SV titration questions & intro

[kolchak]

Hi,
Name is Mark & I’m new to this site, but do have a couple months of CPAP use under my belt. I have the dreaded "complex SA" diagnoses and am eventually hoping to get an SV machine, so I have a Servo Ventilation titration study scheduled in a few days. If anyone here has done a titration with an SV machine (or has experience with one), can you please answer a few questions?

1. Should I expect anything different or prepare any differently for titration with the SV machine? The only previous titration I had was with a CPAP.
2. Can I wear my favorite swift nasal pillow mask and tape over the mouth or do I have to use a specific mask? (I can’t stand full face masks)
3. Did anyone feel better or different the first night with an SV as opposed to XPAP?

Intro & background info in case anyone is interested -
From what I’ve learned over past couple months, I have a typical story – after years of suffering with undiagnosed S.A. and feeling like a sleepy zombie most of the time, a friend suggested I get tested for OSA. After the sleep study I was relieved to discover I had OSA (RDI of 29 & AHI of 20). Finally an actual explanation for all the medical problems and assorted Dr’s during the last 10 years!! I was eager to begin CPAP, but results of my 1st titration study indicated “complex” SA. (Naturally I had to have the “complex” variety instead of the garden variety OSA)
The titration study indicated I responded incompletely to CPAP (RDI of 15), but things got much worse with BiPAP. Evidently the BiPAP triggered very long and frequent centrals with a pressure above 10 cm's.
The Dr said I’d probably do better with an SV machine but I’d have to start with CPAP for insurance reasons. He suggested starting with a Remstar pro M series w/Cflex and a pressure of 10. I’ve been 100% compliant since day one & am feeling a little better. I've got my fingers crossed the SV titration produces better results and leads to an SV machine under my xmas tree.
Thanks for any suggestions, insights, observations or advice you may have and I appoligize the the length of this post.
Mark

[dllfo]

I used my Swift mask in my last sleep study.

I used the Respironics BiPap Auto for about 15 months, then switched to the
Respironics BiPap Auto SV. I love it. One thing on the Respironics SV is that it has an EPAP, Minimum IPAP and Maximum IPAP. I have mine set at
(if I can remember) 6-9-30 and it is auto. It can be set up as a CPAP by setting the same pressure on all 3. No particular prep except to tighten your mask good. Depending on how it is set up, a pressure of 30 pushed my Swift away from my face (I deliberately stopped the air from going in to see what would happen).

1. Should I expect anything different or prepare any differently for titration with the SV machine? The only previous titration I had was with a CPAP.

2. Can I wear my favorite swift nasal pillow mask and tape over the mouth or do I have to use a specific mask? (I can’t stand full face masks) I would think the sleep lab people have the last word on that one. I have had no problems with my Swift on daily use, but I did tighten it some.

3. Did anyone feel better or different the first night with an SV as opposed to XPAP? It took me a few nights to get used to it, but I love it. If you get the Resmed, they should have plenty of people who can help you. The
Respironics SV is so new...so far....I am the only user on this forum and as far as I can find out, the only user in the Sacramento, CA area ( an area of about a million people).

Call and ask the sleep lab. Respironics or Resmed? Which mask?

I am not sure about the Resmed, but Respironics can give you a lot of info.

Don't worry about it, it will be faster...that is..if I inhale, my old machine sort of drug behind...slowing the breath down. The SV accelerates so fast it is a little disconcerting. Now that I am used to it, I like it.

Respironics has...uh...5 alarms? I turned all but the watchdog alarm off.
IF you call and they tell you it will be a Respironics, PM me.

I haven't found anyone who seems to know the difference in the two units.
Bottom line is, mine breathes for me an average of 120-250 times a night.
and it initiated most of the breaths for 34 minutes one morning. I assume the Resmed is just as good and would do the same for you.

[Guest]

dllfo
Thanks for all the info. From the little I've about the SV machines the respironics is the ticket. I'll check with my sleep lab about machine type but getting a return call is such an iffy proposition. Assuming SV works for me, I will specifically request my Dr order the resp. unit. Next challanges will be finding a place that carries them and getting my insurance (care first BCBS) to cover it.
I can't imagine a pressure of 30 hitting me instantaneously as I stop breathing. Does the machine try to coax you into breathing with lower pressures initially or jump right to 30 when you stop? Must feel like a hurricane at first.
Was your SA situation similar to mine? If you've already explained in previous threads I will try to find it.
Thanks again!

[DrowzyDave]

Hi Mark,

Not sure if you had your titration yet, but if you did, how did it go? If you did not, hopefully you will find the following info helpful.

1. Should I expect anything different or prepare any differently for titration with the SV machine? The only previous titration I had was with a CPAP.

I had the same question prior to my titration on the Resmed Adapt SV. I was previously on a Resmed VPAP III ST and a Respironics BiPAP ST before that. I can't speak about the Respironics ASV but in my experience with the Resmed Adapt, the difference that you can expect is that the treatment is way more comfortable and you will likely have one of the best night's sleep you have had in awhile.

2. Can I wear my favorite swift nasal pillow mask and tape over the mouth or do I have to use a specific mask? (I can’t stand full face masks)

The Adapt SV is pretty finicky about which masks will pass its Learn Circuit test. I am not sure if the nasal pillows will or not, but the sleep lab should be able to tell you.

3. Did anyone feel better or different the first night with an SV as opposed to XPAP?

I felt much better after the titration than I felt in a long time. I slept better in a strange bed with all of the wires and sensors hanging off of me than I had been with the ST machines. It was pretty amazing! The test started around 9:00. I woke up once at, I would guess around 12:30 (I did not have my watch on) to visit the bathroom. I went back to sleep and the next time I woke up, it was daylight -- around 6:30.

You indicated in an earlier post that you were leaning towards the Respironcs machine. While I am not familiar with that machine, I would have to say that if they wanted to use the Resmed, I would give it a try. It is so comfortable. When you are breathing on your own, the support is minimal and hardly noticeable. It follows your breathing pattern extremely well. My ST machine felt like it was pushing me around half the time. When support is needed, it comes gradually but rarely if ever startles me.

Good luck and hope this helps.

Dave