[Treatment] Advice Please

[Ryan needs to Sleep]

Hi Everyone- I'm new to this forum.  Most people have no idea what I am talking about in regards to sleep apnea so I am happy to ding "my people"!  Backstory- I've always had trouble sleeping.  Breathing at night has always been hard.  My wife was tired of my leaping for a breath every 20 seconds so she asked me to get a study.  I took a home study which in retrospect was a waste of time.  Doctor put my on a cpap with little success.  I went in for a sleep study and now I am being told I have both obstructive sleep apnea and central apnea.  The doctor wanted to try a bipap-dreamstation.  I have used it for a week and only slight improvement.  I have read that central apnea machines aren't as great as you think which worries me as that is the next step.  Please take a look at the study below and let me know your thoughts-I truly value them!   (40 years old, 6"1" 230 lbs, workout out daily, eat well) Thank you!

[staceyburke]

This will give so some idea of the different pap machines... a lot more than just cpap and bipap...

This info is from the ResMed Sleep Lab Titration Guide

• CPAP (continuous positive airway pressure) Fixed pressure delivered with optional expiratory pressure relief (EPR). It Treats OSA
  

• AutoSet/APAP (automatic positive airway pressure) Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas. It treats OSA
  

• AutoSet for Her/APAP Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas along with an increased sensitivity to each flow-limited breath, providing a more comfortable therapy for women. Increases sensitivity to each flow-limited breath, providing a more comfortable therapy for women (OK for men too). It Treats OSA
  

• VAuto Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas; Pressure Support (PS) is fixed throughout the night and can be set by the clinician. It Treats OSA, non-compliant OSA
  

• S (Spontaneous) Senses when the patient is inhaling and exhaling, and supplies appropriate pressures accordingly. Both treatment pressures are preset: inspiration (IPAP) and expiration (EPAP). It treats Non-compliant OSA and COPD
  

• ST (Spontaneous/Timed) Augments any breaths initiated by the patient, but also supplies additional breaths if the breath rate falls below the clinician’s set “backup” respiratory rate. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• T (Timed) Supplies a clinician-set respiratory rate and inspiratory/expiratory time, regardless of patient effort. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• iVAPS (intelligent Volume-Assured Pressure Support) Maintains a preset target alveolar minute ventilation by monitoring delivered ventilation, adjusting the pressure support and automatically providing an intelligent backup breath. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• ASV (adaptive servo-ventilation) Targets the patient’s minute ventilation, continually learning the patient’s breathing pattern and instantly responding to any changes. It treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
  

• ASVAuto Provides an ASV algorithm plus expiratory positive airway pressure (EPAP) that automatically responds on the patient’s next breath to flow limitation, snore and obstructive sleep apneas. It Treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
  

• PAC (Pressure Assist Control, also known as Pressure Control) The inspiration time is preset in the PAC mode; there is no spontaneous/flow cycling. Inspiration can be triggered by the patient when respiratory rate is above a preset value, or delivered at a set time at the backup rate. It Treats Neuromuscular disease (NMD), pediatric patients
  

ST (Spontaneous/Timed) Augments any breaths initiated by the patient, but also supplies additional breaths if the breath rate falls below the clinician’s set “backup” respiratory rate. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions  



[color=#000000][font=verdana, sans-serif, arial]ASVAuto Provides an ASV algorithm plus expiratory positive airway pressure (EPAP) that automatically responds on the patient’s next breath to flow limitation, snore and obstructive sleep apneas. It Treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)

[staceyburke]

If you do have serious Centrals they can not be fixed on a cpap or bipap. AsvAuto may be the one but they are much more expensive so the Dr. and Insurance may have to try others before allowing you this type of machine. If you only have a few centrals then you would be fine with a bipap. We all have centrals - you just stop breathing for a little while. like holding your breath when you bind over to tie a shoe or roll over in bed. But in my opinion DON'T take the dreamstation, get a RESMED aircurve VAUTO. By far a better machine and won't cost you more but the supplier will try to give you the dreamstation because it is cheaper and they make more money. They get paid the same from insurance for both machines.

[Sleeprider]

The correct machine for complex apnea is the Resmed Aircurve 10 ASV. An adaptive servo ventilator responds with pressure support on a breath by breath basis and eliminates central apnea and hypopnea while the positive exhale pressure keeps the airway patent against obstructive apnea. The Resmed titration guide provides information on all types of positive pressure therapy and how to make pressure adjustments for different kinds of events. You need ASV and the Resmed is just more comfortable and effective than Philips in the ASV category.

If your insurance has copay and deductions ask your doctor for a trial on ASV or to just write the script instead of an expensive study. The default settings rarely née much adjustment to be effective. A lightly used ASV from Supplier #2 costs $1350.

[Ryan needs to Sleep]

Thank you! Has anyone on here had real success with the ASV? Are my numbers out of this world crazy or pretty typical ?

[staceyburke]

I suggest you do a search for avs machine or avs help etc. there are many here that use them. I’m not much help with that I have bipap and would be happy to answer questions on it or Cpap.

[sheepless]

"Has anyone on here had real success with the ASV?"

almost everyone for whom it's appropriate; i.e., those with central or mixed apnea &/or csr.

an optimized resmed asv returned a long term ahi of less than 1.0 for my mixed apnea (nearly equal numbers of ca & oa at the rate of more than 72/hour in my last sleep test). if apnea was my only problem I'd still be using it but I'm sacrificing a low ahi for the more constant / fixed bilevel pressures of the vauto due to the way resmed machines respond to my periodic limb movement induced flow limitations.

if you have mixed apnea, to my knowledge there isn't a better machine out there.

[SarcasticDave94]

102 Central Apnea / 3 Obstructive Apnea / 39 Hypopnea

You will need the ResMed AirCurve 10 ASV. The ASV is the only CA machine to offer treatment that will successfully and consistently work. And it will give you great therapy once we get you your own. Best to you on self advocacy.

[Sleeprider]

Here is a review on our forum http://www.apneaboard.com/forums/Thread-...rve-10-ASV
more: http://www.apneaboard.com/forums/Thread-...tation-ASV
http://www.apneaboard.com/forums/Thread-...rve-10-ASV

[Ryan needs to Sleep]

Very helpful everyone. Thank you for taking the time.