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ASV vs. CPAP
Replies to This Discussion
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Permalink Reply by RichM on
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Yes this is very well done. to bad I don't have a resmed machine. I got a Respironics Bipap S/T. I have not found anyone else that uses this machine yet.
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Permalink Reply by White Beard on
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j n k I just joined this forum last night by judy's request, I normaly post over on a couuple of the other Sleep Apnea forums, but I have been using the ResMed VPAP Adapt SV enhanced since last May, it is completely different than a CPAP or BiPAP, it is actually a Servo Ventilator machine, Judy posted a very good link over on Sherry's thread about the ASV, that explains all about how the ResMed ASV works and their new technology dealing with Central Apneas! Anyway I am sold on the Adapt SV !
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JNK, Thanks so much for all your help, yes it will help me understand what is going on. I really wish my Dr would have let me have the autoSV but he does not believe in them and I do not have much choice due to the cost (they were about the same cost) I can not afford buying my own with out insurance. The first link you gave me to the cpaptalk site was very enlightening and that what I experience with the lack of support from my DME and the sleep center due to that they do not see many S/T machines. It would be nice to get the provider manual for the S/T if someone could get their hands on one it would be nice to have.
Thanks again
Rich
j n k said:Not quite the same machine, but this is close, as far as a provider manual:
http://www.internetage.ws/cpapdata/manuals/BiPAP-AVAPSProvider-%20M...
RichM said:Yes this is very well done. to bad I don't have a resmed machine. I got a Respironics Bipap S/T. I have not found anyone else that uses this machine yet.
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Permalink Reply by Mike on
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why wouldn't your doctor believe in ASVs? is there something unproven about these machines relative to the S/Ts? or is your doctor just being narrow minded, in which case maybe you should go to a different doctor to get another view on whether the ASV would be appropriate for you.
RichM said:JNK, Thanks so much for all your help, yes it will help me understand what is going on. I really wish my Dr would have let me have the autoSV but he does not believe in them and I do not have much choice due to the cost (they were about the same cost) I can not afford buying my own with out insurance. The first link you gave me to the cpaptalk site was very enlightening and that what I experience with the lack of support from my DME and the sleep center due to that they do not see many S/T machines. It would be nice to get the provider manual for the S/T if someone could get their hands on one it would be nice to have.
Thanks again
Rich
j n k said:Not quite the same machine, but this is close, as far as a provider manual:
http://www.internetage.ws/cpapdata/manuals/BiPAP-AVAPSProvider-%20M...
RichM said:Yes this is very well done. to bad I don't have a resmed machine. I got a Respironics Bipap S/T. I have not found anyone else that uses this machine yet.
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Mike my Dr is the only one near me right now and we had a very long talk about this very subject and he does not believe that the ASV is right for me he only things that it is good for Cheyne-Stokes Respiration (CSR) problems and not what I have even thou I have both OSA and CSA he feels that the CSA's are cause by the meds that I am on due to the accident that I had two years ago. I am on morphine (pill form) as my main pain meds. He does not think the Auto machines are really any good right now He says that he goes to all the seminars and schools and his certified in sleep study for Va. (the state) and has been doings this for years (appox 20) he is also a pulmonary doctor and one of the best around according to everyone here in SW Va. I still need to tweak my machine some due to trying to get it in sync with my breathing patterns. He felt that the ASV would take over my breathing and that would not be good for my case and he felt that the ST would do better with the timed breathing. Not sure, I still need to do more reading on this I just ordered Dr Steven Park's book in hopes to learn as much as I can about all this.
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Permalink Reply by sherry on
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Hi, this is Sherry from the 'Is This Machine Obsolete?' thread..Due to all the confusion in my getting my machine last week, I did not set it up till yesterday. This was due to a lot of encouragement from White Beard, thank you very much!
Some asked that I keep you posted on my experience with the Adapt SV, so this may be way too much info, or not what you want. Just don't respond if it is irrevelant. It is just that it is 2 am, it is my first night trying the Adapt, and I am waiting to get sleepy so I can go back to bed without it. Probably typical for first night.
