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Purpose of Review <p>To summarize current concepts in the pathophysiology, diagnosis, and management of central sleep apnoea (CSA), with a focus on periodic breathing in heart failure patients, and to critically appraise the role, safety, and indications of adaptive servo‑ventilation (ASV) based on recent evidence and guideline updates.&#xa0;</p> Recent Findings <p> The evaluation of all available data from randomized and observational studies, including those with modern devices, meta‑analyses and large registries show no excess mortality with ASV in any heart failure subtype and demonstrate sustained improvements in sleep‑disordered breathing severity and patient‑reported outcomes. Based on these re-assessments, recent guidelines and scientific statements suggest potential benefits and lead to positive recommendations for clinical practice.&#xa0;</p> Summary <p> Contemporary evidence confirms ASV as the most effective therapy to normalize CSA and periodic breathing, no longer justifying previous safety concerns. Future research should refine patient selection and define optimal integration with other therapies.&#xa0;</p>

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Adaptive Servo-Ventilation

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Winfried Randerath

摘要

Purpose of Review

To summarize current concepts in the pathophysiology, diagnosis, and management of central sleep apnoea (CSA), with a focus on periodic breathing in heart failure patients, and to critically appraise the role, safety, and indications of adaptive servo‑ventilation (ASV) based on recent evidence and guideline updates. 

Recent Findings

The evaluation of all available data from randomized and observational studies, including those with modern devices, meta‑analyses and large registries show no excess mortality with ASV in any heart failure subtype and demonstrate sustained improvements in sleep‑disordered breathing severity and patient‑reported outcomes. Based on these re-assessments, recent guidelines and scientific statements suggest potential benefits and lead to positive recommendations for clinical practice. 

Summary

Contemporary evidence confirms ASV as the most effective therapy to normalize CSA and periodic breathing, no longer justifying previous safety concerns. Future research should refine patient selection and define optimal integration with other therapies.