Stabilizing Cheyne-Stokes respiration associated with congestive heart failure using computer-assisted positive airway pressure

Many heart failure patients exhibit Cheyne-Stokes respiration (CSR) during sleep. Preliminary data suggest improved transplant-free survival with continuous positive airway pressure (CPAP) therapy. However, nasal CPAP is open initially ineffective in resolving the CSR. This study assessed whether CSR could be stabilized acutely using positive airway pressure modified with an automated algorithm to adjust pressure support. The authors' computer-assisted positive airway pressure (CAPAP) system increased pressure support during the hypopnea phase of CSR and provided timed back-up ventilation during the apnea phase of the CSR article. Using CAPAP, the authors successfully eliminated CSR during sleep in 5 congestive heart failure patients. This resulted in improved sleep quality and pulse oximetry.