ASV units: PR or ResMed?

For ASV, what do the experienced/knowlegeable recommend?

I am hearing good things about the PR units.

Only 10 days in, so data is a little slim, but my central events greatly outnumber my obstructive events, so if things don't change I am probably destined to go there.

tyroneshoes2 wrote:For ASV, what do the experienced/knowlegeable recommend?

I am hearing good things about the PR units.

Only 10 days in, so data is a little slim, but my central events greatly outnumber my obstructive events, so if things don't change I am probably destined to go there.

Both are on pretty much level ground as far as capabilities..

For lower class machines (BiLevel or APAP) I'd would say ResMed hands down because their F.O.T. algorithm for detecting centrals is technically superior, but when talking about ASV machines, this doesn't apply anymore, as it's already a given/been proven in a lab that you have Centrals.

The data available on the Philips 960's is a little more fancy than ResMed's VPAP Adapts. Namely, on PRS1, IPAP is tracked with high and low components for each breath, as well as the percentage of patient triggered breaths, which ResMed doesn't.

PR also has better data retention... meaning it doesn't purge flow data after 7 days... so if your hearing good things about them, and your gut tells you to, go with it!

I personally use an ResMed Adapt ASV, and can't say anything bad about it.. except perhaps the variable EPAP mode is a little disappointing, I have better luck keeping mine set to standard ASV mode with fixed EPAP, otherwise morning headaches wipe me out...

I can't really comment on what it's like to use the PRS1 ASV's, as I've never used one myself.

I should mention if you didn't get centrals in your sleep study, it might be CPAP itself causing them, and you might just need to discuss a pressure adjustment with your doctor.

Machine detected "centrals" aren't always technically centrals, even with the fancy frequency oscillation technique used by Resmed, or the Pressure Pulse "pings" used by Philips Respironics.
The are only really properly detected with an effort belt in conjunction with CPAP data.

I'd like to see a genuine study done on the accuracy of machine event detection.. I'm suspecting the detection error rates will be quite high. :-/

jedimark wrote: I'd like to see a genuine study done on the accuracy of machine event detection.. I'm suspecting the detection error rates will be quite high. :-/

Here is a link you might like...

http://www.healthcare.philips.com/pk_en ... apneas.wpd

I'm not sure how "genuine" it is; I have no idea if the people who did the study work for Philips or if they are affiliated in any way. Just something I stumbled across.

Full Disclosure: I worked for Philips Medical for a few months in 2001 as an intern after they bought Marconi Medical Systems, but I was working on diagnostic software for MRI machines - nothing to do with Respironics or CPAP at all.

My centrals greatly outnumber my obstructive too. Centrals 6-8...Obstructives 1-2. I don't consider this a problem. Why don't you give us some numbers to work with?

I can do that I guess, but I am only 11 days in and my data from SH might be a little skewed due to two days with the mask upside down.

I will have to look at the data and figure out the best way to present it here.

But if you look at individual days, whether AHI was high or low, centrals/unspecifieds outnumber obstructives and hypopneas about 12 to 1. My at-home study did not indicate this; centrals were about 10% of all events.

tyroneshoes2 wrote: due to two days with the mask upside down.

I did that the first couple of nights on CPAP with my Swift FX nasal pillows... just for my first few nights. I still blush when I think about it BTW: this is a great ASV discussion. I hope it goes in greater depth.

MountainHigh wrote: Full Disclosure: I worked for Philips Medical for a few months in 2001 as an intern after they bought Marconi Medical Systems, but I was working on diagnostic software for MRI machines - nothing to do with Respironics or CPAP at all.

Welcome MountainHigh. It sounds like you have a demonstrated software capability and a varied tech background. I'm always extra pleased to welcome folks such as yourself aboard. JediMark is looking for folks like you to help with SH... just thought I'd mention it.

Sir NoddinOff wrote:Welcome MountainHigh. It sounds like you have a demonstrated software capability and a varied tech background. I'm always extra pleased to welcome folks such as yourself aboard. JediMark is looking for folks like you to help with SH... just thought I'd mention it.

Thank you for the warm welcome Sir NoddinOff. I am looking forward to offering whatever assistance I can on SH as soon as I get my complex sleep apnea under control - especially since I would have no idea I had complex sleep apnea if it weren't for this website and the SH software!

tyroneshoes2 wrote:For ASV, what do the experienced/knowlegeable recommend?

I am hearing good things about the PR units.

Only 10 days in, so data is a little slim, but my central events greatly outnumber my obstructive events, so if things don't change I am probably destined to go there.

I think centrals that pop up in the early days are often a temporary function. Check the data to see how long the individual apneas are. Long ones are a lot more concerning than short ones.

Please sign up for an ID and fill in the equipment on your profile so we can help you better. There's a link in my signature line.

That is something I am hearing a lot here, that centrals can easily be false positives. I have looked at them expanded, but I will look closer. Centrals are the scary part*, so any excuse to ignore some of the short ones is probably a good thing.

I plan to fill out details ASAP. Right now I am having trouble even identifying which S9 I have (the ResMed site is pretty confusing and strangely secretive; they have 9 that all look identical). I will refer to my delivery ticket and hopefully get that stuff available.

*Obstructives is just a logistical issue with the airway, and keeping it open is a functional rather than a medical fix, as far as CPAP goes. Centrals beg the question "why is my brain not telling my body to breathe?", which underlines how critical this therapy really is. (all IMHO)

tyroneshoes2 wrote:That is something I am hearing a lot here, that centrals can easily be false positives. I have looked at them expanded, but I will look closer. Centrals are the scary part*, so any excuse to ignore some of the short ones is probably a good thing.

I plan to fill out details ASAP. Right now I am having trouble even identifying which S9 I have (the ResMed site is pretty confusing and strangely secretive; they have 9 that all look identical).

they almost all look identical.

just look above the power button, there's a name there.

what is it.

pick one:
36001 S9 "Escape" (CPAP Only no data)
36002 S9 "Escape Auto" (No data apap mode)
36003 S9 "Elite" (cpap only)
36004 S9 "VPAP S"
36005 S9 "AutoSet" (advanced autoset mode)
36006 S9 "VPAP Auto"
36007 S9 "VPAP Adapt" (older)
36009 S9 "VPAP ST-A" (older)
36034 S9 "VPAP COPD"
36037 S9 "VPAP Adapt"
36038 S9 "VPAP ST"
36039 S9 "VPAP ST-A"
36050 S9 "VPAP Tx"
36065 S9 "AutoSet" 'for her' Pink
36203 AS10 "cpap" no data
36205 AS10 "Elite"
37207 AS10 "Autoset"
37209 AS10 "Autoset for her"

tyroneshoes2 wrote:That is something I am hearing a lot here, that centrals can easily be false positives. I have looked at them expanded, but I will look closer. Centrals are the scary part*, so any excuse to ignore some of the short ones is probably a good thing.

Centrals are probably no more damaging than obstructives of the same length and frequency. They are just harder to get rid of.

MountainHigh wrote:Here is a link you might like...

http://www.healthcare.philips.com/pk_en ... apneas.wpd

Thank, you. That's kinda what I was looking for

For anyone who's interested in the ResMed side, PaleRider pulled this up for me:
http://www.resmed.com/br/assets/documen ... -paper.pdf

Machine detection is by no means useless, but you can see from these (slightly biased) reports why a lot of sleep doctors do not view it as trustworthy without external belt data.

I'd love to see a balanced 3rd party study done into this, but nevertheless, I do believe a high frequency of machine detected C/A events is still a reasonable indicator Centrals are genuinely present.