea, Central / therapy*
  • United States