Could AutoASV machines be used for everyone?

[ignorant1]

I don't see a good reason why the ASV machines couldn't be programmed to optionally do all the therapy modes

Isn't that what the clinical units used in the sleep labs do? (Rhetorical question, obviously)

Excuse my intrusion; I haven't been here in quite a while, and I'm trying to catch up on things.
I'm a long-time user of the original S9 V-Pap Adapt (#36007) which made a PHENOMENAL difference compared to prior PAP modalities. Now I want to know more about the newer 36037 unit...

[letsride]

I have both S9 models 36007 & 36037. The Epap is the only difference I can tell. I used my ASVauto 36037 with my epap auto adjusting between the settings.
I found my AHI went up in ASV auto mode. I change the settings back to standard ASV (fixed epap) my AHI went back down. I'm sure it depends on each person. I see no reason to upgrade unless it is time for a new machine.

[Taringa542]

I have both S9 models 36007 & 36037. The Epap is the only difference I can tell. I used my ASVauto 36037 with my epap auto adjusting between the settings.
I found my AHI went up in ASV auto mode. I change the settings back to standard ASV (fixed epap) my AHI went back down. I'm sure it depends on each person. I see no reason to upgrade unless it is time for a new machine.

Hey Letsride

I've been using the S9 36007 for 12 months & most readings have been 0.00 with the ocassional Ahi of less than one. I'm just waiting on delivery of a S9 36037, going by your experience I hope I haven't wasted my money

[Sir NoddinOff]

I have both S9 models 36007 & 36037. The Epap is the only difference I can tell. I used my ASVauto 36037 with my epap auto adjusting between the settings. I found my AHI went up in ASV auto mode. I change the settings back to standard ASV (fixed epap) my AHI went back down. I'm sure it depends on each person. I see no reason to upgrade unless it is time for a new machine.

Hey Letsride
I've been using the S9 36007 for 12 months & most readings have been 0.00 with the ocassional Ahi of less than one. I'm just waiting on delivery of a S9 36037, going by your experience I hope I haven't wasted my money

Ditto, Letsride. I have the S9 model 36007 ASV and not the 36037. My AHI is 0.0 about 80% of the nights. The other nights might depend on mask experiments, party-hardy indiscretions, raging allergies etc. These nights can go all the way up to 0.7 AHI (yeah, I got the zeros in the right place )

Worth noting: I also have a fairly narrow margin regarding my fixed EPAP setting where it's just right and the pressure doesn't cause other problems with my ASV therapy (too complicated to explain here). In other words, I'm not sure auto-EPAP is such a great idea, but then I'm not a ResMed engineer, so what do I know?

[49er]

Recently, I listened again to the 2010 Krakow podcast in which he constantly mentioned how wonderful the ASV machine was and how people who hadn't been able to successfully use other machines such as folks with insomnia and anxiety were able to adapt to them with success. While I was listening, I was trying to reconcile that information with the excellent posts in this thread talking about how adapting to ASV can take quite awhile.

I just wish there was one I could try out for free so I can see for myself what the deal was. LOL!

49er

[purple]

An ASV, without the proper settings, combined with some health problems can kill people, or cause real physical damage to the patients bodies.

If we made available an ASV, (with as some have pointed out, a few more setting options to emulate what lower machines now do) to many, this is more dangerous to those who are pursuing Sleep Apnea treatment on their own, or with a doctor who does not -somehow- find the right settings.

Manufacturers create crippled machines, with the idea the product line creates more profit for them. That is, if the readers of this post has not been told, most machines are the same under the plastic, but with different programming in the Firmware. So the manufacturers create crippled machines, to create a product line of more expensive machines, to augment their profits.

It is all well and good for a manufacturer to charge more for the work they did to create the firmware for a machine, or for some better sensor in the machine. However, the design, engineering of some of these machines has been around for some years. It is a matter that for an AutoASV, they charge a few bucks more than what is the bottom of the line machine now, and I hope no longer manufacture crippled machines.

