Predictors of One Year Compliance with Adaptive Servo-Ventilation in Patients with Heart Failure and Sleep- Disordered Breathing: Preliminary Data from the ADVENT-HF Trial.

Peak flow-targeted adaptive servo ventilation (ASVpf) suppresses both obstructive (OSA) and central sleep apnoea (CSA). Although high hours of positive airway pressure (PAP) use improves quality of life, long-term compliance is problematic. We evaluated ASVpf use in patients with heart failure and reduced ejection fraction with either OSA or CSA to determine the short and long-term predictors of ASV pf compliance.Of 177 patients randomised to ASVpf, compliance data were available at one and 12 months post-randomisation in 91 with OSA and 45 with CSA. Among patients with OSA, ASVpf use was 4.6 [2.9] h per day at one month but decreased to 4.1 [4.7] h at 12 months (p=0.04). Among patients with CSA, median ASVpf use was 5.2 [4.0] h per day at one month and 5.2 [3.5] h per day at 12 months (p=0.52). The only predictor of ASVpf use at 12 months was hours of use at one month (OR 2.02: CI 1.58-2.60, p<0.01).These data indicate better compliance with ASVpf than previously reported for other PAP devices in patients with cardiovascular diseases. Hours of daily use at one month predicted compliance at 12 months, indicating that if good short-term compliance is achieved, this effect can be sustained long-term.