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. We first review the technical aspects of the available devices, and then the results of clinical trials in different patient populations. Whether volume or flow-targeted, ASV improves most measures of sleep-disordered breathing in patients with central sleep apnea (CSA) or Cheyne-Stokes breathing pattern (CSBP) related to congestive heart failure with preserved ejection fraction, treatment-emergent central sleep apnea syndrome, opioid-related CSA, and with idiopathic central sleep apnea as well.