On the other hand, the RT for my DME said that over ninety percent of her clients have compliance only data, and are perfectly happy with their treatment. If one was to make an argument for the use of such machines, if they have problems they could have another sleep study, which should be more valuable the doc getting all the info from a full data machine.

Another question being which adds more cost to the system? Providing AutoASV machines versus anything else.

It is easy to realize that if the big two in the business, Resmed, and PR starting making AutoASV only, then some manufacturer will come along and make the bricks we all now loathe, and convince insurance companies to buy their bricks, and thereby push the idea of an AutoASV out.

I just went through a sleep study to qualify for a bi level machine. The cost of the sleep study was greater than the difference between a usual Auto with full data, and the Bi Level machine. The result of letting bean counters make medical decisions. Insurance companies that create regulations with the intent discouraging individuals from getting medical care. All the while wasting doctors time, who could be treating more people who desperately need sleep apnea treatment. And using up two hundred dollars more of my very limited money to qualify for a bi level machine. On the other hand, the result of a well run sleep study might reveal how to set my new Bi machine more accurately. Which is only valuable info If I also get the waiver of my Co-payment from the DME so I can get to keep the machine. A a big iffy.

Keep in mind, that someone who is in a fog from a lack of good sleep, with no background in Sleep Apnea treatment, or terminology, should not be setting their own autoASV.

Is this discussion about whether people should treat themselves, or have home studies, or use the Sleep Clinic system with Sleep Doctors? We can forecast that as technology improves, a person can bring home a piece of testing, self adjusting technology that is far superior to anything available to any one today, and not need to have a doctor involved at all.

Can someone define what the technology will be like? Starting with a list of, "Do No Harm." Features? Then all the detection features?

[johnthomasmacdonald]

I have both S9 models 36007 & 36037. The Epap is the only difference I can tell. I used my ASVauto 36037 with my epap auto adjusting between the settings. I found my AHI went up in ASV auto mode. I change the settings back to standard ASV (fixed epap) my AHI went back down. I'm sure it depends on each person. I see no reason to upgrade unless it is time for a new machine.

Hey Letsride
I've been using the S9 36007 for 12 months & most readings have been 0.00 with the ocassional Ahi of less than one. I'm just waiting on delivery of a S9 36037, going by your experience I hope I haven't wasted my money

Ditto, Letsride. I have the S9 model 36007 ASV and not the 36037. My AHI is 0.0 about 80% of the nights. The other nights might depend on mask experiments, party-hardy indiscretions, raging allergies etc. These nights can go all the way up to 0.7 AHI (yeah, I got the zeros in the right place )

Worth noting: I also have a fairly narrow margin regarding my fixed EPAP setting where it's just right and the pressure doesn't cause other problems with my ASV therapy (too complicated to explain here). In other words, I'm not sure auto-EPAP is such a great idea, but then I'm not a ResMed engineer, so what do I know?

My experience is that nothing i've tried comes close to the resmed 36037 ( I'm assuming that's the number of my unit - auto EPAP on an resmed asv machine with a heated humidifier). Most nights my ahi is 0.0 to 0.5, i sleep 7-8 hours with no wakeups. Machines i've used: respironics System one - apap, apap/bipap, 950 unit with auto epap but not a heated humidifer hose; REsmed vpap Bipap (not auto) and a Resmed ASV enhanced based on the S8 unit

with this unit, i don't really need for the technology to improve in the future, i could use this unit every night for the rest of my life - in the 3 months that i've had it, i think i once dozed off for 15 minutes when reading without having the unit on - otherwise,i haven't slept a second without it

with this unit, my apnea is effectively "cured"

And to add, without this forum and people like Sir Noddinoff willing to take the time out to give advice and discuss his/their experiences I would have given this up long ago. To reach the point i've gotten to was quite an adventure and i'd rate the contribution of the medical community as around 5% and the contribution of this forum about 95% in solving my apnea difficulties

[49er]