Last night I hooked it up, did the mask setup as per the User Guide, the mask I have is only nasal pillows, which is definitely a nono on the ResMed site..but the clinic person insisted they would work fine, so..I used the full face setting as White Beard suggested, then realized that I did not have the little tube connected, so fixed that and started again, and got the invalid reading..over and over and over..I figured it was due to the mask type. Decided to hunt for some of the other features that I have seen discussed here, and found to my dismay there was no Results menu, only Service and Setup. Not happy. Bundled it all back up in the spiffy little case, intending to return it this morning and go from there..
This morning I thought, I will check out the CD that was in the case to see if I can find anything else out, it turned out to be the clinician's guide. ( I had tried to sneak the hard copy when I got the machine, but the person noticed it was gone and I had to give it back < :-( )
Anyway, it said in the PDF (which I have saved on my hard drive) that to enter the Clinician's setup guide, to hold down the arrow button and button to the right of it for 3 seconds and it would take you there. Tonight I did just that. (I have to mention here that the crt called me today to see how I was doing, and I informed her about the results screens etc. not being visible. She said, oh gosh, I must not have enabled that. I said, that is OK, I know how to do it. She said, gee, you are learning so much about this machine I will be calling you for help. She also told me I could use the mask, just SKIP the learning setup)
I enabled the Results, the mask fit, the leak rate, and everything else in there. Also deleted the data as it was all from when I was trying to get the mask setup the night before. Then I hooked the mask back up, skipped the learning setup as she suggested, and it worked fine. Except it was blowing so hard it was making my ears pop and also making my nostrils puff out. I went back in and lowered the min (it was set for 6-13) to 4.8, which was much better but still pretty pushy, especially the rate of inhale exhale, but I was hesitant to make it lower. (Note--I suggest you write down the original settings, I should have thought to do it before I changed anything.)
When I went to bed, I tried it for about 5 minutes, air was gushing thru the exhale vents in the mask, finally I got up and changed it to 3.5. Much better, although it was breathing a lot faster than I was. After a while, I noticed that about every 2 minutes, the inhale/exhale speed was slowing down. Don't believe this machine has a Ramp up? Not in the menus. Anyway, it was nice to see that it was actually responding to my breathing pace. I felt a little optimistic for the first time!
Then another problem--I started drifting to sleep, but every time I would drift, the machine would gush and wake me up. Of course, I guess this is exactly the problem, I must stop breathing or hold my breath when I start dreaming. ( I hold my breath a lot even when not sleeping, when I concentrate on something). However, I'm not sure if I'm holding my breath, or just breathing more slowly all of a sudden. But I agree with Rich M's doctor, there is a definite feeling of not being able to breathe on your own. I did relax at one point and just let the machine breathe for me, which made it very happy, when you try to fight it, it retaliates with a noseful of air.
Will try again tomorrow night, I think I can get used to it if some of the abruptness can be smoothed out. I do not remember experiencing the sudden pressure changes when I had the good sleep test t the lab (first one was not good), I went to sleep OK and only woke up because the mask had pinched my nose till it hurt, not because of blowing air.
As I said, this may not be of interest, but I'm getting sleepy and can go back to bed now! LOL
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Permalink Reply by Duane McDade on
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WOW!!! This is a nightmare !! So let me get this strait you did not have a sleep study where a technician titrtrated you for the adapt SV.?? Have you be told you have Central Sleep Apnea? Complex Sleep Apnea, COPD??? and how do they know what your veep is?? are they just guessing?? Where I come from this is illegal!
sherry said:Hi, this is Sherry from the 'Is This Machine Obsolete?' thread..Due to all the confusion in my getting my machine last week, I did not set it up till yesterday. This was due to a lot of encouragement from White Beard, thank you very much!
Some asked that I keep you posted on my experience with the Adapt SV, so this may be way too much info, or not what you want. Just don't respond if it is irrevelant. It is just that it is 2 am, it is my first night trying the Adapt, and I am waiting to get sleepy so I can go back to bed without it. Probably typical for first night.
