Have a Vpap Adapt SV or want to know who its for ?

[dsm]

This presentation is a very easy read & understand presentation (requires flash player). It is only slides but flash slides.

It may be the best presentation on the Vpap Adapt SV & its use.

http://www2.tjc.edu/respiratorycare/oct ... m/VPAP.swf

Happy reading

DSM

PS I have one on the Respironics Bipap Auto SV but not the lateswt Advanced model.

[JohnBFisher]

Thank you for posting this. It is helpful to have a good resource such as this to help answer questions and use as a reference.

I would also be interested in seeing the presentation on the Respironics unit.

[Fred D]

What a great link. I am waiting patiently for an ASV machine to be delivered to me, hopefully later this week. I'm not sure if it will be the Resmed or the Respironics version. All I know is I'm ready for it to get here.......

On page two of the presentation I wish they would add one more patient type to their list as I don't feel like I am in any of the categories they have listed.

Maybe one titled--- Really Unlucky

Fred

[JohnBFisher]

... I wish they would add one more patient type to their list ... Maybe one titled--- "Really Unlucky" ...

Fred, let me take a little more hopeful view of this.

Trust me, I too am bummed out that I need an ASV unit. In my case it may indicate a serious progression of my neurological disorder. That's the "glass half empty" side of the equation.

But the "glass half full" side has a REALLY strong argument: An ASV unit is INCREDIBLY effective at treating CSA, Periodic Breathing, CompSA, and similar conditions. It often drops apneas to nothing. When higher than that, they tend to be closer to norm than most people experience with ANY other treatment. (That is what slides 22, 23 and 24 show).

I know that without my ASV unit, my health would continue to deteriorate. With it, I stand a chance of clawing my way back toward better health. It's not all "fixed". For me, it never can be. But I now have hope. Three years ago these units were not approved by the FDA (here in the States). So, this is a fairly recent option.

[Fred D]

You're right, John. I am glad the option is even available to treat this. Has CSA always been a category but did not have an effective treatment or was it lumped in with OSA and all that was on hand to treat it was xpap and hope for the best?

CSA, I would guess, has always been around. Kind of like children being diagnosed with ADD nowadays. When I was a kid you were just "hyperactive" or "not paying attention". Instead of taking a pill; you got whacked on the behind for your treatment.lol

Thanks for a better perspective. I'm just anxious to get the ASV here so I can retire my bipap machine and hopefully start getting my energy level back up to some semblance of what it used to be.

As soon as it arrives I will list it in my profile. I haven't listed what I'm using now since I will be changing it out soon but FYI it is called a Respironics BiPap Duet System.

Fred

[JohnBFisher]

... You're right, John. I am glad the option is even available to treat this. Has CSA always been a category but did not have an effective treatment or was it lumped in with OSA and all that was on hand to treat it was xpap and hope for the best? ...

At first, the only tool availabe was CPAP. That helped a lot of people.

But then researchers realized some people did poorly with just CPAP. They created BiPAP. It helped more people.

But that did not fully meet the needs, especially with someone who has CSA. So, they created BiPAP S/T (spontaneous/timed). It has a "backup rate" programmed into it. So, if you don't breathe x number of times per minute, it will trigger the change from expiration pressure to inspiration pressure. It helps, but not everyone.

Though it helped, it did not touch severe cases of CSA or even begin to touch periodic breathing such as Cheyne-Stokes Respiration (CSR). So, researchers found another path, the ASV unit. It significantly helps those patients that the traditional approaches did not help.

Will there be more? Yes. Some patients will move toward a ventilator. Newer models of ASV units will appear (as just happened with the Respironics BiPAP AutoSV Advanced). Depending on the cause of the problem, you may see new technologies. For example, if the problem is due to brainstem malfunction, you might eventually see breathing pacemakers implanted. They would need to handle all the autonomic functions the brainstem normally handles. But technology is moving very quickly. I would be VERY surprised if this was not an option within 20 years.

