Who needs a ASV machine??

[racprops]

Here is a DEEP question: How can I tell if my ASV machine is really needed and or if the ASV feature is being used??
 
I cannot see any indications of it being needed nor used in any of my OSCAR reports, especially when compared to a simpler BiPap machine. They both seem to do the same job and report the same results.
 
Both machines deal with all the same events, and both machines treat them seemly the same.
 
So I am asking what is an Auto Servo Ventilator need FOR, and how can I tell if I really need it or would I be just as well treated by a BiPap machine??  

Rich

[slowriter]

An ASV is primarily used when you need a bilevel, but when using a standard bilevel results in excessive central apneas.

So, for example, if you use a standard bilevel and you have an AHI of 15, where most of the events are centrals, switching to an ASV could result in the AHI being cut to close to 0.

Hence, if you don't get centrals, you don't need ASV.

[racprops]

Thanks, I get centrals but the BiPap seems to be able to treat them as well.

So now I have an idea for what to look for when I try the BiPap inplace of my BiPapASV.

Thanks.

Rich

[SarcasticDave94]

It isn't a really deep question like you think. An ASV would have been scripted to combat central apnea. In ResMed's titration protocol PDF for ASV, it's stated to treat patients with central and/or complex apnea and then Periodic Breathing.

What did your sleep studies and titrations say on events and counts? If CA or complex apnea were named, this is the reason you have an ASV machine. And if you've had CA or mixed apnea listed at 50% or more on the PSG sleep study, that also indicates medical need to have the ASV.

A BPAP that does not have backup rate used by a patient that needs ASV backup rates to combat CA sounds to me like a recipe for disaster. I've experienced a regular BPAP before the doctor came to his senses and scripted an ASV, and it was a huge disaster for me being on a regular BPAP.

Do note that CA have the consistently inconsistent factor, up or down randomly even per night. So I see something wrong 2 ways. First if you don't notice any differences between BPAP and ASV, the question why comes up. This could be that your machines aren't working very well, they're not setup very well, or similar issues. Second is how long have you tried BPAP vs ASV to compare?

We've discussed in the past that a ResMed ASV is better at treatment than the Respironics. Your answer is mostly the same. It'll be something like "I tried a ResMed xPAP (that was not ASV) and it wasn't good, so I believe their ASV will be bad too." When we say get the ResMed, mostly your answer is somebody needs to give you one. Why not be proactive instead of passive? I had medical needs provided because I asked, researched, and self advocated and fought to get what was needed. This isn't the same as your approach. Historically I think you'd fairly recently accepted a DreamStation SV Auto, when you could have requested to get ResMed. And yes I believe there is that much difference between ResMed and Respironics on these ASVs.

[slowriter]

I get centrals but the BiPap seems to be able to treat them as well.

A standard bilevel not only can't treat centrals, but tends to make them worse.

So I'm a little confused.

[Gideon]

A BiLevel with Backup (Timed Breathing) can, and in the past, was used to treat CA. This put the user 100% on timed, forced breathing, with high PS, which applies the fix even when assistance is not needed. BiLevel PS levels prescribed to treat CA are usually much lower than what is needed to do so.

An ASV applies only as much PS (usually much lower than what is needed on a BiLevel) as is needed to keep your breathing volume constant.