Which Machine - ASV

[DonC]

Hi Everyone,
After all this time it is great to report that I finally had an ASV Titration on Sunday night. I was only told that it had helped but the technician would not give me numbers. As some of you will remember I have been pushing for this for a while and a few of you have been telling me all along that this is what was needed.
Well, I need your help again. The doctor actually listens to me so I want to know which machine I should push for. I think he will listen to me but then there is the insurance.... Who knows.
But anyway, what I need to know is which machine should I push for? Any comments or Pros and Cons will be recieved gratefully. I currently have the ResMed AirSense 10 if that means anything. I look forward to your comments.
Don

[DeepBreathing]

Hi Don - good news!

On the Resmed side the choice is easy - either an Aircurve 10 ASV or (superseded) S9 VPAP Adapt. The Aircurve ASV is also called the AirCurve CS PaceWave in some markets, including Australia. Resmed ASV machines are relatively simple to set up, as the majority of adjustments are done by software. You need to set EPAP_Min, EPAP_Max, PS_Min, PS_Max and IPAP_Max. You can also set the ramp and humidity and I think that's about it. The machine is very good at following your breathing pattern and (in my experience) feels very gentle, even though it can push out some pretty high pressures.

I don't pretend to understand Respironics' naming system, but it's called "Philips Respironics BiPAP AutoSV Advanced 60 Series". I believe the new DreamStation series also has an ASV model. With the 60 series there are additional adjustments to the breathing cycle timing, backup rate etc. These can all be adjusted to tailor the therapy - but there are a lot of things to get wrong. I had one of these for a while but at the time I didn't know about all these additional adjustments and I had a very bad time with it. Once I changed to the Resmed I slept much better and my AHI instantly dropped from around 20 (62 untreated) to less than 5.

The Respironics seems to have a more comprehensive range of reported data than the Resmed, which might be important to you. I find I get sufficient data from the Resmed.

If you have the opportunity, try both and select the one that suits you best (remembering that the Respironics needs to be fine tuned). In my own case I certainly don't regret getting the Resmed and that would be my choice when / if I ever need to replace my current machine.

[Sleeprider]

Both the Resmed and Respironics machines are highly regarded, and there are many personal experience stories on the various forums. In general, the Resmed seems less adjustable, but works very harmoniously with people in Auto mode. The Respironics machines have many more settings that can be tweaked, and it works well in auto mode, but it seems to take a little longer to fully adjust. This is strictly anecdotal on the individuals I have observed and helped find that sweet spot. Both machines work great and many people find zero-events is consistently achievable.

The hard part is done, getting the machine justified as medically necessary. The easy part will be accepting either one of those, and making it work for you. I don't think you can actually go wrong unless someone tries to put you on a ST machine. Try not to let that happen.

[DonC]

Thanks very much both of you.
I think I will try for the ResMed as I have experience with their machines. But can someone explain the difference between the Aircurve 10 ASV and the S9 equivalent? Is it just the design or is one better than the other?
Thanks again,
Don

[trish6hundred]

Hi DonC,
It’s great to hear that you finally got your ASV titration done.
Good luck to you on your machine decision and also with dealing with your insurance.

[DeepBreathing]

It's a bit hard to tell from the Resmed website - they don't really put out a lot of meaningful data, just a lot of sales bumpf. My understanding is that the S9 and Aircurve are the same basic machine inside, and both use Resmed's PaceWave algorithm. These companies invest a fortune in R&D, so there are likely to be a host of minor improvements in the newer machine.

[HermannTheGerman]

Resmed uses the same algorithm in both machines.
At least in europe.
The main difference is the design (size) and the A10 has a build in celphone modem.

[klv329]

Yeah, go with the resmed ASV. it's easier to find suitable programming for me at least. It seems to react more quickly and hit higher pressures more often than the respironics, and that can be a good thing for some people. In the S9 ASVauto you just have 5 settings: MIN EPAP, MAX EPAP, MIN PS, MAX PS, and ramp. Relative to respironics ASV, I think it's Resmed's quicker and stronger responses that make it easier to program and avoid the more careful settings the respironics may require for some people.

[Asjb]

Hello DonC

A couple of months ago I was changed from the Airsense 10 Auto that you are using, to the Aircurve CS Pacewave ASV. I found the transition seamless and a great success. There's the advantage of immediately knowing and understanding most of the machine and its settings, as the two are so similar. And I found the way that the Aircurve reponds to my breathing to be very comfortable. My AHI has dropped from 3-12 down to almost always less than 1. My mean pO2 has increased from 94% to 96% and the graph is now almost a straight line! - very few desaturation events, and those that happen are not significant clinically. I have yet to have any central or obstructive events with the Aircurve, just occasional hypos, and I just continued successfully with the same mask, even though my ASV is set to a pressure of up to 19 (I couldn't tolerate more than 12 with APAP).

But, I have no experience with Respironics machines so can't comment on them.

The only disadvantage, and it is minimal, is that there are a few minor bugs with the Aircurve ASV and the current version of Sleepyhead.

I hope that whichever you chose is very effective for you. Thanks to the Resmed ASV I finally understand what a life can be like without daily fatigue...

[DonC]

Thanks again Everybody,
I have emailed the Doctor and asked him to consider the AirCurve 10 ASV. He did say that if the next appointment I could get was weeks out, this is the case, he would write the prescription for the machine in advance so long as the raw data supported it.
I am so looking forward to results like the ones you achieved Asjb as my numbers look very similar to yours before you went on ASV. Mine are actually a couple of digits higher on both the lower and higher end but are pretty much the same. I just want to join you and enjoy time without daily fatigue. It is amazing how old this has gotten since I learnt that it could be fixed. I was just living with it before.
Thanks again,
Don