ASV users - which machine?

[wolewyck]

I'm looking for people's recommendations on ASV machines. I know I certainly want something data-capable and quiet. I've been very happy with the Resmed S9 Elite (except of course that it hasn't treated my centrals). Is there a similar model that has ASV capability? Or do people suggest something else for whatever reason? Thanks so much!!

(I'm sure some thoughts are in the archives, somewhere --- I've done a little poking around but didn't find a hit easily, and and since a new machine is being ordered for me really soon, want to suggest something to my doctor before it's a done deal.)

[Bright Choice]

I am waiting to get the S9 vpap adapt. New in last few months. I slept with it in lab and thought it was wonderful. I too have complex sleep apnea - I think in a mild form. The algorhythms are supposed to be quite sophisticated in the way they adapt to your breathing. I had lots of restorative sleep in lab.

[máirtín]

I have been using the Resmed VPAP ASV (not to be confused with the Resmed VPAP ASV - yikes, now I'm confused).
The machine is data capable but not from a simple data card like the S9. It needs a special cable. I have not been able to make it work.
For that reason I would not recommend it since I have no idea how effective the treatment is.

[JohnBFisher]

There is a Resmed S9 version of an ASV unit:

http://www.resmed.com/us/products/s9_vp ... adapt.html

There is also a Respironics System One version of their ASV unit:

https://www.cpap.com/productpage/PR-Sys ... anced.html

As I've noted, I personally prefer the Resmed unit. Some people complain that it is a real task master with the breathing. My problem is severe central sleep apnea, so it is a big help for me to have something that enforces good breathing. I sleep wonderfully with it. Without it, I stop breathing for more than a minute at a time. I tend to have horrible headaches if I fall asleep without it. Needless to say, I avoid that as much as possible. The Respironics version works, but I find I have more problem synchronizing with it. It does not seem to enforce a strict breathing pattern. So, I often catch myself having held my breath as I fall asleep.

But others find it easier to sleep with the Respironics than the Resmed, simply because it does not seem to enforce the same strict breathing pattern.

[BleepingBeauty]

I use the older version of the Respironics ASV machine (not the new PR System One), and I love it. But I've never used any ResMed machine, so I can't compare the two for you.

When the time comes to replace my machine, I'll likely stick with Respironics, just because I'm used to it and it gives me very effective therapy. Best of luck in your decision-making.

[Bandnuts]

I bought a used ResMed VPAP Adapt SV Enhanced to use during a couple of months until the S9 VPAP Adapt came out. The older VPAP Adapt SV was very good, but I have to admit the S9 version is wonderful. There's no need to match the mask to the machine (called a "learn" cycle) and you can use just about any type mask you want. That was important to me as I really am more comfortable using a nasal pillow system (the S9 VPAP Adapt allows pillows). Also, the flow vs pressure charts from the S9 seem more detailed and when downloaded into ResScan.

In the end, it's small, quiet, and works great.

[avi123]

del, I agree that it does not belong

[BleepingBeauty]

Why a clinician posted this:
Zoom it in View

First, what does this have to do with the OP's question about which ASV to consider?

Second, that's one man's opinion. Here's mine: ASV works very well for me (and for several others around here). Ted's experience is just that - his experience (as a clinician, not even a user). Mine is mine. On that score, I win.

My sleep doc said I didn't need this type of machine. But I was tired (quite literally) of following directions like a good li'l patient and getting nowhere. Several months after joining the forum and educating myself, and after two years of full compliance and (still) ineffective CPAP therapy, I bought my ASV on CL. Only now am I getting the restorative and refreshing sleep we're all aiming for (with no sleep doc involved).

Maybe Ted and his buddies in the industry don't know about ASV success stories like mine because people like me go around the medical community and treat ourselves. Nobody will ever convince me that ASV is not effective. (I don't call my machine "Houdini" for nuttin'. )

[avi123]

[quote="BleepingBeauty"][quote="avi123"]Why a clinician posted this:


First, what does this have to do with the OP's question about which ASV to consider?

Reply: The OP has not mentioned who has decided that he/she needs an ASV machine. It's possible that he/she has no underlying conditions as yours in which case getting an ASV could be a waste of money, and more important, it could cause harm if used for certain OSDs not meant for its use. Also, most sleep clinics and their MDs are not familiar with ASVs. These leaves the user at the mercy of unscrupulous mavin's for help or searching the right set-up by experimentations as you did. Congratulations!

[wolewyck]

For clarification - it was my sleep doctor who suggested I have an ASV sleep study. It was done, and although I'm still waiting for the full results, the tech said it was very effective. Don't know for sure that I'll be getting an ASV machine--won't count on that until I have one in hand-- but it seems likely.

And thank you all for the suggestions!

[Mr Bill]

I've never tried the ResMed but I really like my Philips Respironics ASV. I've had mine for six months now. It has unbelievably improved the quality of my life. Sleeping without it is simply not sleep. Those of us who need an ASV, really need them.

