Could AutoASV machines be used for everyone?

[Stormynights]

I have had 3 SS's but never tested on a bipap even thought that was what the last study was supposed to be. Grrrrrr My doctor wanted me titrated with my machine and that never happened. I don't think for a minute that I need this machine. I was just miserable with the apap and my doctor wanted me to try bipap. I got tired of jumping through hoops and bought this one on Craigslist. I absolutely love it. My doctor doesn't mind that I use it at all. I am just having problems with my insurance furnishing supplies for this machine. They consider it junk because it came from Craigslist. For some stupid reason they prefer paying for more SS's and buying another machine to just suppling filters and hoses.

[Stormynights]

The lady from my insurance called me today and told me to quit using my ASV machine. She said they would buy me a new cpap. I told her I didn't need or want one. She said I needed to try a different pressure on cpap so I told her I would try that. She argued that I couldn't set it properly and only a profession person could adjust the settings. I told her I had bad headaches and brain fog on cpap. Then she said I should have another sleep study for bipap. Now I have to see a sleep doctor. She called and made the appointment for me. They are wasting so much money. I just don't get it.

[STL Mark]

I have had 3 SS's but never tested on a bipap even thought that was what the last study was supposed to be. Grrrrrr My doctor wanted me titrated with my machine and that never happened. I don't think for a minute that I need this machine. I was just miserable with the apap and my doctor wanted me to try bipap. I got tired of jumping through hoops and bought this one on Craigslist. I absolutely love it. My doctor doesn't mind that I use it at all. I am just having problems with my insurance furnishing supplies for this machine. They consider it junk because it came from Craigslist. For some stupid reason they prefer paying for more SS's and buying another machine to just suppling filters and hoses.

My insurance company purchased a S9 Autoset for me which I used for about 18 months. I then purchased a used S9 VPAP Auto which I used for about 18 months. Now I have moved to a S9 VPAP Adapt which I purchased. I have been lucky my supply needs have not alerted the insurance company to changes. I guess that is one reason to remain brand loyal. But I can't quite understand their position unless it is due to some liability issue of providing supplies for a unprescribed product. I wonder if a script provided from your PCP for the current machine would calm them down?

[Stormynights]

She told me my machine wasn't safe because it was a discontinued model.

[STL Mark]

She told me my machine wasn't safe because it was a discontinued model.

Wow, nice company. I guess they sent letters to all the people with 50 series machines as soon as the 60 series came out and told them a new machine was being authorized for them because their old one had been discontinued. It does sound as if you are getting the run around. Your only solution may be to let them buy you a machine that uses the same supplies as your ASV. Then sell it or keep it in the closet incase yours ever needs repairs.

[Stormynights]

I would have to show compliance.

[patrissimo]

Could AutoASV machines be used for everyone?

So help me understand what are the negatives to using this type of machine other than cost?

Rhetorically: if an OSA patient has upper-airway obstruction problems, but no central issues, how might ASV benefit them? I would think, theoretically, that ASV offers OSA patients no additional benefits if there are no central flow/volume problems requiring correction. Conversely, if an obstructive patient ALSO has a central issue, then ASV makes good sense IMO.

Theory does not always match practice, and that is not what I have experienced, nor does it match Dr. Krakow's broader clinical experience.

The mechanism for ASV and xPAP are pretty different, the pressure waves they delivery are pretty different, why would they necessarily work the same for vanilla OSA? I don't see, even in theory, why a machine that changes pressure levels in seconds must offer "no additional benefits" over one that changes pressure in minutes.

I've only had one night in the lab with ASV (I'm still trying to get a machine), but it was a noticeable and significant improvement over APAP and BiLevel for my UARS. And I have almost no centrals. On APAP I hardly even have apneas or hypnopneas, my AHI is about 1. But I have mild RERAs that wake me up.

And ASV treats them - on APAP/BIPAP in the lab, my RDI was 33/hr, almost all RERAs (my CAI was 0.8 ). Two nights later, on ASV in the lab, my RDI was 5/hr (CAI 0.3). That looks to me like ASV had way more of an effect on my obstructive events than my central ones, though I'd like to know if you have another interpretation.