Until then, my ASV unit is a Godsend.

... CSA, I would guess, has always been around. Kind of like children being diagnosed with ADD nowadays. When I was a kid you were just "hyperactive" or "not paying attention". Instead of taking a pill; you got whacked on the behind for your treatment.lol ...

Yup. Everyone has heard me recount the story of the sleep specialist who told me that central sleep apnea is very rare, so I could not have it. I read that sleep study. It CLEARLY indicated my central apneas had climbed since my previous sleep study. They did not yet exceed obstructive apneas, but just handling the obstructive events was not enough. (I know know that in retrospect as I started to dive deeper into the management of central apneas).

But as with unmanaged hyperactivity in children there are consequences to not treating CSA. Children tend to grow up with a pattern of disruptive behavior, if the hyperactivity is untreated. It can lead to problems throughout their lives.

So, is the case with central apneas. That's what happened to me. My central apneas remained a untreated problem for me. My sleep continued to degrade for years. It definitely led to obesity (lack of energy and increased stress means your body starts to pack away food). It led (perhaps indirectly) to diabetes. It led to hypertension. It's led to decreased kidney function (diabetes and hypertension cause that).

So, just ignoring the central apneas - if they are there and enough to cause problems (and remember, my doctor was right, they are pretty rare at that level) - is as bad as ignoring obstructive sleep apnea.

... I'm just anxious to get the ASV here so I can retire my bipap machine and hopefully start getting my energy level back up to some semblance of what it used to be. ...

It takes a while to adjust to how the ASV unit works. But you should start to see some glimmer of hope in how you feel. It just probably will not be consistent until your body fully adjusts to the strong swings in pressure you might have.

... it [was] called a Respironics BiPap Duet System. ...

Ah, you did have an older system. The older BiPAP units "kicked" the pressure fairly quickly from one level to another. The newer units will feel a bit softer in the transition from one pressure to the other. I think you will like it.

[Fred D]

You Da Man.... Thanks

[rested gal]

You Da Man.... Thanks

John is that, indeed! I always enjoy reading posts by JohnBFisher.

Hope all goes well for you, Fred!

[dsm]

John

You will be very interested to hear that Resmed may announce a variant of the Vpap Adapt SV that actively monitors PaCO2 and adjust the pressure (using an SV algorithm) to keep PaCO2 within predefined range worked out for the user.

Resmed just had a patent published (in late 2009) on how it works & based on past timings my guess is by about 2011 they will have a machine out but am not sure what the FDA requirements are - that approval may take additional time.

The way it works is that the RT looks at the patients medical history & weight, sets a base pressure range, then sets a 'swing' range of pressure that is used to control PaCO2 (am assuming this is like the SV range). One of the steps is to do a test run with the patient awake to gather information of PaCO2 levels during wakefulness & these get set into the machine as boundaries for the therapy.

The machine relies on a PaCO2 sensor being part of the apparatus. I guess that can be in or on the mask.

DSM

PS Really enjoyed your summary - don't let anyone tell you your brain isn't working well

D

[dsm]

Here is a link to the Bipap Auto SV presentation. I have posted it before but a long while back.

I wasn't going to post it in this thread because it really applies to the pre advanced model but

as long as anyone reading it realizes that is the case & a newer version would certainly have more info & different titration suggestions.

http://www.internetage.ws/cpapdata/manu ... -preso.pdf

Cheers

DSM

[dsm]

Just wanted to add a post addressed to 'Banned' regarding our past couple of interactions in regard to why not to suggest BiLevel mode to anyone with an ASV who comes here for advice & says they were diagnosed with CompSA.

Banned my good friend, look at the Vpap Adapt SV presentation linked to in the 1st post & go to slide 10 then read bulleted point #5.

"Bilevel induces worsening of centrals (Reducing CO2)"

That sums it up.

Cheers

Doug