Last night I hooked it up, did the mask setup as per the User Guide, the mask I have is only nasal pillows, which is definitely a nono on the ResMed site..but the clinic person insisted they would work fine, so..I used the full face setting as White Beard suggested, then realized that I did not have the little tube connected, so fixed that and started again, and got the invalid reading..over and over and over..I figured it was due to the mask type. Decided to hunt for some of the other features that I have seen discussed here, and found to my dismay there was no Results menu, only Service and Setup. Not happy. Bundled it all back up in the spiffy little case, intending to return it this morning and go from there..
This morning I thought, I will check out the CD that was in the case to see if I can find anything else out, it turned out to be the clinician's guide. ( I had tried to sneak the hard copy when I got the machine, but the person noticed it was gone and I had to give it back < :-( )
Anyway, it said in the PDF (which I have saved on my hard drive) that to enter the Clinician's setup guide, to hold down the arrow button and button to the right of it for 3 seconds and it would take you there. Tonight I did just that. (I have to mention here that the crt called me today to see how I was doing, and I informed her about the results screens etc. not being visible. She said, oh gosh, I must not have enabled that. I said, that is OK, I know how to do it. She said, gee, you are learning so much about this machine I will be calling you for help. She also told me I could use the mask, just SKIP the learning setup)
I enabled the Results, the mask fit, the leak rate, and everything else in there. Also deleted the data as it was all from when I was trying to get the mask setup the night before. Then I hooked the mask back up, skipped the learning setup as she suggested, and it worked fine. Except it was blowing so hard it was making my ears pop and also making my nostrils puff out. I went back in and lowered the min (it was set for 6-13) to 4.8, which was much better but still pretty pushy, especially the rate of inhale exhale, but I was hesitant to make it lower. (Note--I suggest you write down the original settings, I should have thought to do it before I changed anything.)
When I went to bed, I tried it for about 5 minutes, air was gushing thru the exhale vents in the mask, finally I got up and changed it to 3.5. Much better, although it was breathing a lot faster than I was. After a while, I noticed that about every 2 minutes, the inhale/exhale speed was slowing down. Don't believe this machine has a Ramp up? Not in the menus. Anyway, it was nice to see that it was actually responding to my breathing pace. I felt a little optimistic for the first time!
Then another problem--I started drifting to sleep, but every time I would drift, the machine would gush and wake me up. Of course, I guess this is exactly the problem, I must stop breathing or hold my breath when I start dreaming. ( I hold my breath a lot even when not sleeping, when I concentrate on something). However, I'm not sure if I'm holding my breath, or just breathing more slowly all of a sudden. But I agree with Rich M's doctor, there is a definite feeling of not being able to breathe on your own. I did relax at one point and just let the machine breathe for me, which made it very happy, when you try to fight it, it retaliates with a noseful of air.
Will try again tomorrow night, I think I can get used to it if some of the abruptness can be smoothed out. I do not remember experiencing the sudden pressure changes when I had the good sleep test t the lab (first one was not good), I went to sleep OK and only woke up because the mask had pinched my nose till it hurt, not because of blowing air.
As I said, this may not be of interest, but I'm getting sleepy and can go back to bed now! LOL
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Sherry, this is great info, and will give folks a lot to respond to. I would recommend starting its own thread, though, since it's a new experience you had. I'll break it out as such for you.
sherry said:Hi, this is Sherry from the 'Is This Machine Obsolete?' thread..Due to all the confusion in my getting my machine last week, I did not set it up till yesterday. This was due to a lot of encouragement from White Beard, thank you very much!
Some asked that I keep you posted on my experience with the Adapt SV, so this may be way too much info, or not what you want. Just don't respond if it is irrevelant. It is just that it is 2 am, it is my first night trying the Adapt, and I am waiting to get sleepy so I can go back to bed without it. Probably typical for first night.
Last night I hooked it up, did the mask setup as per the User Guide, the mask I have is only nasal pillows, which is definitely a nono on the ResMed site..but the clinic person insisted they would work fine, so..I used the full face setting as White Beard suggested, then realized that I did not have the little tube connected, so fixed that and started again, and got the invalid reading..over and over and over..I figured it was due to the mask type. Decided to hunt for some of the other features that I have seen discussed here, and found to my dismay there was no Results menu, only Service and Setup. Not happy. Bundled it all back up in the spiffy little case, intending to return it this morning and go from there..
