Day 2 - How long does it take to get used to ASV machine?

[dif]

I was wondering how long it typically takes to get used to the ASV machine? Last night was night #2 and I woke up once nearly every hour. I don't necessarily feel as though I slept any worse than normal but just wondered if I will eventually get more used to the machine and then sleep better? Also, my machine does not seem to provide my breathing data, just the tightness of the mask and average pressure. How can I get the measures of # of Central apneas I have, number of times I wake up, Oxygen levels, etc.

[patdart]

DIF, you don't say what ASV stands for. Maybe if that were clearer to newbie's like me you'd get more answers.

[dsm]

I was wondering how long it typically takes to get used to the ASV machine? Last night was night #2 and I woke up once nearly every hour. I don't necessarily feel as though I slept any worse than normal but just wondered if I will eventually get more used to the machine and then sleep better? Also, my machine does not seem to provide my breathing data, just the tightness of the mask and average pressure. How can I get the measures of # of Central apneas I have, number of times I wake up, Oxygen levels, etc.

Dif, If the ASV is working you shouldn't be having *any* centrals. Also, in a prior post you said your wife heard the machine 'rev up' in the night. The ASV you say you have is so quiet most folk question if it is even on especially spouses.

Can you provide some clearer details of exactly what you have and what it was prescribed for.

Cheers

DSM

[JohnBFisher]

Greetings dif !! Hopefully you will find folks who can help you here. I'll do what I can. But can you help us help you? If you register in the forum, and register your equipment, we will be better able to tailor our answers to your equipment and not just generically answer your questons.

... I was wondering how long it typically takes to get used to the ASV machine? ...

It took me several weeks. I suffer from severe central sleep apnea. It seemed to take me several weeks for my body to learn to trust the machine.

You don't mention why you were prescribed a BiLevel Adaptive Servo Ventilation unit. Do you have problems with periodic breathing? Do you have problems with central apnea? I suspect the type and serverity of the problem may impact the time it takes to adjust.

... Last night was night #2 and I woke up once nearly every hour. I don't necessarily feel as though I slept any worse than normal but just wondered if I will eventually get more used to the machine and then sleep better? ...

I do. Though let's face if, if you have such severe sleep problems you may continue to struggle with sleep issues. As my neurologist explained to me, the fact that I have problems in my brainstem that leads to poor regulation of my breathing during sleep also means my sleep architecture (normal sleep patterns) will no longer be very normal.

So, while you will get better sleep, it may never be "normal" again. Once again, it depends on the type of problem and severity of the problem.

... Also, my machine does not seem to provide my breathing data, just the tightness of the mask and average pressure. ... How can I get the measures of # of Central apneas I have, number of times I wake up, Oxygen levels, etc. ...

I assume it tells you the mask leak, the average pressure and the length of use. In that case, you are probably using a ResMed VPAP Adapt SV unit. It is probably a VPAP Adapt SV Enahnced unit. You will need to get a null modem cable and a USB to Serial adapter (unless your computer has a DB9 serial port). You will then need the ResScan software to read the statistics from your machine.

The VPAP Adapt SV does not normally connect to a Pulse Oximeter. You can search in this forum for various models others use.

Also, as DSM says, the ASV unit is amazing in its ability to help us regulate our breathing. The ASV unit will essentially squash the overshoot / undershoot situation that causes the central apneas. It's a VERY rare day that shows I had a central or obstructive apnea. I often have an AHI of zero.

Hope that helps.

[JohnBFisher]

DIF, you don't say what ASV stands for. Maybe if that were clearer to newbie's like me you'd get more answers.

ASV stands for Adaptive Servo Ventilation. This is essentially a VERY souped up BiPAP unit that will help guarantee your breathe enough when your body heads into a central apnea situation. But they are VERY, VERY expensive. Here's Respironics BiPAP AutoSV Advanced:

https://www.cpap.com/productpage/remsta ... chine.html

Remember, that is a discounted price from CPAP.com. Double or triple the price from a DME. Seriously.

It may be WAY more information than you wanted, but it will probably help others. So, here's some Adaptive Servo-Ventilation articles:

Efficacy of Adaptive Servoventilation in Treatment of Complex and Central Sleep Apnea Syndromes
http://chestjournal.chestpubs.org/conte ... l.pdf+html

Adaptive Servoventilation (ASV) in Patients with Sleep Disordered Breathing Associated with Chronic Opioid Medications for Non-Malignant Pain
http://www.ncbi.nlm.nih.gov/pmc/article ... .4.311.pdf

Adaptive servo-ventilation and deadspace: effects on central sleep apnoea
http://www.sciencesleep.org/ziliao/Adap ... apnoea.pdf

A Randomised Controlled Trial of Adaptive Ventilation for Cheyne-Stokes Breathing in Heart Failure
http://ajrccm.atsjournals.org/cgi/repri ... 2-1476OCv1

Adaptive Servo-Ventilation in Patients With Idiopathic Cheyne-Stokes Breathing
http://www.aasmnet.org/JCSM/Articles/020212.pdf

Adaptive Servoventilation Versus Noninvasive Positive Pressure Ventilation For Central, Mixed, And Complex Sleep Apnea Syndromes
http://www.resmed.net/us/documents/Morg ... ilevel.pdf

[dif]

John,

Thank you very much for the information. You are correct, I have been prescribed with the VPAP Adapt SV due to the large number of central apneas that I suffer from. I was originally prescribed to use a CPAP but they eventually discovered that by increasing the pressure, they were actually increasing the number of central apneas. I have extremely poor sleep quality and need to try to find a solution to the problem but am struggling to get comfortable with the ASV over the first four days of treatment. Do you have any additional advice? Thanks.