[BleepingBeauty]

Why a clinician posted this:

First, what does this have to do with the OP's question about which ASV to consider?

Reply: The OP has not mentioned who has decided that he/she needs an ASV machine. It's possible that he/she has no underlying conditions as yours in which case getting an ASV could be a waste of money, and more important, it could cause harm if used for certain OSDs not meant for its use.

I've been reading this forum for over two years, and I've never seen a post from anyone who wanted an ASV for no good reason. They're very expensive machines, and I can't imagine anyone without a good indication of necessity wanting to buy one out-of-pocket just to see what it's like. Those of us who need them really need them, as Mr Bill said above.

But even if someone's getting therapy with the "wrong" machine, what's the potential "harm?" It's pressurized air, not something you might O.D. on. I had the wrong machine for two years, and I haven't suffered any ill consequences (aside from not getting good sleep for all that time).

Also, most sleep clinics and their MDs are not familiar with ASVs. These leaves the user at the mercy of unscrupulous mavin's for help or searching the right set-up by experimentations as you did.

Docs usually have to justify the need for an ASV; this often means the user has to suffer through CPAP/APAP/BiPAP and "fail" to achieve successful therapy before an ASV is deemed necessary. I don't think sleep docs (or any other medical professionals) are prescribing ASV machines willy-nilly to just anyone. (Nobody ever did that for me, no matter how much I wanted that script.)

Congratulations!

Thanks. I'd never have made it without this forum.

[JohnBFisher]

... that's one man's opinion. Here's mine: ASV works very well for me (and for several others around here). Ted's experience is just that - his experience (as a clinician, not even a user). Mine is mine. On that score, I win. ...

I definitely agree with you on this one.

[ ... begin rant ... ]

Some sleep techs and sleep doctors doubt the need for ASV units. They often come from the same camp of doctors who told me that central sleep apnea is very rare, so I must not have it. There's a quote that seems all too appropriate.

Stupid is as stupid does.

Science and medicine should be about verifiable facts. As I asked my doctor, "What do the numbers show? Do they show I have untreated central apneas or not?" After lots of hemming and hawing he admitted they do show untreated central apneas, but it must not be important because it is so rare, thus I could not have it. At that point, I realized that some doctors might have graduated, but one half of them must finish at the bottom of their class! Idiot! I found another doctor.

Here is the issue. Do the numbers show improvement? And yes, you can numerically capture subjective feelings. About 20 months ago I started ASV therapy. We could have used any scale [such as the Epworth Sleepiness Scale]you wanted then and compared it to today and you would find a *significant* improvement in the values. That is how you measure subjective values. My health is greatly improved. I *feel* much better. I can think much more clearly.

What do the numbers show? Do they show improvement by a certain percentage of the population, for whom the therapy was designed? If yes (as many of us here have observed), then the ASV therapy is effective.

Science is not about opinion. It is about observable and verifiable results. The results for many of us here are in. ASV is effective. It is not a therapeutic modality in hunt for a disease. It was designed to address central sleep apnea (CSA in all its forms) by addressing the underlying cycle of undershoot/overshoot in the respiration. The premise of the therapy is that by supporting respiration, it can help break into the cycle and avoid the central sleep apnea. This can and should be measured and studied. It has been. Here is an example of the analysis done during one of the studies:



This is fact based analysis. ASV is an effective therapy for those who suffer from CSA, regardless of the cause of the CSA.

[ ... end rant ... ]

[Bright Choice]

...This is fact based analysis. ASV is an effective therapy for those who suffer from CSA, regardless of the cause of the CSA.

That chart is really interesting. I was surprised to see that those people on ASV are people with lower AHI's - or am I reading that incorrectly?

Does the "AHI" reflect obstructives and hypopneas and not count the CA's?

[JohnBFisher]

... I was surprised to see that those people on ASV are people with lower AHI's - or am I reading that incorrectly?

Does the "AHI" reflect obstructives and hypopneas and not count the CA's? ...

First, that is the result from use of ASV, not untreated. That's the "Diagnostic" range. The explanation from the study for that particular graph is:

With all patient groups combined, ASV significantly improves the total AHI. Using pairwise comparisons, ASV lowered the AHI greater than CPAP, BPAP-S, BPAP-S/T, and diagnostic. When comparison is made between ASV and CPAP+O2, ASV lowers total AHI and CAI more than CPAP+O2.

For much more detail, read the original study:

http://chestjournal.chestpubs.org/conte ... 9.full.pdf

That study in 2007 noted:

ASV is a new treatment modality that has been shown effective in treating CSA, CSA/CSR, and CompSAS. Our findings clarify and extend prior observations, and suggest that ASV is an appropriate consideration to other positive airway pressure treatments and is effective for most patients with these nonobstructive sleep-related breathing disorders.

Another study showed similar results:

http://www.resmed.net/us/documents/Morg ... ilevel.pdf

There have been numerous studies since those two. However, they clearly made the point.