[patrissimo]

I purchased the machine (36037). I think the only thing I changed after restoring the default settings was setting mode to ASVAuto, setting Ramp off, and turning Sleep Quality on. I spent about 30 to 45 minutes with the machine on laying awake and wondering what it was doing. It all seemed so magical. It took zero effort to exhale (compared to what I was used to) and inhaling while assisted was a easy experience. A few times as I got drowsy it had done something but I'm not even sure what. I got up and really wanted to look at the data but accepted that it would tell me nothing. It was an interesting experience. I showered and got ready for bed. I slept about 10 hours and feel wonderful this morning. I'm downloading ResScan to see what it has to think. SleepyHead reports are attached. I've never seen a 0.0 AHI before. I don't think there is a chance this machine is going to be resold.

Congrats! When I went to Dr. Krakow's lab in September, his recommendation was that I get the 36037. His tech found during my study that the AutoSV stabilized my breathing even better than the ASV (which was much better than ABIPAP, which was a little better than APAP).

I had no problem adjusting to it in one night, though that may be due to me not having any centrals, and thus not needing the huge pressure swings, as John suggests. Still trying to get a machine to use at home.

[patrissimo]

The blower motor originally designed for the S7 ASV is a classic case of new capability finding additional applications: the Easy Breathe feature in non-ASV machines.

Just like ASV applied to vanilla OSA - another classic case of new capability finding additional applications .

[hueyville]

I go in tomorrow night for an auto ASV study. I am excited. We have tried cpap, bipap anx biflex with backup rate. I still have 50 to 120 centrals per night and have not had a good nights sleep in years. Treated my average AHI is mid 50's with enough nights above 100 to be willing to try anything. My doc feels the auto ASV machine is going to be an approvement. Says if fomorrows lab turns out decent he is going to try and have me a top of the line Respironics auto ASV within a week if he can push it that fast.

[49er]

I go in tomorrow night for an auto ASV study. I am excited. We have tried cpap, bipap anx biflex with backup rate. I still have 50 to 120 centrals per night and have not had a good nights sleep in years. Treated my average AHI is mid 50's with enough nights above 100 to be willing to try anything. My doc feels the auto ASV machine is going to be an approvement. Says if fomorrows lab turns out decent he is going to try and have me a top of the line Respironics auto ASV within a week if he can push it that fast.

Lots of luck hueyville. It is about time you have some good fortune after everything you have been through.

49er

[letsride]

I found this in the vpap adapt manual.

Looks like ResMed says it will work for most types of apnea.

"VPAP Adapt indications for use
The VPAP Adapt is indicated for the treatment of patients weighing more than 66 lb (30 kg) with obstructive sleep apnea (OSA), central and/or mixed apneas, or periodic breathing. The VPAP Adapt is intended for home and hospital use."

[JohnBFisher]

While it can treat all sorts of issues, the fact that it can does not mean that it's an easy adjustment to ASV therapy. I spend most of my time helping others adjust to the therapy. If everyone was given an ASV unit, I suspect the "drop out" rate would be much higher than 50%. Some people take to it like a fish in water. But far more struggle with the ever changing pressure. It's not at all normal and does take time before your body adjusts. Too many people would give up if this was the first line of therapy.

[Taringa542]

While it can treat all sorts of issues, the fact that it can does not mean that it's an easy adjustment to ASV therapy. I spend most of my time helping others adjust to the therapy. If everyone was given an ASV unit, I suspect the "drop out" rate would be much higher than 50%. Some people take to it like a fish in water. But far more struggle with the ever changing pressure. It's not at all normal and does take time before your body adjusts. Too many people would give up if this was the first line of therapy.

I have to agree, it took me a month to get use to mine, I could have thrown it out the window on more than one occassion, now I wouldn't be without it.

[archangle]

Some of the "lesser" machines such as Auto machines and "lesser" bilevel machines have modes that are more comfortable for some patients.

For instance, I don't think most ASV machines will do the same therapy as an APAP set at 10-16 auto mode.

I don't see a good reason why the ASV machines couldn't be programmed to optionally do all the therapy modes, including manual CPAP, Auto, manual bilevel, auto bilevel, T/ST mode bilevel, AVAPS, etc. The ASV hardware can do all of this, and I still think the ASV hardware on S9 and PRS1 is the same as the fully data capable manual models, other than maybe needing more memory.