This morning I thought, I will check out the CD that was in the case to see if I can find anything else out, it turned out to be the clinician's guide. ( I had tried to sneak the hard copy when I got the machine, but the person noticed it was gone and I had to give it back < :-( )
Anyway, it said in the PDF (which I have saved on my hard drive) that to enter the Clinician's setup guide, to hold down the arrow button and button to the right of it for 3 seconds and it would take you there. Tonight I did just that. (I have to mention here that the crt called me today to see how I was doing, and I informed her about the results screens etc. not being visible. She said, oh gosh, I must not have enabled that. I said, that is OK, I know how to do it. She said, gee, you are learning so much about this machine I will be calling you for help. She also told me I could use the mask, just SKIP the learning setup)
I enabled the Results, the mask fit, the leak rate, and everything else in there. Also deleted the data as it was all from when I was trying to get the mask setup the night before. Then I hooked the mask back up, skipped the learning setup as she suggested, and it worked fine. Except it was blowing so hard it was making my ears pop and also making my nostrils puff out. I went back in and lowered the min (it was set for 6-13) to 4.8, which was much better but still pretty pushy, especially the rate of inhale exhale, but I was hesitant to make it lower. (Note--I suggest you write down the original settings, I should have thought to do it before I changed anything.)
When I went to bed, I tried it for about 5 minutes, air was gushing thru the exhale vents in the mask, finally I got up and changed it to 3.5. Much better, although it was breathing a lot faster than I was. After a while, I noticed that about every 2 minutes, the inhale/exhale speed was slowing down. Don't believe this machine has a Ramp up? Not in the menus. Anyway, it was nice to see that it was actually responding to my breathing pace. I felt a little optimistic for the first time!
Then another problem--I started drifting to sleep, but every time I would drift, the machine would gush and wake me up. Of course, I guess this is exactly the problem, I must stop breathing or hold my breath when I start dreaming. ( I hold my breath a lot even when not sleeping, when I concentrate on something). However, I'm not sure if I'm holding my breath, or just breathing more slowly all of a sudden. But I agree with Rich M's doctor, there is a definite feeling of not being able to breathe on your own. I did relax at one point and just let the machine breathe for me, which made it very happy, when you try to fight it, it retaliates with a noseful of air.
Will try again tomorrow night, I think I can get used to it if some of the abruptness can be smoothed out. I do not remember experiencing the sudden pressure changes when I had the good sleep test t the lab (first one was not good), I went to sleep OK and only woke up because the mask had pinched my nose till it hurt, not because of blowing air.
As I said, this may not be of interest, but I'm getting sleepy and can go back to bed now! LOL
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Permalink Reply by RockRpsgt on
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Thanks Mike, I guess I missed this one earlier.
Mike said:Rock, i have a ton of respect for you as a professional for coming forward and admitting to not knowing something. any professional can try to talk one step ahead of a lay person and pull the wool over his eyes as to knowing his stuff -- it takes a true pro to know when he knows or doesn't know something, and being willing to admit it.
Rock Hinkle said:NO WAY! I have barely seen these machines. Let alone understand them. I have learned more about them from this forum than anywhere else I have looked. Even reading the manual(which I have not yet) without ever using the machine I would not even try to explain the differences between the 2. So Judy I will stay off center stage for this one.
Judy said:Yer yoking, right??? I'm still struggling to understand the Resmed VPAP Auto (bi-level auto) and I also have a Respironics pre-M Series Bi-PAP Auto w/Bi-Flex as a backup that I hope I never have to tangle w/and try to use!!! I did take it in and have my local DME supplier set it according to my in-lab titration but .... its the one I'm hoping to get the "stench" out of. The Adapt SV is some type of even more sophisticated bi-level I think.
I'll put Rock Hinkle on the spot:
He has the Resmed VPAP Adapt SV Clinicians Manual (in all fairness he only received it w/in the last 2 days or so) so maybe he'd like to stick his neck out and explain the differences and maybe he'll want to pass until he has a chance to study it a bit.
Daniel Levy should be able to explain perhaps since he is a DME supplier and I would expect will have had more experience w/them than Rock Hinkle who is a PSGT working on getting his RPSGT.