My experience is that nothing i've tried comes close to the resmed 36037 ( I'm assuming that's the number of my unit - auto EPAP on an resmed asv machine with a heated humidifier). Most nights my ahi is 0.0 to 0.5, i sleep 7-8 hours with no wakeups. Machines i've used: respironics System one - apap, apap/bipap, 950 unit with auto epap but not a heated humidifer hose; REsmed vpap Bipap (not auto) and a Resmed ASV enhanced based on the S8 unit

with this unit, i don't really need for the technology to improve in the future, i could use this unit every night for the rest of my life - in the 3 months that i've had it, i think i once dozed off for 15 minutes when reading without having the unit on - otherwise,i haven't slept a second without it

with this unit, my apnea is effectively "cured"

And to add, without this forum and people like Sir Noddinoff willing to take the time out to give advice and discuss his/their experiences I would have given this up long ago. To reach the point i've gotten to was quite an adventure and i'd rate the contribution of the medical community as around 5% and the contribution of this forum about 95% in solving my apnea difficulties

John,

I am curious as to why you feel using the Resmed ASV has led to no wakeups vs. the other machines you have used. Is it the mechanism of the machine or something else? I realize it may be hard to explain in a post but anything information you can provide would be greatly appreciated.

By the way, I am so happy you are having a successful experience knowing how much you have struggled. You definitely deserve it.

Yup, this forum deserves alot of kudos. Sad that it is hard to get assistance from doctors but that is reality unfortunately.

49er

[bwexler]

I agree with John. Once I was diagnosed I found this site and used the knowledge gained here to tell my doctor what to put on the prescription.
Having recently stumbled into a good sleep doc and a good sleep lab I would have to say 20% for them and 80% here.

Of course there is always the ongoing battle with the DME (Crapria), the medical group and the insurance company.

[johnthomasmacdonald]

I agree with John. Once I was diagnosed I found this site and used the knowledge gained here to tell my doctor what to put on the prescription.
Having recently stumbled into a good sleep doc and a good sleep lab I would have to say 20% for them and 80% here.

Of course there is always the ongoing battle with the DME (Crapria), the medical group and the insurance company.

I like my doctor ( who is board certified in neurology and sleep medicine) because she'll support writing whatever i want but if i hadn't been on this forum and went with what she prescribed it was for a generic asv which was interpreted by the DME her office used as a respironics unit that was discontinued 6 years ago and provided no data and the DME was quite outraged when i told them what i wanted - i had to call resmed and find a DME in the area that took my insurance

it is tragic how much you have to be responsible for your own medical care here - not for getting the best of the best, but just getting something that will work - and this is with Excellent insurance

[letsride]

The support from the so call medical/DME experts has been less than stellar. I have yet to find one that is interested in my apnea issues. I have learned from this forum and taking that to the doctors office. I finally realized it is about selling numerous machines and sleep studies (greed). I finally received a prescription for an ASV machine but been unable to get it filled by the DME. What I find strange is the insurance has sent a letter of approval to the DME and myself. I like to have a back up machine, Thanks to STL Mark I have a new primary ASVauto.
I find it highly unlikely a machine that Adapts to your breathing patterns will do any harm. If you have centrals you will have to adapt the the pressure/volume increases.
I believe any centrals/low oxygen isn't good.

[Guest]

An ASV, without the proper settings, combined with some health problems can kill people, or cause real physical damage to the patients bodies.

If we made available an ASV, (with as some have pointed out, a few more setting options to emulate what lower machines now do) to many, this is more dangerous to those who are pursuing Sleep Apnea treatment on their own, or with a doctor who does not -somehow- find the right settings.

Manufacturers create crippled machines, with the idea the product line creates more profit for them. That is, if the readers of this post has not been told, most machines are the same under the plastic, but with different programming in the Firmware. So the manufacturers create crippled machines, to create a product line of more expensive machines, to augment their profits.

It is all well and good for a manufacturer to charge more for the work they did to create the firmware for a machine, or for some better sensor in the machine. However, the design, engineering of some of these machines has been around for some years. It is a matter that for an AutoASV, they charge a few bucks more than what is the bottom of the line machine now, and I hope no longer manufacture crippled machines.

