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Ron sent this question in error to me, but meant it for the entire group:
"Hi everyone,
I recently had my third sleep study. First one was done about 8 years ago where I was diagnosed with obstructive sleep apnea and was given a CPAP machine. About two years ago another study was done because we felt that pressures were too low. Pressures were set higher but this has been bothersome and I usually end up throwing it off during the night sometime. A recent third study shows that I have what is known as central sleep apnea. This is when the brain doesn't give the signal to the lungs to BREATHE! No one seems too concerned about this and it has taken forever to just get the report back. I am going to a neuro next week due to a brain CT showing moderate gray matter loss and to possibly see about a new machine called an ASV? It is supposed to be a computer that records your normal breathing pattern. then when you stop breathing the machine jumps in with the normal pattern and gets you back on track. Gee, I thought that was what CPAP did. I am very tired all the time, sleep a LOT. I am beginning to think that nothing will help me and I will just die in my sleep. Anyone heard of any good results from this. My pulse rate went way low at my last study and my o2 sat rate went down to 80% at one point. This can't be good."
"Hi everyone,
I recently had my third sleep study. First one was done about 8 years ago where I was diagnosed with obstructive sleep apnea and was given a CPAP machine. About two years ago another study was done because we felt that pressures were too low. Pressures were set higher but this has been bothersome and I usually end up throwing it off during the night sometime. A recent third study shows that I have what is known as central sleep apnea. This is when the brain doesn't give the signal to the lungs to BREATHE! No one seems too concerned about this and it has taken forever to just get the report back. I am going to a neuro next week due to a brain CT showing moderate gray matter loss and to possibly see about a new machine called an ASV? It is supposed to be a computer that records your normal breathing pattern. then when you stop breathing the machine jumps in with the normal pattern and gets you back on track. Gee, I thought that was what CPAP did. I am very tired all the time, sleep a LOT. I am beginning to think that nothing will help me and I will just die in my sleep. Anyone heard of any good results from this. My pulse rate went way low at my last study and my o2 sat rate went down to 80% at one point. This can't be good."
Views: 1253
Replies to This Discussion
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Permalink Reply by Butch Hernandez on
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ASV is a relatively new type of treatment that can help treat CSA pts! As a technologist, I have ran treatment studies (titrations) on a handful of pts with awesome results! CPAP is a continuous amount of pressure coming at you and has no idea whether your awake or asleep. The ASV units actually learn your breathing pattern and pick up the slack when a CSA event occurs via a very refined algorithm. Sounds very intimidating, I know, but don't worry, it's just as easy to use and maintain as a traditional CPAP unit. Of the two units I'm familiar with, they are maybe a bit larger in size depending on which manufacturers unit you get. Now, as a working technologist, I have my clinical opinions about the Respironics AutoSV and the ResMed ASV units. Both are capable of delivering the right treatment to you! Think of it as a Ford/Chevy comparison...both get you down the road! I've seen these ASV units do some truly amazing work on some pts!
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Permalink Reply by RockRpsgt on
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I personally have not used one of these machines. I have read the studies, and the results for CSA have been really good. Unfortunately as a technician we are kind of stuck jumping through insurance hoops for cases like this. In the first study we have to prove that you have apnea, the second we titrate on normal CPAP. After this we have to prove to the insurance companies that CPAP has failed you. Unfortunately as far as the sleep goes, as in any other medical instance, the insurance companies set rules. From what I read Butch is right. This should be the machine for you.
Butch Hernandez said:ASV is a relatively new type of treatment that can help treat CSA pts! As a technologist, I have ran treatment studies (titrations) on a handful of pts with awesome results! CPAP is a continuous amount of pressure coming at you and has no idea whether your awake or asleep. The ASV units actually learn your breathing pattern and pick up the slack when a CSA event occurs via a very refined algorithm. Sounds very intimidating, I know, but don't worry, it's just as easy to use and maintain as a traditional CPAP unit. Of the two units I'm familiar with, they are maybe a bit larger in size depending on which manufacturers unit you get. Now, as a working technologist, I have my clinical opinions about the Respironics AutoSV and the ResMed ASV units. Both are capable of delivering the right treatment to you! Think of it as a Ford/Chevy comparison...both get you down the road! I've seen these ASV units do some truly amazing work on some pts!
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Rock is right, we have to demonstrate that CPAP failed and even Bilevel as well. As I understand it, over 50% of scored events have to be CSA to qualify for an ASV titration. As techs, we see the writing on the wall, but we have to play by the insurance companies rules unfortunately. But in the end, if you get the right treatment, it's all worth it!
