[CPAP] UARS, data interpretation OSCAR, what to do?

[KingKongBingBong]

Yep that is an ASV. Only the ASV has ASV and ASV Auto modes. This is one Sleeprider mentioned that treats Central and mixed Apnea, so what he said is correct.

so im screwed? theres nothing i can do with this machine?

[SarcasticDave94]

If I understood your explanation correctly, this is a trial machine, a loaner of some sort. Report to them that you're in need of a different model ResMed as mentioned by Sleeprider. VAuto or AutoSet sounds like a good direction.

[Sleeprider]

You are in AU. It is incredibly hard and expensive to get a Resmed S9 VPAP Adapt Pacewave. It should not be hard to find someone that needs that machine, and that may be able to trade a S9 VPAP Auto or Aircurve 10 Vauto. Yours is the more valuable machine, but it is a ventilator. Alternatively contact Supplier #2 and have them quote a lightly used Aircurve 10 Vauto for shipment to AU. Their current pricing is under $800 USD, and shipping will add about $100.. You are already using the best settings possible, and your AHI is nearly zero. If that is not working for you, then that is as good as it gets with ASV. A VPAP auto will provide consistent pressure support throughout therapy rather than targeting minute vent like your ASV does.

[KingKongBingBong]

If I understood your explanation correctly, this is a trial machine, a loaner of some sort. Report to them that you're in need of a different model ResMed as mentioned by Sleeprider. VAuto or AutoSet sounds like a good direction.

Yes. I can get another one but it's not always easy for some reason. so yea.

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You are in AU. It is incredibly hard and expensive to get a Resmed S9 VPAP Adapt Pacewave.  It should not be hard to find someone that needs that machine, and that may be able to trade a  S9 VPAP Auto or Aircurve 10 Vauto. Yours is the more valuable machine, but it is a ventilator. Alternatively contact Supplier #2 and have them quote a lightly used Aircurve 10 Vauto for shipment to AU.  Their current pricing is under $800 USD, and shipping will add about $100..  You are already using the best settings possible, and your AHI is nearly zero.  If that is not working for you, then that is as good as it gets with ASV.  A VPAP auto will provide consistent pressure support throughout therapy rather than targeting minute vent like your ASV does.

Why is the consistent pressure support better for RERAs than targeting minute ventilation?

[Ratchick]

Why is the consistent pressure support better for RERAs than targeting minute ventilation?

In my understanding, it's kind of for the same reason that antibiotics are good for bacterial infections and no good for viruses or fungal infections, which require their own antiviral or antifungal medications - different treatments are targeted at different things, with different underlying causes. You might get some relief with the wrong medication, but you probably won't get adequate results.

My understanding is (and I'm no expert) that not all sleep-disordered breathing has the same cause or response to different xPAP therapies. It's not a case of going from CPAP to BiPAP to ASV from ok to better to best. They just work in different ways, and support different disorders with different underlying needs.CPAP/APAP works great on OSA. BiPAP is better for other non-SDB respiratory issues (my father uses one for COPD), as well as perhaps better at managing RERAs and Flow Limitation and UARS, whereas ASV is great for central and complex sleep apnea. But they're not designed specifically to do everything the other types of machine do, and so probably aren't as effective as the correct machine with the most appropriate treatment algorithm.

I hope that helps (and I'm not getting things muddled!).

[KingKongBingBong]

Why is the consistent pressure support better for RERAs than targeting minute ventilation?

In my understanding, it's kind of for the same reason that antibiotics are good for bacterial infections and no good for viruses or fungal infections, which require their own antiviral or antifungal medications - different treatments are targeted at different things, with different underlying causes. You might get some relief with the wrong medication, but you probably won't get adequate results.

My understanding is (and I'm no expert) that not all sleep-disordered breathing has the same cause or response to different xPAP therapies. It's not a case of going from CPAP to BiPAP to ASV from ok to better to best. They just work in different ways, and support different disorders with different underlying needs.CPAP/APAP works great on OSA. BiPAP is better for other non-SDB respiratory issues (my father uses one for COPD), as well as perhaps better at managing RERAs and Flow Limitation and UARS, whereas ASV is great for central and complex sleep apnea. But they're not designed specifically to do everything the other types of machine do, and so probably aren't as effective as the correct machine with the most appropriate treatment algorithm.

I hope that helps (and I'm not getting things muddled!).

Why does Barry Krakow advocate foremostly for ASV then? What is his reasoning?

[Gideon]

An ASV works by stopping periods where you literally stop breathing by maintaining a constant minute vent by forcing a breath.

A BiLevel works by providing enough PS to normalize a flow limited breathform.

2 totally different tasks.

[Ratchick]

Why does Barry Krakow advocate foremostly for ASV then? What is his reasoning?

Unfortunately, I'm not inside his head, so I can't tell you his thought processes. .

[KingKongBingBong]

BTW is there any way to assess machine-generated breaths?

[Gideon]

It's a manual process developed over time. Look in The Guide and optimizing therapy wiki articles for commented examples,. I'm always adding more.