Is Resmed ASV more feature limited than Philips?

[JDS74]

Its likely that a firmware upgrade will supply that and other little features.
See Accbio for the upgrade.

[jmrobert48]

I have used both machines. I couldn't get used to the PR machine because it doesn't monitor your current breath. It uses a 4 minute rolling window to "predict" what your next breath will be. I have periodic breathing and it would wake me up on average, 3 times a night. The Resumed machine monitors your current breath, and adjusts the inhale, exhale times to match what You are doing. It was very easy to get used to, I wouldn't go back to the PR.

[Overflow]

I have used both machines. I couldn't get used to the PR machine because it doesn't monitor your current breath. It uses a 4 minute rolling window to "predict" what your next breath will be. I have periodic breathing and it would wake me up on average, 3 times a night. The Resumed machine monitors your current breath, and adjusts the inhale, exhale times to match what You are doing. It was very easy to get used to, I wouldn't go back to the PR.

Thats interesting. Anyone else have similar or opposite experiences?



Had a much better night with machine last night, but that was partly because I took sleeping aids as my insomnia was becoming bad. I did use the ramp too much though looking at the results. It was used 5 times that night after each awakening so that is 2.5 hours without therapy. I also had 107 Pressure pulse events, what are they exactly?

[Pugsy]

107 Pressure pulse events, what are they exactly?

http://sourceforge.net/apps/mediawiki/s ... r_Glossary

[Overflow]

Ok new question here. I'm finding that ASV might indeed be a 'bad' algorithm for me at the present time as it is disturbing my sleep more than helping it; I really just wanted a machine slightly more comfortable than APAP to help me stay sleeping throughout the night.

But it is early days yet, and who knows after weeks/months or if in the future ASV might be helpful. So what I am wondering now is if I should get an ASV machine and just run it in bipap mode? Does this mean the machines highly annoying insistence that it wants to chuck a breath down you will disappear?

Which machine would be better to set on bipap only mode. I know the Philips has no modes, only settings. Does Resmed allow bipap only on the adapt, leaving ASV turned off?

[Pugsy]

Does Resmed allow bipap only on the adapt, leaving ASV turned off?

Mine doesn't

[squid13]

Neither does mine.

[sawinglogz]

I have used both machines. I couldn't get used to the PR machine because it doesn't monitor your current breath. It uses a 4 minute rolling window to "predict" what your next breath will be. I have periodic breathing and it would wake me up on average, 3 times a night. The Resumed machine monitors your current breath, and adjusts the inhale, exhale times to match what You are doing. It was very easy to get used to, I wouldn't go back to the PR.

Thats interesting. Anyone else have similar or opposite experiences?

It's not an accurate description of how it works, though I'm certain his experience made it seem like it wasn't monitoring his current breath.

After all, how would it establish that 4-minute rolling window if it weren't monitoring your breathing?

Noninvasive ventilation (NIV) machines (which encompass bi-level S/T as well as ASV) by their nature are designed to make you breathe if you pause for too long. How they define "too long" is rather flexible, ranging from a fixed minimum breathing rate to an "auto" mode that lets your rate change by N% before giving you a nudge.

Regardless of how they decide when you need to breathe, if you do breathe, they notice and don't interfere (just switching from EPAP to IPAP in response to your spontaneous breath). If you don't, then they do it on their own.

ASV adds the twist of cranking up the IPAP dramatically over several breaths if you don't breathe in response to the previous nudge(s).

The biggest problem I encounter with my PR ASV is when I wake up from a vivid dream. My breathing rate was elevated during the dream, but then it slows down when I wake up. The ASV thinks that's a sudden drop in unconscious breathing rate and tries to keep me breathing quickly. I just press the ramp button and then slow down my exhaling so that there's very little gap between exhaling and inhaling. The ASV knows that there's no obstruction or cessation of breathing effort, so it doesn't panic. After a few breaths like that, it's usually pretty close to my new breathing rate. If that doesn't work, you can always turn therapy off and back on to reset the window.

Or you could set it for a fixed minimum that's below your lowest normal breathing rate.

As to how well a given machine detects when you're inhaling vs. inhaling, I imagine that is highly variable from person to person and machine to machine. (And EPR/biflex can affect this.) But it's simply not correct to say that the PR doesn't monitor your current breath.

[Sir NoddinOff]

So what I am wondering now is if I should get an ASV machine and just run it in bipap mode?

Overflow: Check out this thread regarding the above:

viewtopic.php?f=1&t=86930&p=792886&hili ... el#p794795

[Overflow]

I have used both machines. I couldn't get used to the PR machine because it doesn't monitor your current breath. It uses a 4 minute rolling window to "predict" what your next breath will be. I have periodic breathing and it would wake me up on average, 3 times a night. The Resumed machine monitors your current breath, and adjusts the inhale, exhale times to match what You are doing. It was very easy to get used to, I wouldn't go back to the PR.

Thats interesting. Anyone else have similar or opposite experiences?

It's not an accurate description of how it works, though I'm certain his experience made it seem like it wasn't monitoring his current breath.