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This study might bring some clarity to this subject RichM said:Mike my Dr is the only one near me right now and we had a very long talk about this very subject and he does not believe that the ASV is right for me he only things that it is good for Cheyne-Stokes Respiration (CSR) problems and not what I have even thou I have both OSA and CSA he feels that the CSA's are cause by the meds that I am on due to the accident that I had two years ago. I am on morphine (pill form) as my main pain meds. He does not think the Auto machines are really any good right now He says that he goes to all the seminars and schools and his certified in sleep study for Va. (the state) and has been doings this for years (appox 20) he is also a pulmonary doctor and one of the best around according to everyone here in SW Va. I still need to tweak my machine some due to trying to get it in sync with my breathing patterns. He felt that the ASV would take over my breathing and that would not be good for my case and he felt that the ST would do better with the timed breathing. Not sure, I still need to do more reading on this I just ordered Dr Steven Park's book in hopes to learn as much as I can about all this.
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Also I have been told that nasal pillow masks are not good for any of the auto machines because if they do get up to higher pressures they will either flare your nostrils or blow out of your nose as you have already experienced.
Duane McDade said:WOW!!! This is a nightmare !! So let me get this strait you did not have a sleep study where a technician titrtrated you for the adapt SV.?? Have you be told you have Central Sleep Apnea? Complex Sleep Apnea, COPD??? and how do they know what your veep is?? are they just guessing?? Where I come from this is illegal!
sherry said:Hi, this is Sherry from the 'Is This Machine Obsolete?' thread..Due to all the confusion in my getting my machine last week, I did not set it up till yesterday. This was due to a lot of encouragement from White Beard, thank you very much!
Some asked that I keep you posted on my experience with the Adapt SV, so this may be way too much info, or not what you want. Just don't respond if it is irrevelant. It is just that it is 2 am, it is my first night trying the Adapt, and I am waiting to get sleepy so I can go back to bed without it. Probably typical for first night.
Last night I hooked it up, did the mask setup as per the User Guide, the mask I have is only nasal pillows, which is definitely a nono on the ResMed site..but the clinic person insisted they would work fine, so..I used the full face setting as White Beard suggested, then realized that I did not have the little tube connected, so fixed that and started again, and got the invalid reading..over and over and over..I figured it was due to the mask type. Decided to hunt for some of the other features that I have seen discussed here, and found to my dismay there was no Results menu, only Service and Setup. Not happy. Bundled it all back up in the spiffy little case, intending to return it this morning and go from there..
This morning I thought, I will check out the CD that was in the case to see if I can find anything else out, it turned out to be the clinician's guide. ( I had tried to sneak the hard copy when I got the machine, but the person noticed it was gone and I had to give it back < :-( )
Anyway, it said in the PDF (which I have saved on my hard drive) that to enter the Clinician's setup guide, to hold down the arrow button and button to the right of it for 3 seconds and it would take you there. Tonight I did just that. (I have to mention here that the crt called me today to see how I was doing, and I informed her about the results screens etc. not being visible. She said, oh gosh, I must not have enabled that. I said, that is OK, I know how to do it. She said, gee, you are learning so much about this machine I will be calling you for help. She also told me I could use the mask, just SKIP the learning setup)
I enabled the Results, the mask fit, the leak rate, and everything else in there. Also deleted the data as it was all from when I was trying to get the mask setup the night before. Then I hooked the mask back up, skipped the learning setup as she suggested, and it worked fine. Except it was blowing so hard it was making my ears pop and also making my nostrils puff out. I went back in and lowered the min (it was set for 6-13) to 4.8, which was much better but still pretty pushy, especially the rate of inhale exhale, but I was hesitant to make it lower. (Note--I suggest you write down the original settings, I should have thought to do it before I changed anything.)
When I went to bed, I tried it for about 5 minutes, air was gushing thru the exhale vents in the mask, finally I got up and changed it to 3.5. Much better, although it was breathing a lot faster than I was. After a while, I noticed that about every 2 minutes, the inhale/exhale speed was slowing down. Don't believe this machine has a Ramp up? Not in the menus. Anyway, it was nice to see that it was actually responding to my breathing pace. I felt a little optimistic for the first time!
