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==Introduction and Purpose==
This study compares the use of AutoASV (adaptive servo-ventilation) therapy against ST (bilevel spontaneous/timed) in a blind trial with a cohort of patients using Opioid therapy and exhibiting symptoms of central apnea. There are very few studies that actually compare ASV with ST head-to-head, and it is important to demonstrate that ST is not intended, nor effective in the treatment of central and complex apnea<ref>https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf</ref>. While the cohort in this cohort consists of study is associated with central apnea associated with chronic opioid usersuse, we believe the results are applicable to any causation of CSA in general including neurological, PAP therapy onset CSA and idiopathic cases. We are disappointed A very high visitation rate by CSA patients prescribed the use of bilevel and Bilevel ST machines indicates that ST continues to be prescribed to central apnea patients because we . We repeatedly see very poor results and patients experiencing high levels of apnea and discomfort when prescribed ST therapy rather than ASV. None of the major manufacturers of respiratory assist devices recommend the use of bilevel ST for the treatment of ST, and yet we see this egregious practice repeated time after time. This article is suggested as a means of quantitatively demonstrating the significant difference in efficacy for ASV vs ST in the hopes we can spare a few patients the pain and frustration of having to endure the wrong therapy. Please use the linked study and provide it to your doctor if they prescribe ST for a central apnea problem, and ask them for any study which demonstrates that the efficacy of ST is efficacious in the treatment of CSA, and particularly to show where ST has ever proven superior to ASV in the treatment of central or complex sleep disordered breathing. Although this study dates to 2014, we are unaware of any study that recommends ST as superior to ASV in any medical study. Based on our observations of repeated failure to achieve efficacy, the use of ST to treat central and complex sleep apnea should be discontinued.
==A novel adaptive servoventilation (ASVAuto) for the treatment of central sleep apnea associated with chronic use of opioids==
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