Using a Bipap Auto SV and using a Vpap Adapt SV

[-SWS]

Sorry, I couldn't resist! LOL

Say, isn't that the Swiss SV? At only 1,400 it's cheaper than the other two SV devices up for discussion.
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[dsm]

[quote="-SWS"]So far we have race cars veering off roads, holes being dug with shovels, and SDB diagnoses à la vanilla extract: science by logic and metaphors rather than methodology. The problem with science by logic and metaphors is that it has a rich history of yielding "irrefutable fact" that turns out to be false. So I'll take your word for it that you sleep better with the BiPAP autoSV.

But how do you have the slightest clue that SV is "tidying up" your obstructions as opposed to doing exactly what it was designed for, let alone at the measured backup rate of 40 to 70 times per hour?

And how to you propose to generalize any one or two uncontrolled experiments across an entire pathologically diverse patient population?
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[-SWS]

Amen, Doug!

I generally think that trial and error is great. And I think you probably nailed it with that BiPAP autoSV, regarding your own efficacy. But we don't know what in your pathophysiology got "nailed" per say. Tidied up OSA events are a definite possibility. But I'm not going to work that side of the topic's exploration since you are doing it well. You know my quirky method: construct as many competing theories as possible, then try to topple them; the ones standing after that may be insufficiently tested, complementary, or part of a unified theory (esp. in cases of high complexity).

Truth is I suspect there may be a lot of us "vanilla OSA" patients who would benefit from a consolidation of breath rate while achieving target volumes. There's mechanical unloading, airway inflation, highly-regular vagal stimulation, potentiation, kinetic blood gas regulation, and yet other promising factors at play...

But we don't know exactly why you sleep better with BiPAP autoSV, and I'm sure everyone here would just love to know the answer to that secret in physiology! I sure would!

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[dsm]

[quote="-SWS"]Amen, Doug!

I generally think that trial and error is great. And I think you probably nailed it with that BiPAP autoSV, regarding your own efficacy. But we don't know what in your pathophysiology got "nailed" per say. Tidied up OSA events are a definite possibility. But I'm not going to work that side of the topic's exploration since you are doing it well. You know my quirky method: construct as many competing theories as possible, then try to topple them; the ones standing after that may be insufficiently tested, complementary, or part of a unified theory (esp. in cases of high complexity).

Truth is I suspect there may be a lot of us "vanilla OSA" patients who would benefit from a consolidation of breath rate while achieving target volumes. There's mechanical unloading, airway inflation, highly-regular vagal stimulation, potentiation, kinetic blood gas regulation, and yet other promising factors at play...

But we don't know exactly why you sleep better with BiPAP autoSV, and I'm sure everyone here would just love to know the answer to that secret in physiology! I sure would!

.

[rested gal]

But amusingly RG now sounds a lot more like a an RT (whose tail's she like to pull so often) or like a manufacturer's rep (only use the machine as per the brochure - any other results are not to be relied on)

Huh?????

- It is kind of surprising to have her of all people telling us lab ratters what we should & shouldn't do according to sales literature

Double HUH?????

[-SWS]

Well truth is my wife hits me on the head with a spade each night.

Time to get out the adaptive servo shovel repeller! That model's been known to work for conjugal spades as well!

But amusingly RG now sounds a lot more like a an RT (whose tail's she like to pull so often) or like a manufacturer's rep (only use the machine as per the brochure - any other results are not to be relied on)

Huh?????

- It is kind of surprising to have her of all people telling us lab ratters what we should & shouldn't do according to sales literature

Double HUH?????

Might not proper message board vernacular also include: "Whaaa???"

I think Rested Gal is the patron saint of taking her own therapy into her own hands. But I also think she pursues the entire topic of central dysregulation with extreme caution. I respect and agree with that approach of hers.

[feeling_better]

rested gal, With that price one would have expected at least one of those tools could splint open vanilla OSA. Perhaps somebody should let them know about the field of PAPs

PS I noticed this post got out of order, probably because others had arrived before my post. I was referring to rested gal's link to the universal tool.

[Guest]

Question for anyone please? about Aadpt SV machine and "external" humidifier. The one I have is from Fisher and Paykel, it is not the official Resmed external humidifier. The technician from Resmed Co. said only their official external humidifier will work properly with the Adapt SV machine. I said that the adapt SV had passes the learning circuit OK, and I tried it several times, and each time it passed. He said "that doesn't make any difference; the machine will may not work properly even if the learning circuit says everything is ok." That was scary to me. Dos this mean the learning circuit can NOT be trusted?

[-SWS]

PS I noticed this post got out of order, probably because others had arrived before my post. I was referring to rested gal's link to the universal tool.

Responses appearing out of order or out of sequence tends to happen on quicker-moving threads. And all too often I forget to preserve the sequence or context by using the quote feature. But when I do remember to do that it helps with the flow!

Question for anyone please? about Aadpt SV machine and "external" humidifier. The one I have is from Fisher and Paykel, it is not the official Resmed external humidifier. The technician from Resmed Co. said only their official external humidifier will work properly with the Adapt SV machine. I said that the adapt SV had passes the learning circuit OK, and I tried it several times, and each time it passed. He said "that doesn't make any difference; the machine will may not work properly even if the learning circuit says everything is ok." That was scary to me. Dos this mean the learning circuit can NOT be trusted?

I'm thinking Banned probably knows the scoop about using "other brand" humidifiers with the Resmed Adapt SV.

I thought I recall a message-board patient having said they received an Adapt SV titration at a research-oriented sleep clinic that used only F&P's... but I may very well be wrong about that. My memory's foggy at times like the inside of a steamy humidifier... Hope Banned is around to take a crack at your Adapt SV question. At the very least he'll have an informed opinion for you.