Then another problem--I started drifting to sleep, but every time I would drift, the machine would gush and wake me up. Of course, I guess this is exactly the problem, I must stop breathing or hold my breath when I start dreaming. ( I hold my breath a lot even when not sleeping, when I concentrate on something). However, I'm not sure if I'm holding my breath, or just breathing more slowly all of a sudden. But I agree with Rich M's doctor, there is a definite feeling of not being able to breathe on your own. I did relax at one point and just let the machine breathe for me, which made it very happy, when you try to fight it, it retaliates with a noseful of air.
Will try again tomorrow night, I think I can get used to it if some of the abruptness can be smoothed out. I do not remember experiencing the sudden pressure changes when I had the good sleep test t the lab (first one was not good), I went to sleep OK and only woke up because the mask had pinched my nose till it hurt, not because of blowing air.
As I said, this may not be of interest, but I'm getting sleepy and can go back to bed now! LOL
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Jnk, thanks for the great info I not a dr either or even play one on the net, But I like to learn as much as I can about the problems that I have so I can be proactive in my treatment. Yes I agree with you about the pain and keeping you from sleeping or at least getting good sleep. I do get a good number of CSAs I just got today the viewer software and card reader so I will be able to see how things are going now. I still dont get the sleep that I need but I am still working at it. Thanks again
Rich
j n k said:Any machine with a timed backup has the potential to 'take over' your breathing. But the doc has your complete history in front of him and may have an angle we don't know about. I am not a doctor and I do not work in this field, so my opinion isn't worth the paper this post isn't written on (:-)), but I could imagine that the doctor may be worried about defending the need for an SV to your insurance. (That tends to be how things work in this day and age, from I what I read and hear.) So you could always ask the doc if it would be worth it to get titrated with a ResMed VPAP Adapt SV Enhanced and then for the doc to prescribe that one be rented for you for a few weeks so that he could see what the data indicated as far as efficacy in your case. I don't know if that is something possible, but your asking about that approach would make it clear you are serious about it, if you decide to be.
I agree with your doc that auto machines aren't all they're advertised to be, but they are tools that can be tweaked to do some amazing things in the right hands, nonetheless, as far as mini-titrations and convenience. In my opinion they will NEVER take the place of a good PSG, but they are still useful, as long as they aren't sent out wide open, 4 to 20 (or 25) to run that way every night. I haven't heard of that working well.
If you are having trouble with your therapy, it may be worth it to be willing to travel a ways to get to a sleep doc connected with a lab with some SV experience that is willing to try you out with that machine, should you see that things aren't going well.
If you are only having a few centrals that don't last a long time and don't desaturate you or disrupt your sleep, I agree with the opinion that you don't NEED an SV. (I have heard, for example, that most people with chronic pain have a good number of centrals at night, since they tend to hold their breath when they move in their sleep.) But if you are having (1) many centrals (2) all through the night that are (3) disrupting your sleep or desaturating you, it may be that a properly set up SV might do the right trick.
Please keep in mind that sleeping and breathing are only my hobbies, not my profession. So my views may be way out in left field. In fact, even I don't always agree with everything I say. :-)
RichM said:Mike my Dr is the only one near me right now and we had a very long talk about this very subject and he does not believe that the ASV is right for me he only things that it is good for Cheyne-Stokes Respiration (CSR) problems and not what I have even thou I have both OSA and CSA he feels that the CSA's are cause by the meds that I am on due to the accident that I had two years ago. I am on morphine (pill form) as my main pain meds. He does not think the Auto machines are really any good right now He says that he goes to all the seminars and schools and his certified in sleep study for Va. (the state) and has been doings this for years (appox 20) he is also a pulmonary doctor and one of the best around according to everyone here in SW Va. I still need to tweak my machine some due to trying to get it in sync with my breathing patterns. He felt that the ASV would take over my breathing and that would not be good for my case and he felt that the ST would do better with the timed breathing. Not sure, I still need to do more reading on this I just ordered Dr Steven Park's book in hopes to learn as much as I can about all this.
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