Respironics vs Resmed ASV

[rich0]

I'm scheduled for my third sleep study now, with an ASV this time (I had numerous centrals during my last study even with BiPAP - I was basically awake for half the night fighting the pressure and rhythm of the machine, and at one point I was actually conscious of the fact that I hadn't taken a breath in a while when I was about to drift off (this alarmed me and woke me up gasping out of rhythm), and that was before I even learned what central apnea was). They mentioned that I had 32 apnea events before CPAP (she described this as "moderate" but said yes when I asked if that was per-hour, so I don't know for sure if that is an AHI and 32 probably is a bit more than moderate if so), and in the end had 130 central apnea events once they did have me under pressure (again, I'm not sure that this is per hour but obviously it is a considerable number either way since I was only hooked up 7 hours total).

I saw a thread from a few years ago about Respironics vs Resmed, but it seems pretty dated in light of new generations of machines from both companies. Since getting either unit is going to cost me a fair bit even with insurance I don't want to be in a position where I get the "wrong one." Is there any reason I should be pushing for one vs the other? Also, based on what I read I'm not sure how well a titration using one machine will be transferable to the other. If they titrate me on one of them I'd probably be taking a risk trying to get the other one, unless somehow I can rent and switch.

Is the consensus that either brand is going to be adequate? Or, should I really make waves and push for a study at a clinic that uses one model vs the other? From talking to the doctor's office it sounds like they don't have a great deal of experience with ASV.

[DavidT]

When I went in for titration on ASV, I asked what manufacturer's machine they would titrate with. He said Respironics and that I would receive the Respironics ASV because of that, so your assumption is correct. I couldn't find a lot of informaton comparing the 2 brands, either, but there were a few posts on it...

[bemused]

Hi,
I am also a new user, 3rd week on Resmed s9 Vpap Adapt. My doc has said I may also try the PR System One Bipap Avaps machine. My understanding so far is both are excellent machines, although they have different algorithms. The S9 is more automatic (only 3 therapy parameters to set) but so far I have found it very comfortable to use. The PR has more parameters that can be 'tweaked'. No personal experience with Philips Respironics yet but I think you will find either one an excellent choice. My insurance pays 50% and cost for me is same for either machine.

Resmed say the Adapt is for the treatment of Complex and Central Sleep Apnea, Respironics recommend their machine for COPD patients, but both are ASV.

There are some very experienced members on the forum familiar with ASV, so ask away if you have any questions.

[JohnBFisher]

... an AHI and 32 probably is a bit more than moderate .. and in the end had 130 central apnea events once they did have me under pressure ..

Greetings! Welcome to the forum. It sounds as if you have complex sleep apnea. That is, as you have pressure applied you develop central sleep apnea. This makes it more difficult for the ASV unit to make a difference. It does, but the pressure can induce a central apnea, so it takes a little more tweaking to reduce problems.

... I saw a thread from a few years ago about Respironics vs Resmed, but it seems pretty dated in light of new generations of machines from both companies. ...

There is not a lot of difference from those older versions to the current versions.

... Is there any reason I should be pushing for one vs the other? ...

Yes. The Respironics version has a "looser" feel. That is, if you fail to breathe right on schedule, it will allow a little more "leeway" before it starts to kick in the higher pressure. This can make it quite a bit easier for someone with Complex Sleep Apnea. It encourages normal breathing as much as possible, then steps into the picture when needed. The Resmed unit will also work, but it is a LOT more insistent about breathing on the mark.

I like to compare it to the difference between a luxury car and a sports car. The luxury car does not react as quickly as the sports car, but in a way that is less demanding when you drive a long distance. Ditto with the units. The Respironics unit has more "leeway" built into it. If you have severe central apnea, the Resmed unit is ideal. That's not to say the Resmed won't do the job. It just has a tighter feel. And the mask tends to leak more because it is SO insistent about the breathing.