Sir Banned, if you are still around...

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[dsm]

[quote="Anonymous"]Question for anyone please? about Aadpt SV machine and "external" humidifier. The one I have is from Fisher and Paykel, it is not the official Resmed external humidifier. The technician from Resmed Co. said only their official external humidifier will work properly with the Adapt SV machine. I said that the adapt SV had passes the learning circuit OK, and I tried it several times, and each time it passed. He said "that doesn't make any difference; the machine will may not work properly even if the learning circuit says everything is ok." That was scary to me. Dos this mean the learning circuit can NOT be trusted?

[dsm]

But amusingly RG now sounds a lot more like a an RT (whose tail's she like to pull so often) or like a manufacturer's rep (only use the machine as per the brochure - any other results are not to be relied on)

Huh?????

- It is kind of surprising to have her of all people telling us lab ratters what we should & shouldn't do according to sales literature

Double HUH?????

RG,

Refer back to your post here Thu Jun 19, 2008 5:17 am

RG (responding to an Ozij comment) "In my opinion Adaptive Servo Ventilators are not the ideal treatment machines for purely obstructive Sleep Disordered Breathing. I do think the majority of SDB people are, indeed, plain vanilla OSA'ers. But there probably is a very significant number who have (at least at times) more complicated SDB that could respond to SV treatment. "

RG
"Both manufacturers keep making improvements in all their machines -- not just the adaptive servo ventilators. Maybe someday there will be a magic bullet one-size-fits-all machine to treat whatever form of SDB it sees. But at present, for the vast majority out there with plain OSA (I know, ozij...that refrigerator light... loved that! Laughing ) adaptive servo ventilation would not give them as effective treatment for obstructive sleep apnea as cpap/bilevel/autopaps can. Just my non-medical opinion, of course! "


In both those comments you keep referring to "purely OSA" or "plain OSA" when in the days before we have a warm spirited set of posts pointing out repeatedly that we all know & agree that the SV machines are not sold as machines for vanilla OSA.

You also state that a Bilevel would be better for OSA than an AdaptSV but you ignore the fact that an Adapt SV is a bilevel (a bilevel with added features for timed mode and controlling irregular breathing, in other words it is a Bilevel+). This point has to be so obvious that one might wonder why you would write that a BipapSV isn't as effective for OSA ?

Ozij had also made a comment that she wondered if anyone really had just vanilla OSA but you appeared to miss her point and quoted her in support of your repeated argument that a Biap SV is no good for vanilla OSA ?.

The fact here is that the BipapSV is internally identical to a Bipap S/T but it has added algorithms to allow it to manage irregular breathing. My contention throughout this whole thread has been that having used a Bipap SV it not only takes care of OSA but seems to offer side benefits not in the manufacturers brochures.

Why you want to keep shooting the comments about "look at what else this machine can do" down and why you keep referring to the vendor's brochures to bolster an already defeated case that the Bipap SV can't handle OSA better than a bilevel (when even Respironics brochures state in big black, white and colored letters that it treats OSA using bilevel titration) that prompted my chiding

Let me state again - The Bipap SV is a Bipap S/T with an added algorithm to track Peak Flow and provide PS to keep it in line. That Bipap S/T is still sold as one of Respironics' top-of-the-line Bilevel machines.[/b]

So the BipapSV is not anything mechanically new - only the added algorithm behind the PS is the new bit & that is software.

DSM

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, bipap, Titration, CPAP

[Guest]

Thanks for your reassurance. I read with interest your discussions. They are on a very high level indeed. rgds

[Banned]

The F&P water chamber is also a lot smaller than the Humidaire unit. In plain terms it is a better fit to the adapt SV than the Humidaire.

Translation:) The problem is the ResMed technician has to tow the ResMed party line. Learn Circuit has no agenda or party affiliation. Trust Learn Circuit.

Banned

[-SWS]

Let me state again - The Bipap SV is a Bipap S/T with an added algorithm to track Peak Flow and provide PS to keep it in line. That Bipap S/T is still sold as one of Respironics' top-of-the-line Bilevel machines.[/b]

So the BipapSV is not anything mechanically new - only the added algorithm behind the PS is the new bit & that is software.

In Laryssa's case, for instance, the SV part of the algorithm is turned off---making the machine behave like a BiPAP ST (which her doctor prescribed). That masking of additional functionality is very similar to buying an APAP, then running it as a functionally lower CPAP.

Doug, what I'm not sure is whether you contend that allowing that SV algorithm to run will likely treat simple OSA patients better than say a spontaneous BiLevel. And if your contention is that it will treat simple OSA patients better, what functional aspects of the SV algorithm will treat OSA better?

Speaking of Laryssa, it's her birthday this week!
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[dsm]

Let me state again - The Bipap SV is a Bipap S/T with an added algorithm to track Peak Flow and provide PS to keep it in line. That Bipap S/T is still sold as one of Respironics' top-of-the-line Bilevel machines.[/b]

So the BipapSV is not anything mechanically new - only the added algorithm behind the PS is the new bit & that is software.

In Laryssa's case, for instance, the SV part of the algorithm is turned off---making the machine behave like the BiPAP ST.

Very similar to buying an APAP, then running it as a functionally lower CPAP. Only much more expensive, of course.

Doug, what I'm not sure is whether you contend that allowing that SV algorithm to run will likely treat simple OSA patients better than say a spontaneous BiLevel. And if your contention is that it will treat simple OSA patients better, what functional aspects of the SV algorithm will treat OSA better?