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BACKGROUND Adaptive servo-ventilation (ASV) (AutoSetCS, ResMed) is a novel non-invasive ventilation modality for the treatment of Cheyne-Stokes-Respiration (CSR) in patients with heart failure. This study aimed to investigate the effect of ASV on sleep disordered breathing (SDB), afternoon nap duration, urine voidings, and quality of life. METHODS 11 patients with CSR due to heart failure (EF < 40 %) were treated with ASV for a period of 6 weeks. Apnea-Hypopnoe-Index (AHI), Arousalindex (AI), duration of afternoon nap, number of voidings, and heart specific quality of life were assessed before and at the end of the treatment period. RESULTS The average usage time of ASV was 5.8 +/- 2.1/h per day. With ASV the AHI was reduced from 48.2 +/- 11.6 to 6.4 +/- 8.3/h (p < 0.001) and the AI from 33.9 +/- 12.5 to 18.4 +/- 9.3 /h (p < 0.05). The afternoon nap duration was significantly less (1.4 +/- 0.6 vs. 0.7 +/- 0.4 hours per day; p = 0.004) as was the number of nocturnal voidings (2.9 +/- 0.7 vs. 1.1 +/- 0.3 per night; p = 0.007). There was a significant improvement in heart specific quality of life as measured with the Minnesota Living with heart failure questionnaire (43.5 +/- 21.1 vs. 27.6 +/- 15.7 (p = 0.02). CONCLUSION ASV is well tolerated and improves SDB and quality of life of patients with heart failure with CSR.