[dsm]

dif

One of the challenges we here have when asked generic questions, is that we sometimes have to either ask for more specific details or provide a shotgun reply in the hope that something hits the target.

You are very lucky to have JohnB give you a shotgun reply as that takes time and effort & a hope that it is on target.

What helps us here greatly is a number of inputs ...

- any details on the sleep study or reason an ASV machine was preferred
- the nature of the doctor or clinic that came to the conclusion (helps us try to determine their specialization & expertise)
- some really specific descriptions of any problems being experienced (such as dry mouth, squeaking noises, always waking up etc: etc: )
- also it helps enormously if you offer a little background such as any medical conditions or treatment going on at this time

There are many helpful folk here but most will hold back if they are faced with too hard a guessing game. Can you spell out
a bit more, the real nature of what is making the machine use problematic, it may take a couple of posts & responses but
hopefully the issues will become clearer.

Cheers
& good luck

DSM

[dif]

I am now using the Resmed VPAP Adapt SV and have been prescribed the ASV machine due to my predominance of central apneas vs OSAs. I had originally been prescribed with a CPAP but the increased pressure apparently increased my CSAs. I started waking up with tremors, tingles in my hands, and extreme dizziness and so I returned to the sleep study for further examination. At that point, I was prescribed the ASV machine. Please let me know if you need any additional information. Thanks.

[timbalionguy]

I am now using the Resmed VPAP Adapt SV and have been prescribed the ASV machine due to my predominance of central apneas vs OSAs. I had originally been prescribed with a CPAP but the increased pressure apparently increased my CSAs. I started waking up with tremors, tingles in my hands, and extreme dizziness and so I returned to the sleep study for further examination. At that point, I was prescribed the ASV machine. Please let me know if you need any additional information. Thanks.

No history of heart disease, etc.?

[JohnBFisher]

Greetings dif! First, it's good to see that you registered and added your equipment. A minor "nit", but it will help. You should remove the "machine" from your list of registered equipment. We have a unit that CPAP.com never sold, so they don't have it listed. Both DSM and I have the same and listed our systems slightly differently. You did essentially what I did. I added mine as a comment, so have you. But the VPAP Malibu is a different unit all together.

Again, I am sorry you continue to struggle with those symptoms. I know how frustrating this can be.

First, you really should to go back to your doctor and report that your symptoms (the shaking, the tingling, etc) continue. Such symptoms are neither normal, and they can be a sign of serious issues (low O2 levels comes to mind, but others are possible).

Second, in addition, you might want to look for a pulse oximeter. It's possible you continue to have apnea events that are serious enough that your body is reacting the the low levels. You can check recommendations in the forum.

Third, let's make certain your machine is doing what it should. It's very possible you have a large leak with your mask. If so, the ResMed VPAP Adapt SV is much, much less effective.

To check to see if you have that issue, we need to check the metrics in your machine. It should have the word "Enhanced" above the "Alarm Mute" botton on the bottom right side of the control panel. (Below the LCD display area).

If so, then you can use the ResScan software to find out things like the leak rate and the number of apneas and hypopneas observed.

I saw you asked someone else about the ResScan software.

You will also need a null modem cable to connect between your computer and the ResMed VPAP Adapt SV unit. Assuming you need a USB to Serial conenction (most computers no longer have a DB9 serial port), then you will want the following items:

• Null Modem Cable - http://www.newegg.com/Product/Product.a ... 6812200051
• USB to Serial Adapter - http://www.newegg.com/Product/Product.a ... 6812339013

This is just one combination you can get. You might be able to find a cheaper combination.

If your computer has a DB9 serial port, then you will probably only need the null modem cable. However, be certain you check that the ends of the cable are what you need. It should be two "female" ends, but I just can not guarantee what PC manufacturers provide. I can help further via private message if you have more detailed questions.

Anyway, that will allow you to see if your mask is leaking excessively.

But like I say, I would recommend going back to your doctor. I know it can be a frustrating process. Trust me, I understand. But you really need to include your medical team in this process.

[dif]

John,

I am still struggling to deal with the machine and continue to wake throughout the night, but I am unable to determine how many apneas I am having. I don't think that my doctor even has the software needed to analyze my machine's findings, do you think that I should just continue trying to adapt to the machine or touch base with my doctor to re-assess everything. I am struggling since I don't think there are many options after this machine...

Thanks,

Dave