Rock Hinkle said:I personally have not used one of these machines. I have read the studies, and the results for CSA have been really good. Unfortunately as a technician we are kind of stuck jumping through insurance hoops for cases like this. In the first study we have to prove that you have apnea, the second we titrate on normal CPAP. After this we have to prove to the insurance companies that CPAP has failed you. Unfortunately as far as the sleep goes, as in any other medical instance, the insurance companies set rules. From what I read Butch is right. This should be the machine for you.
Butch Hernandez said:ASV is a relatively new type of treatment that can help treat CSA pts! As a technologist, I have ran treatment studies (titrations) on a handful of pts with awesome results! CPAP is a continuous amount of pressure coming at you and has no idea whether your awake or asleep. The ASV units actually learn your breathing pattern and pick up the slack when a CSA event occurs via a very refined algorithm. Sounds very intimidating, I know, but don't worry, it's just as easy to use and maintain as a traditional CPAP unit. Of the two units I'm familiar with, they are maybe a bit larger in size depending on which manufacturers unit you get. Now, as a working technologist, I have my clinical opinions about the Respironics AutoSV and the ResMed ASV units. Both are capable of delivering the right treatment to you! Think of it as a Ford/Chevy comparison...both get you down the road! I've seen these ASV units do some truly amazing work on some pts!
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Permalink Reply by Rock Conner RRT on
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A preeminent sleep physician recently told me that he thinks ASV will eventually become the standard for treating obstructive, central & mixed sleep apneas. We, too, have encountered the challenges of reimbursement, & in fact have had patients who titrated well on ASV have to return to suboptimal therapies because of insurance claim denials. Such is the case with many emerging therapies. I'm old enough to remember reimbursement battles about heated humidifiers and those newfangled bilevel machines.
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Permalink Reply by Ron Sowell on
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Butch Hernandez said:ASV is a relatively new type of treatment that can help treat CSA pts! As a technologist, I have ran treatment studies (titrations) on a handful of pts with awesome results! CPAP is a continuous amount of pressure coming at you and has no idea whether your awake or asleep. The ASV units actually learn your breathing pattern and pick up the slack when a CSA event occurs via a very refined algorithm. Sounds very intimidating, I know, but don't worry, it's just as easy to use and maintain as a traditional CPAP unit. Of the two units I'm familiar with, they are maybe a bit larger in size depending on which manufacturers unit you get. Now, as a working technologist, I have my clinical opinions about the Respironics AutoSV and the ResMed ASV units. Both are capable of delivering the right treatment to you! Think of it as a Ford/Chevy comparison...both get you down the road! I've seen these ASV units do some truly amazing work on some pts!
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thanks Butch and Rock. This will be very helpful next week when I see neurology. I think when my insurance company sees the sleep study they will ok the ASV. It really urks me that insurance determines what help we get and someone at the insurance company determines what we need, not the doctors ! - but that is for another day. So it sounds like a computer that is input with the data of your correct breathing, and when your body fails to do that, it starts to breathe for you at your rhythm. I suppose when you begin to breathe right again on your own the machine goes back to idle to wait until the next time? However it works, I will be happy to try it. At this rate I don't know how much more "gray matter" I can lose!! As to the insurance nightmare, how about doctors who don't even give you the results of your test - you have to go get them and then you have to have them help you 'look up' a doctor who is qualified to tackle the problem - and this doctor is in another state! Unbelievable.
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Permalink Reply by Melodie on
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Ron Sowell said:thanks Butch and Rock. This will be very helpful next week when I see neurology. I think when my insurance company sees the sleep study they will ok the ASV. It really urks me that insurance determines what help we get and someone at the insurance company determines what we need, not the doctors ! - but that is for another day. So it sounds like a computer that is input with the data of your correct breathing, and when your body fails to do that, it starts to breathe for you at your rhythm. I suppose when you begin to breathe right again on your own the machine goes back to idle to wait until the next time? However it works, I will be happy to try it. At this rate I don't know how much more "gray matter" I can lose!! As to the insurance nightmare, how about doctors who don't even give you the results of your test - you have to go get them and then you have to have them help you 'look up' a doctor who is qualified to tackle the problem - and this doctor is in another state! Unbelievable.
