Resmed or Respironics ASV - which is best for me?

[CROWPAT]

I have been on CPAP for years and am 100% compliant in or out of the country. Remstar Pro then Remstar Auto (last year) after I found this forum and its wealth of information from great people. AHI hovers around 4 or so with some great nights around 2. Few snores. Var Breathing around 25% or so. I know I get centrals over 13 so I keep it at 10-13 without CFLEX, but with humidifier. Nevertheless I get a number of centrals between 0500 and 0700 each morning confirmed by a second sleep study in December. Mask leak is within design parameters - UMFF, and no large leaks. Have a great doctor after firing 3 previous ones who knew less than you have taught me here. New doctor wants to titrate me on the Remed Adapt SV because of the centrals and continued daytime drowsiness that did not respond to Provigil. Have read all I can find on both SV machines, though little to be found on the Respironics version. Read the 31 pages of comments on both here too, though I didn't understand some of the technical stuff very well.

Question: Which machine is better given the information provided above?

Pat

[Snoredog]

before I'd spend $4500 on something, I'd want to try them both.

[DME_Guy]

For central sleep apnea, the Resmed Adapt SV is the better choice. It's the first device approved by the FDA to treat central sleep apnea.

http://www.resmed.com/en-us/products/fl ... u=products

Go to the Respironics web site and see if you can find any documentation about their products being used for central sleep apnea.

[Snoredog]

[quote="DME_Guy"]For central sleep apnea, the Resmed Adapt SV is the better choice. It's the first device approved by the FDA to treat central sleep apnea.

http://www.resmed.com/en-us/products/fl ... u=products

Go to the Respironics web site and see if you can find any documentation about their products being used for central sleep apnea.

[DME_Guy]

[quote="Snoredog"][quote="DME_Guy"]For central sleep apnea, the Resmed Adapt SV is the better choice. It's the first device approved by the FDA to treat central sleep apnea.

http://www.resmed.com/en-us/products/fl ... u=products

Go to the Respironics web site and see if you can find any documentation about their products being used for central sleep apnea.

[hhopper]

Respironics now has what they call A-flex which is more sensitive than C-flex. They have an auto machine with A-flex that I think is similar to the Resmed Adapt SV.

A-Flex: A New Dimension in Sleep Therapy Comfort.

A-Flex technology utilizes our patented Digital Auto-Trak™ Sensitivity to distinguish between exhalation and inhalation. During exhalation, A-Flex provides variable expiratory pressure relief that is the same as our clinically proven C-Flex™ technology. During inhalation, A-Flex also provides inspiratory comfort that varies with the patient's pressure level. The result is a pressure pattern that matches the patient's entire breathing cycle. Like C-Flex, there are three patient-selectable A-Flex settings to make therapy more personal.

For you, the addition of A-Flex to our Flex Family of pressure relief technologies means that every patient can enjoy more comfortable and effective therapy. In fact, you may never deal with ordinary constant pressure therapy again.

[Alice]

Crowpat:
I think you'll find that ResMed's Adapt SV has been available for many years in other countries (EU). It specially designed to treat your CSA (along with your OSA). I did a search on PubMed for clinical papers and there are several on the Adapt (also known as AutoSet CS2) mostly from Europe.

I think A-Flex is just another form of OSA treatment. My understanding is that unless the manufacturer says specifically that it can treat CSA then assume it can't. The BiPAP ST device that DMEGuy mentions is a standard ventilator (usually these are used on people with poor lung function rather than plain old OSA). It sounds like these have been used on people with CSA but because they're not specifically designed to treat the CSA they've failed.

My suggestion is that you look for a device that actually states that it treats your CSA.

[hhopper]

You're right. The A-Flex works on inhale and exhale where the C-Flex just works on exhale.

Respironics does make a machine like the ASV now.

[Lubman]

Respironics does have a new machine that is reportedly for treating complex sleep issues. I don't think it is any of the ones mentioned in this post. Dig around in the (now) 33 page post on ResMed ASV because there are several references to it. Respironics called it HeartPap in overseas studies.

It does appear to work differently than the ResMed Assist SV, which is what
I use and which more sleep MD's and Labs have experience.

I use the ResMed ASV and like it -- but you need to see what works for you.

Respironics has recently been talking to Sleep MDs and labs in some of the states to "introduce" their new machine. It appears to be in limited roll out.

Trying it and evaluating the results of both may be the only way to know if they are for you.

Lubman