Why is there such a fuss about giving a CPAP with ASV?

[mugen4u]

If it is clear that the vast majority of your AHI consists of CSA, why is the hospital making such a fuss about giving you a CPAP with ASV (Adaptive Servo Ventilator)?

This will be the 3rd time that I will receive the CPAP treatment and again they refuse to give me an ASV 'because you can also be treated with CPAP', in this case the Resmed Airsense 11.
They indicated that the air the device blows can also reduce CSA because (and then they gave a huge medical story that I didn't understand).

I read in some people that CPAP such as Airsense 10 or 11 actually helps them even though they have CSA, while in others this just makes everything worse.

what exactly is it? Why does it help some but not others?

[SarcasticDave94]

Getting ASV depends on need, especially if your insurance company is involved.

Do you have predominant Central Apnea? This means your sleep study had 50% or so Central to Obstructive Apnea. The cause doesn't matter much, but this count of half does.

Also what happens to your Central Apnea events while on CPAP count. And the ASV isn't necessarily going to be prescribed when it's treatment emergent Central Apnea, due to cost and that treatment emergent CA should diminish over time.

ASV stands for Adaptive Servo Ventilator. It has specific algorithm controls that treat Central Apnea. It's going to feel different to some users, which can be somewhat difficult getting used to.

[Sleeprider]

CPAP does not normally resolve CSA, however most insurance requires that a patient fail a trial with CPAP before they will compensate for advanced PAP. Getting ASV starts wtih an appropriate diagnosis by your doctor that you have predominately central sleep apnea, and his recommendation for ASV therapy. We see too many doctors that simply don't have a clue how to treat CSA. What is your diagnosis? Do you have a copy of your sleep study? A hospital or device supplier has no primacy over the decision what to prescribe or dispense. Why is the hospital involved?

[mugen4u]

SarcasticDave94
Getting ASV depends on need, especially if your insurance company is involved.

Do you have predominant Central Apnea? This means your sleep study had 50% or so Central to Obstructive Apnea. The cause doesn't matter much, but this count of half does.

Also what happens to your Central Apnea events while on CPAP count. And the ASV isn't necessarily going to be prescribed when it's treatment emergent Central Apnea, due to cost and that treatment emergent CA should diminish over time.

ASV stands for Adaptive Servo Ventilator. It has specific algorithm controls that treat Central Apnea. It's going to feel different to some users,c which can be somewhat difficult getting used to.
__________________________________

i have no idea. i had an average AHI of 18 (22 during REM) and about 11 was central (dont know how much it was during during REM).

________________________________
Sleeprider
CPAP does not normally resolve CSA, however most insurance requires that a patient fail a trial with CPAP before they will compensate for advanced PAP. Getting ASV starts wtih an appropriate diagnosis by your doctor that you have predominately central sleep apnea, and his recommendation for ASV therapy. We see too many doctors that simply don't have a clue how to treat CSA. What is your diagnosis? Do you have a copy of your sleep study? A hospital or device supplier has no primacy over the decision what to prescribe or dispense. Why is the hospital involved?
____________________________________

she said that CPAP can help CSA and ASV is not always required.

the only information i got about the result was this:
https://ibb.co/mvfDRNx

[CLCCW]

My doc just reviewed my first almost 3-weeks on AirSense11 APAP setting for my mostly CSA. I was monitoring on OSCAR and said, things are not getting better for me, etc. He agreed, said in CSAs are about where they were on my orig sleep test. I Just got notice he ordered the titration test for ASV and I am hopeful I am on the correct path! Thanks for all the encouragement to give me support in my understanding of what I actually need and advocate for it.

[mugen4u]

My doc just reviewed my first almost 3-weeks on AirSense11 APAP setting for my mostly CSA. I was monitoring on OSCAR and said, things are not getting better for me, etc. He agreed, said in CSAs are about where they were on my orig sleep test. I Just got notice he ordered the titration test for ASV and I am hopeful I am on the correct path! Thanks for all the encouragement to give me support in my understanding of what I actually need and advocate for it.

what was your sleep result when it comes to AHI in both OSA and CSA?

[CLCCW]

what was your sleep result when it comes to AHI in both OSA and CSA?

My home test revealed: "Severe Obstructive and Central Sleep Apnea, with an AHI of 37.8 events/hour and an RDI of 41.5 events/hour (normal <
5 events/hour). The scored respiratory events included 10.0 central events/hour.
The supine AHI was 65.4 events/hour. The non-supine AHI was 27.1 events/hour.
The mean oxygen saturation was 91%. Respiratory events were associated with oxygen desaturations to the
mid-upper 80s.

[mugen4u]

My home test revealed: "Severe Obstructive and Central Sleep Apnea, with an AHI of 37.8 events/hour and an RDI of 41.5 events/hour (normal <
5 events/hour). The scored respiratory events included 10.0 central events/hour.
The supine AHI was 65.4 events/hour. The non-supine AHI was 27.1 events/hour.
The mean oxygen saturation was 91%. Respiratory events were associated with oxygen desaturations to the
mid-upper 80s.

Damn, you mus feel horrible every day with those numbers ;/ 

to be fair, i did lose all hope after i read your post about the CPAP machine not helping your centrals at all.

[CLCCW]

I never felt that bad, just excessive afternoon drowsiness and then waking up at night and not being able to fall back to sleep!

[SarcasticDave94]

Your 11 Central Apnea is at least half the events. It's possible this medical team doesn't know what Central Apnea is and/or how to treat them.

Here's the ResMed basic description for ASV

"AirCurve 10 ASV
Leveraging adaptive servo-ventilation (ASV) to target a patient’s recent minute ventilation, the AirCurve™ 10 ASV offers truly personalized therapy for obstructive sleep apnea (OSA), central and/or mixed apneas and periodic breathing. Auto-adjusting pressure support is designed to treat central breathing disorders, while auto-adjusting EPAP is suitable for upper airway obstruction."

Maybe either share this with the medical team, or you may need to look somewhere else that knows about Central Apnea and how to treat them.