Ron,
This is Melodie (Mel). I too have central sleep apnea. I was first put on a C-PAP, but shortly after, my Pulmonologist realized that it was NOT the correct machine for me and I was still having problems breathing at night. He did a 3rd sleep study and found that, indeed, I have central sleep apnea and that is when he changed me to a Bi-PAP Auto SV unit. It has 3 different breathing levels. Mine is set at 14-4-14. From what I have been told, the 3rd level kicks in whenever the device senses that I am NOT breathing properly - and sort of acts similar to a respirator to get you back to breathing correctly. I love my Bi-PAP Auto SV unti with heated humidifier, and since receiving it, am sleeping much better than I have in my entire 51 years of life! My cat no longer wakes me up in the middle of the night, and I also do not get up during the night at all. In fact, I sleep a full 6-8 hours without waking at all.
I am medically disabled, due to several other medical illnesses, and am finally on Social Security Disability. I am pretty much homebound, so I don't have to get up at any specific time and just let myself wake up naturally. I do have to take sleep medication for my insomnia, but I no longer wake during the night and usually wake up feeling much more rested than I ever have before. I am very thankful for the new technology of the Bi-PAP Auto SV unit! It has made me sleep and rest better than I ever thought possible. I am also an oxygen patient, and my oxygen is bled into the Bi-PAP Auto SV at a rate of 4 liters per minute throughout the night. Everything is working just fine in that area for me now!
I wish you all the luck in the world with your new Bi-PAP Auto SV. You'll have to let us know how it is working for you and if you are getting better results than with the C-PAP. Hopefully you have a good DME and they send your unit out with a Respiratory Therapist that is familiar with this type of device and can fully explain everything to you. I was lucky to have a fabulous Respiratory Therapist, and she was highly knowledgeable about my new Bi-PAP Auto SV and stayed with me until she felt like I fully understood how to use the machine, clean it, and had no questions left unanswered.
Feel free to contact me if you need any suggestions or advice on your new Bi-PAP.
Regards,
Melodie (Mel) Aultman-Morris
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Permalink Reply by White Beard on
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Ron
I have been on the Res Med VPAP Adapt SV since last May and this ASV machine has been a real Godsend! I can't sing its praises enough! I have Complex Sleep Apnea, and I originally started off on CPAP then CPAP with supplemental O2 and then BiPAP, 18 months and 6 sleep studies later I finally got put on the ASV treatment with 3lpm supplemental O2, and finally I started getting some relief from this SA! Within 2 or 3 weeks of using the VPAP Adapt SV my severe night sweats disappeared and so did the nocturia, in about 3 months the tiredness and extreme fatigue started losing its grip on me! The machine really made a difference for me. I also purchased the Reslink and Nonin Pulse Ox for it along with the card and card reader ans ResScan 3.5 software. Daily I check the data screen on the machine and look at my daily (nightly) AHI and AI averages and my average pressure and respiration rate and VT and MV. Once a week I take the card out of the ResLink and down load the detailed data into my computer, it shows my O2 saturation and Pulse along with all the other data, right down to the moment that it happens while I sleep!
Anyway the ResMed VPAP Adapt SV is made just to treat Central apneas and Complex Sleep Apnea and Cheyne-Stokes breathing patterns, The machine samples your breathing pattern when you first use it every night and then tries to maintain your breathing, it monitors you and if it senses that you are going to have an apnea, it will do what ever it needs to do to prevent you from having the apnea! My nightly average pressure is 12.2 but when looking at my detailed data the pressure will often go up to 25cm to prevent an apnea from occurring. My average AHI is 0.4 to 2.6 but it varies some but my AI is usually always 0.0 so the AHI is actually only HI's. This machine is actuallly a ventilator of sorts so it is different than a normal CPAP or BiPAP machine! Anyway I highly recommend the ResMed ASV machine.
Good Luck to You White Beard
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Permalink Reply by RL on
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Glad I found this thread. I am recently diagnosed with complex SA, and am trying to understand the central apnea part. My central apnea is "idiosyncratic" as there is no cause for this discovered at this time. My thyroid levels are good, also EKG was "healthy" with no arrhythmias and no known neurological causes. My Rx is for CPAP 7 cmH20 with 3l O2. I have tolerated the equipment well for my first eleven days using a nasal pillow mask. My PCP referred me to a pulmonoligist, which I will be seeing end of next week, to check for anything else. I am trying to understand the central apnea and the prognosis for that. My Rx indicates no C-flex or EPR (not sure what EPR is) due to best results from only this pressure. I am wondering about asking to try the ASV unit which is mentioned by the sleep doc's report, but not prescribed at this time. The DME comments made me think that a variable pressure unit would not be appropriate for me. I figure it will take some time to tell if the CPAP is effective, and plan to ask my DME for a printout of log the day before seeing the pulmonoligist so I can share that info with him. I was hoping that maybe if the CPAP worked well that I might be able to quit using the oxygen at some point, but I don't see anyone saying that could or has happened.