After all, how would it establish that 4-minute rolling window if it weren't monitoring your breathing?

Noninvasive ventilation (NIV) machines (which encompass bi-level S/T as well as ASV) by their nature are designed to make you breathe if you pause for too long. How they define "too long" is rather flexible, ranging from a fixed minimum breathing rate to an "auto" mode that lets your rate change by N% before giving you a nudge.

Regardless of how they decide when you need to breathe, if you do breathe, they notice and don't interfere (just switching from EPAP to IPAP in response to your spontaneous breath). If you don't, then they do it on their own.

ASV adds the twist of cranking up the IPAP dramatically over several breaths if you don't breathe in response to the previous nudge(s).

The biggest problem I encounter with my PR ASV is when I wake up from a vivid dream. My breathing rate was elevated during the dream, but then it slows down when I wake up. The ASV thinks that's a sudden drop in unconscious breathing rate and tries to keep me breathing quickly. I just press the ramp button and then slow down my exhaling so that there's very little gap between exhaling and inhaling. The ASV knows that there's no obstruction or cessation of breathing effort, so it doesn't panic. After a few breaths like that, it's usually pretty close to my new breathing rate. If that doesn't work, you can always turn therapy off and back on to reset the window.

Or you could set it for a fixed minimum that's below your lowest normal breathing rate.

As to how well a given machine detects when you're inhaling vs. inhaling, I imagine that is highly variable from person to person and machine to machine. (And EPR/biflex can affect this.) But it's simply not correct to say that the PR doesn't monitor your current breath.

Nice perspective. Its almost annoying when one user proclaims one machine inherently superior because it makes me curious if that would be same response with me its pretty unlikely I would ever get to also try a Resmed ASV and if I were to purchase one today it would have to be the Philips as that is all I know now in the ASV world. WOuld be nice to try both machines of course (as poster below me has )

So what I am wondering now is if I should get an ASV machine and just run it in bipap mode?

Overflow: Check out this thread regarding the above:

viewtopic.php?f=1&t=86930&p=792886&hili ... el#p794795

Very useful thanks. I also ran across this yesterday: viewtopic/p444989/viewtopic.php?p=445190#p445190

If I continue to have some bad nights with ASV I might try last few nights in bipap just to see how those machines will fare.

[Overflow]

I am revisiting this topic now and just wanted a refresher (have a nasty half amnesiac feeling this was covered before but can't see it) Does this still apply to the series 60 AutoSV?

http://www.healthcare.philips.com/main/ ... sv/faq.wpd

Does the BiPAP autoSV operate like an Auto CPAP or Auto Bi-level device for treating obstructive events?

No – The device does not have an auto-titrating algorithm to alleviate obstructive events. The innovative algorithm was designed to treat complex apnea and periodic breathing. The obstructive component of SDB is treated utilizing a clinician adjustable CPAP or BiPAP pressure level.

Or if the ASV has to be manually set to treat OSA is it actually *worse* for bog standard events than APAP and Bipap?

EDIT:

If anyone else is curious, it seems like this document is quite out of date and refers to the pre system one series of machines that used to have an auto sv and auto sv advanced model. The SV only did not treat OSA automatically as explained here:

viewtopic/t53676/viewtopic.php?p=499481#p499481

It is confusing as the current machine is often referred to as Auto SV and ASV advanced.

[Overflow]

Ok just wanted to comment again on the auto off feature which we were discussing earlier this year.

Have the 960P now and it also does not have the auto off function. It was manufactured in January 2014 and has firmware version 2.

The more modern manual also mentions no auto off, only the older one does and that also seems to omit the Min PS setting and always discusses bilevel therapy and on one page says "The BiPap Auto measures:" before displaying a chart which does not mention CSA at all.

So I think this manual is actually for the 600 or 700 series and has been mistakingly identified as for the 900 series. The 900 series does *not* have auto off, as confirmed by two models now. The more modern manual correctly identifies that auto off is not available in 900 series.

I am quite confused at how JDS has auto off though. Are you sure your machine is the 900 series?

[bellabid]

I have CSA and I have used both the PR and the S9 ASV. I have the previous S9 model: 36007. I can tell you unequivocally that the S9 saved my life. I could not adapt to the PR and no amount of adjusting by the sleep lab seemed to work. After several weeks they switched me to the S9 and i have had NO problems since. I would NEVER go back to the PR Adapt SV.

[wilsonintexas]

just to make things more confusing, resmed anounced their new asv machine.

[cnaumann]

I would love to try the new ResMed machine. I have a couple of issues with the PR. I have given up on the auto backup rate and use a manual setting of 9 BPM with an inhale time of 2.3s. The auto backup rate tends to be too aggressive for me and causes some issues.

The other issue i have is that is the the machine sometime get 'stuck' on high pressure inhale. This seems to happen when I start out breathing slow and deep, and later shift to a faster, shallower breathing pattern. The machine does not like this and tend to keep the inhale pressure very high to try to match the depth of the earlier shallow breathing. This causes a lot of swallowed air and some other problems.