Adaptive Servoventilation in Treatment of Sleep-Disordered Breathing

Adaptive servoventilation (ASV) monitors ventilation on a breath-by-breath basis and adjusts output to maintain set goals. Several different algorithms for monitoring, targeting, and sustaining ventilation have been developed and clinically tested. This article serves as a review of the operating characteristics, clinical use, and effectiveness of ASV. The technical aspects of the available devices and then the results of clinical trials in different patient populations are reviewed. Volume- or flow-targeted ASV improves most measures of sleep-disordered breathing in patients with central sleep apnea (CSA) or Cheyne-Stokes breathing pattern related to congestive heart failure, complex sleep apnea syndrome, opioid-related CSA, and idiopathic CSA.