Any thoughts and/or updates on your own experiences would be appreciated.
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Permalink Reply by Wes Carlson on
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I would like add my two cents worth to this discussion.I was diagnosed in August of 2009 with Complex apnea.At first I wondered if I could handle all of this but now I am very greatful for the sleep apnea machine.I had no choice on machines.I was prescribed a Respironics Bipap with auto SV since it was the only one that would top out at 30 cmH2o.Yes,that is not a miss print.My settings are EPAP of 14 cmH2o,IPAP Min of 15 cmH2o and Max IPAP of 30 cmH2o.I have the card reader so I watch my readings every day.There are some days looking at the Patient Triggered Breaths that would scare a regular patient but thanks for the machine kicking in helping get me back on track I am very thankful.I have seen times and not too many thank goodness that the PTB will hit bottom.When looking at the chart when this happens,I go straight up to the Pressure chart and see the machine tops out with peaks right at 30 cmH2o.I feel a world of differance with not being sleepy durning the day,blood pressure has started to drop and No middle of the night bathroom runs.As I have told differant people this therapy is worth more than Gold.Extenting the time I can live is well worth the extra time getting set for a Great nights sleep.
Everyone can do it if they give it their all !!!
Wes
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That's amazing, and encouraging White Beard & Wes! I wonder if I would benefit from the ASV type unit, and if the insurance will require me to try the BiPAP first. I note that Whitebeard struggled for 18 months and six sleep studies before being allowed to get the ASV PAP. I wonder if the insurance companies are learning anything from this yet. It just tells me not to give up if I don't feel better right away, even six months down the road. Thanks for the info. Thanks to everyone else on this thread also. I will try to talk with my pulmonologist about this, once I get set up with him and have more data from the CPAP. At least I want to get started with a machine that can give me the data myself, in order to monitor results more closely.
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hi! I read your post and wondered how long it took to adjust to the new ASV. I've had one about 3 weeks and am not adjusting to it. I thought it was going to be magic and make everything in my life better and instead I feel worse. I don't think I'm waking up because of sleep apnea any longer but am being awakened by the change in pressures and the stupid noises the air leaking makes. I'm also swallowing a ton of air and wake up to have big burps. It seems like the seal of the mask has to be a lot tighter and I don't know how much tighter I can make it without cutting off the circulation to my face. I already have mask marks for more than half the day. I don't see my doctor for follow up for another 10days. Even if the machine isn't annoying me I'm still having trouble falling asleep and staying asleep. I also feel like the machine changes pressure when I'm awake. Thanks for listening to my rant- I'm just frustrated and feeling desperate and looking for answers!
White Beard said:Ron
I have been on the Res Med VPAP Adapt SV since last May and this ASV machine has been a real Godsend! I can't sing its praises enough! I have Complex Sleep Apnea, and I originally started off on CPAP then CPAP with supplemental O2 and then BiPAP, 18 months and 6 sleep studies later I finally got put on the ASV treatment with 3lpm supplemental O2, and finally I started getting some relief from this SA! Within 2 or 3 weeks of using the VPAP Adapt SV my severe night sweats disappeared and so did the nocturia, in about 3 months the tiredness and extreme fatigue started losing its grip on me! The machine really made a difference for me. I also purchased the Reslink and Nonin Pulse Ox for it along with the card and card reader ans ResScan 3.5 software. Daily I check the data screen on the machine and look at my daily (nightly) AHI and AI averages and my average pressure and respiration rate and VT and MV. Once a week I take the card out of the ResLink and down load the detailed data into my computer, it shows my O2 saturation and Pulse along with all the other data, right down to the moment that it happens while I sleep!
Anyway the ResMed VPAP Adapt SV is made just to treat Central apneas and Complex Sleep Apnea and Cheyne-Stokes breathing patterns, The machine samples your breathing pattern when you first use it every night and then tries to maintain your breathing, it monitors you and if it senses that you are going to have an apnea, it will do what ever it needs to do to prevent you from having the apnea! My nightly average pressure is 12.2 but when looking at my detailed data the pressure will often go up to 25cm to prevent an apnea from occurring. My average AHI is 0.4 to 2.6 but it varies some but my AI is usually always 0.0 so the AHI is actually only HI's. This machine is actuallly a ventilator of sorts so it is different than a normal CPAP or BiPAP machine! Anyway I highly recommend the ResMed ASV machine.
Good Luck to You White Beard
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