[Diagnosis] Unique situation, wondering if anyone could elaborate on my study

[kc90]

   

Hello everyone   -

I have been on ASV therapy for just over 2 years. During my initial sleep study, I did not have insurance and went through a telehealth provider who did my sleep study, consultations and ultimately sold me the device as they carried DME as well. They are no longer practicing and I decided to go with a local sleep doctor for supplies this year.

Fast forward to today, and after meeting with my new local sleep doc, he asked me why I was on ASV in the 1st place? He stated that while I did have some CSA, they were minor and a normal CPAP would have been just fine and that's the direction he would like to move forward with for my next machine. 

I found it odd, but it sounded like he was hinting at that I was sold something I didn't necessarily need. ASV has been working for me, but I am just curious what someone in the know might think of my situation and data. 

Thank you for anyone who reads and provides feedback!

[SarcasticDave94]

If that was the test result that caused you to be placed on ASV, it might have been a mistake. I think there should have been a method to categorize hypopnea, differentiating between obstructive and central. That is maybe the only reason for ASV, but it's only a guess.

If we take what's actually given, 18 CA of the total 384 events, is not 50% of the total. That 50% CA is a criteria for ASV. So again if these are the true representation of numbers for events, ASV was probably wrong.

You have to decide if you want to retest, especially if the therapy from the ASV isn't beneficial.

One side note, it's almost never in your best interest to buy machines from the same facility that the doctor has a stake.

[Gideon]

I cannot speak to is an ASV was appropriate for you when you got it because you presented no data that led up to it.

Per the above set of data, i assume you are in otherwise perfect health, and you know what they say about assume, an APAP should be appropriate for you, IMHO insist on a ResMed.

[kc90]

replied directly to users with quotes

[kc90]

I cannot speak to is an ASV was appropriate for you when you got it because you presented no data that led up to it.

Per the above set of data, i assume you are in otherwise perfect health, and you know what they say about assume, an APAP should be appropriate for you, IMHO insist on a ResMed.

Thank you for responding! Yes I am in good health outside of some obesity and previous opiate usage which may have played a factor in the small amount of central sleep apnea. Again, I don't want to assume anything about the doctor but given that he sold the machines as well as did the sleep studies and consultations. I think I was just oversold on a machine I mostly did not need.

That said can you explain APAP? I am on ResMed now for my ASV but I only know CPAP BiPAP and ASV, APAP is a new one to me. All the best.

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If that was the test result that caused you to be placed on ASV, it might have been a mistake. I think there should have been a method to categorize hypopnea, differentiating between obstructive and central. That is maybe the only reason for ASV, but it's only a guess.

If we take what's actually given, 18 CA of the total 384 events, is not 50% of the total. That 50% CA is a criteria for ASV. So again if these are the true representation of numbers for events, ASV was probably wrong.

You have to decide if you want to retest, especially if the therapy from the ASV isn't beneficial.

One side note, it's almost never in your best interest to buy machines from the same facility that the doctor has a stake.

Thank you for the response! Yes this is the only sleep study I ever had done and resulted in me getting on ASV therapy. Again, it isn't that the ASV isn't benefitting me, my AHI is always below 1 for going on 2 years, usually closer to 0. I just think I got talked into buying a machine I truly do not medically need and going forward would rather get a cheaper machine if it does the same thing you know? 

The biggest mistake was me thinking a 1 stop shop for all things sleep would be the most beneficial way to do things but you live you learn

[SarcasticDave94]

What are your current ASV pressure settings? You'll have the following: Mode, EPAP single number or Min and Max, PS Min and Max.

There's something with the ASV you can try to see if therapy can be more like what you'd get on APAP. Note it won't be real close to APAP as the ASV cannot do that, but I'll mention something you can try.

Go into your clinical menu. Set the Mode to CPAP. Edit the single pressure you'll see to something like 7. See how that feels.

The 7 I'd mentioned can be replaced with any number, so it may be considered a placeholder. I did want to choose something that could be therapeutic somewhat.

CPAP in the ASV will be a static single pressure, absolutely no variation. Example, back to that number 7, that will be exactly what you get with it.

Alternate:
Use ASV Auto mode.
EPAP Min and Max ? Right now until we know your current
PS maybe we'll do 0-5
Attempt to minimize ASV pressure movement...

[Gideon]

APAP is na Automatic CPAP in a similar manner that ASV has an Auto-ASV mode