On the other hand, the RT for my DME said that over ninety percent of her clients have compliance only data, and are perfectly happy with their treatment. If one was to make an argument for the use of such machines, if they have problems they could have another sleep study, which should be more valuable the doc getting all the info from a full data machine.

Another question being which adds more cost to the system? Providing AutoASV machines versus anything else.

It is easy to realize that if the big two in the business, Resmed, and PR starting making AutoASV only, then some manufacturer will come along and make the bricks we all now loathe, and convince insurance companies to buy their bricks, and thereby push the idea of an AutoASV out.

I just went through a sleep study to qualify for a bi level machine. The cost of the sleep study was greater than the difference between a usual Auto with full data, and the Bi Level machine. The result of letting bean counters make medical decisions. Insurance companies that create regulations with the intent discouraging individuals from getting medical care. All the while wasting doctors time, who could be treating more people who desperately need sleep apnea treatment. And using up two hundred dollars more of my very limited money to qualify for a bi level machine. On the other hand, the result of a well run sleep study might reveal how to set my new Bi machine more accurately. Which is only valuable info If I also get the waiver of my Co-payment from the DME so I can get to keep the machine. A a big iffy.

Keep in mind, that someone who is in a fog from a lack of good sleep, with no background in Sleep Apnea treatment, or terminology, should not be setting their own autoASV.

Is this discussion about whether people should treat themselves, or have home studies, or use the Sleep Clinic system with Sleep Doctors? We can forecast that as technology improves, a person can bring home a piece of testing, self adjusting technology that is far superior to anything available to any one today, and not need to have a doctor involved at all.

Can someone define what the technology will be like? Starting with a list of, "Do No Harm." Features? Then all the detection features?

and how do you figure an asv could kill someone?

[Taringa542]

[quote="purple"]An ASV, without the proper settings, combined with some health problems can kill people, or cause real physical damage to the patients bodies.

Is there documented proof?

[purple]

One of the simplest. If a person can not exhale against pressure, and the machine is set to auto, a Leak can cause the machine to start increasing pressure. Not everyone wakes up when they can not get air. The machine decides the individual needs more pressure to open the airway, and increases the pressure again. In truth the Vent is the one machine can be programmed to evade this one scenario, but it does not mean that it will be. Not by a person who is sleep deprived foggy, with little knowledge of how to set the machine. Well.

There are several here who need to use a Vent, I am sure that they can describe their own personal horror scenario.

This is an excellent question to ask. As for the question of do I know of any specific case where this has occurred, no I do not.

However the person who asks the question might also realize that in the US, there is frequently attempts by medical examiners to find some reason for a death such that the hospital, doctor, is not likely to be sued.

Perhaps some of those who are trained RT's can come along share their wisdom on this subject.

Perhaps those who poised the question can look up Cheyne Stokes or Periodic Breathing, and give us their opinion.

[letsride]

Your post is confusing.
With the ASV being regulated by the settings.
The ASV always returns to the epap settings, which helps while you exhale.
What are you trying to say?

One of the simplest. If a person can not exhale against pressure, and the machine is set to auto, a Leak can cause the machine to start increasing pressure. Not everyone wakes up when they can not get air. The machine decides the individual needs more pressure to open the airway, and increases the pressure again. In truth the Vent is the one machine can be programmed to evade this one scenario, but it does not mean that it will be. Not by a person who is sleep deprived foggy, with little knowledge of how to set the machine. Well.

There are several here who need to use a Vent, I am sure that they can describe their own personal horror scenario.

This is an excellent question to ask. As for the question of do I know of any specific case where this has occurred, no I do not.

However the person who asks the question might also realize that in the US, there is frequently attempts by medical examiners to find some reason for a death such that the hospital, doctor, is not likely to be sued.

Perhaps some of those who are trained RT's can come along share their wisdom on this subject.

Perhaps those who poised the question can look up Cheyne Stokes or Periodic Breathing, and give us their opinion.