Switch to IVAPS?

[Chalkie]

I have been offereed the chance to try a ResMed Lumis 150 IVAPS machine. 

It appears to be the equivalent of Respironics AVAPS mode.

Judging by this old thread it may not be what I need. I have complex apnea and currently use BiPAP. 

A second option I have been offered is to revert to CPAP, with fixed continuous pressure.

What I had been hoping for was an ASV machine, specifically a ResMed  AirCurve model. I may have to look into buying one privately,  but for now, need to make a decision on this offer.

Below is a screenshot of last night's data.

     

[Sleeprider]

The Resmed Lumis 150 iVAPS is more sophisticated than the Respironics AVAPS version and is a much better choice, and an alternative to ASV. I think it would be helpful to understand the purpose and intention of the iVAPS as compared to the ASV. If you have complex or central apnea, then the ASV is the much better choice as it allows for spontaneous breathing with a breath by breath backup of pressure support to cause a breath during a central apnea or hypopnea. The iVAPS is really intended to deal with pulmonary disease or hypoventilation, where the patient is unable to maintain sufficient spontaneous effort to maintain the ventilation volume. This reference discusses the therapeutic intention of the different machines as well as procedures for titration. https://document.resmed.com/documents/pr...er_eng.pdf

Your current ST is set for fixed pressure of 23/15 (PS 8.0) and is doing a fairly miserable job. The ST is also used for patients with COPD and hypoventilation and has no intelligent or adaptive pressure support. You have indicated in the past that you do not have lung disease or respiratory insufficiency, which seems to be confirmed by a relatively high tidal volume when apena is not present. I think the correct machine for you remains the Resmed Aircurve 10 ASV, and I don't know why your doctor persists in prescribing machines that do not address central and complex apnea, but instead are intended for lung disease, pulmonary paralysis and obesity related hypoventilation.

[Chalkie]

Thanks, Sleeprider.

It is frustrating not to offer the ASV, but I was told I would not be.

It sounds from what you say that the Lumis 150 might be a better bet than what I have, so I am minded to trying it while pointing out that I feel the ASV is what I feel I really need.

If this machine is not the answer I will be looking at buying the Aircurve 10 privately.

This NHS clinic is, I believe, used to treating people with lung disease. Maybe that is why I am clept with that group.

Apparently, the Resprironicsw recall is also delaying everything.

Anyhow, that is very useful information SlepRider, and helps inform my decision.