In general, central sleep apnea is not as common as obstructive sleep apnea but it is common in patients with heart failure. It has been repeatedly shown that central sleep apnea worsens the prognosis of heart failure. The current concept in the development of CSA is hypocapnia which causes temporary cessation of respiratory neural output. Different methods for supplement of CO2 have been used to eliminate CSA. However, variation of CO2 concentration during overnight treatment and tight-fitting mask made the treatment uncomfortable. It is important to develop a device with a comfortable mask to supply constant low dose CO2 without breathing difficulty. We recently developed a device for treatment of CSA.
Objective: To determine whether the device could improve sleep quality while eliminating CSA during the overnight study. Methods: Patients with central sleep apnea diagnosed by diaphragm EMG will be recruited in this study. CO2 concentration for treatment would be manually titrated during overnight PSG. Patients were then treated with an effective lowest concentration of CO2 derived from titration under PSG on the third night. The sleep apnea hypopnea index (AHI), central sleep apnea index (CHI), arousal index (ArI), Oxygen desaturation index (ODI), sleep structure, blood pressure, heart rate, diaphragm EMG, treatment side effects and treatment preference were to be observed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Using a device with a comfortable mask to supply constant low dose CO2 to treat patients.
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China
Apnea Hypopnea Index
Total number of apneas and hypopneas/total sleep time (h)
Time frame: One full night
Central sleep apnea index
Total number of central sleep apneas/total sleep time (h)
Time frame: One full night
Arousal Index
Total number of arousals/total sleep time(h)
Time frame: One full night
Oxygen Desaturation Index
Total number of oxygen desaturations≥3% /total sleep time(h)
Time frame: One full night
Sleep structure
Assessment of the sleep efficiency (percentage is calculated by dividing Total Sleep Time by Total Time in bed)
Time frame: One full night
Sleep structure
Assessment of the sleep stage distribution (percentage calculated by diving the time of stage N1, N2, N3, NREM by total sleep time)
Time frame: One full night
Adverse effects
Using questionnaire named side effects of feeling to assess adverse effects exiting or not, including dyspnea, noise, bloating, itchy face, dry mouth, ophthalmalgia, stuffy nose, et al. When the side effect events in intervening condition 2 times more than baseline is worse outcome.
Time frame: One full night
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