... Also, based on what I read I'm not sure how well a titration using one machine will be transferable to the other.
Yup. They do.

... Is the consensus that either brand is going to be adequate? ...

Either would be fine - but the Respironics does provide a little more "leeway" which will help promote more normal breathing. Since you have Complex Sleep Apnea that is probably more important for you. It also can be "tweaked" a LOT more than the Resmed unit. However, it is more expensive as a result of the extra features.

Hope that helps.

[jamiswolf]

Bemused wrote: My doc has said I may also try the PR System One Bipap Avaps machine.

I saw this statement and just wanted clarify things for you (and readers). If this was a "typo"...then my apologies. The avaps machine is very different then an ASV machine. It's a "volume assured" machine specifically for people with hypoventilation issues. neuro-muscular disease, obesity related hypoventilation and COPD. People who retain CO2 and need a machine that will promote an adequate tidal volume or minute ventilation.

ASV machines are tailored to deal with PB/CS respirations and complex apnea. Not that the two conditions can't co-exist.
J

[bemused]

jamiswolf, yes the PR equivalent is likely the System One Bipap AutoSV. Thanks for the correction.

[jamiswolf]

jamiswolf, yes the PR equivalent is likely the System One Bipap AutoSV. Thanks for the correction.

I can be sort of picky...hence the three ex-wives.

Respironics vs Resmed: John has giving some great information.

Resmed asv only has auto BPM settings while Respironics can be set to "manual" with a wide range (6 to 30 BPM if memory serves me). This might seem obscure, but I actually have seen patients have to switch from Resmed to Respironics because of that specific feature.

Sometimes people who have an unusual breath rates (awake or asleep and high or low) find auto is not perfect for them. So those folks should choose the Respironics ASV...in case the manual option is needed.
Cheers,
Jamis

Edit: And to Rich0...regarding the severity of your apnea. The guidelines (definitions) are fairly arbitrary and use the AHI number. 21 AHI to 50 AHI is considered moderate. Below being mild and above being severe. No distinction is made regarding OAs vs CAs.

[Mary Z]

I found this site to be helpful. ASV users can comment on its validity.
http://www.lakesidepress.com/CPAP/ASV.htm

[rich0]

Thanks so much for your replies - I've actually been following posts here by a few of you for a week or two now (and I'm working on getting SleepyHead supported on Gentoo linux as well - main thing holding me back so far is not having data to test it on). Your input is very helpful.

I'm going to go ahead and talk to the sleep clinic and try to find out what they'll titrate me on. If I can get titrated on the Respironics machine that seems like a smarter move. I don't want to end up in a situation where I get all the settings worked out on the Resmed and then have no idea if the other would work or not and be in a sticky situation reimbursement-wise, assuming I can't just rent them both for a while without much incremental cost. I suspect I'll end up in a pick-one-and-pay-for-it model, and while the insurance will cover 90% of the cost most likely, I probably won't get more than one shot at it.

For me something I'm looking at is whether I'm able to get through the sleep study with some kind of qualitative improvement in sleep. I'll try to keep an open mind since there will be a need to adjust. I just want to get some kind of sense of assurance that this will improve my life/health before I plop down a few hundred dollars on a machine at DME prices. From what I've heard from others I'm expecting things to improve - I'll just need to find a machine I'm not fighting all night and the description of the Respironics seems to fit that bill more.

[punknbud]

My husband just started on the Respironics ASV 3 nights ago. He had used a Resmed Auto VPAP for 4 months. Then we found out he was prescribed the wrong machine my our primary care doctor. I knew things still were not right and took him to a board certified sleep disorder doctor. He got the sleep study report and knew right away we were given the wrong machine. So, another sleep study and we just got the Respironics ASV on Friday. He has worn it 8 hours the last 3 nights. I cannot believe the difference I am seeing already. You have to be your own advocate when dealing with doctors. If one is not right, just find one that is right for you.