Resmed's VPAP Adapt SV machine may not work with your mask.

Resmed has done some testing for their new machine, and maybe it covers other Resmed machines, but the test is called "Learned circuit test".

The Resmed Swift failed it. The Ultra Mirage, Mirage Vista and Mirage Activa are the nasal masks that passed.

Just a head's up...I don't know which FF masks work on it....didn't ask, but I can if anyone is interested.

I wonder what their criteria was? Anyone familiar with this test???

Dave,

What I do know is that the Vpap Adapt uses an external pressure sensor line to the mask to accurately monitor pressure at the mask air inlet point.

The machine function is sensitive to masks that vary in leaks (as distinct from the predictable fixed leak rates).

From what I understand, anyone using one of these machines, has to go through a set-up procedure, part of which is determining if the mask being used with the patient (user) is going to fit within the operating parameters selected by way of basline pressure and the maximum pressures applied.

This machine in its present form does seem to require a qualified professional to do the fitting.

It is possible Resmed may come out with a down market model that is perhaps less sophisticated, but may not require professional set up.

Also from what I am seeing, these machines will be a lot less expensive than the VPAP III range traditionally were. Here in Australia I was told by someone who should know, that the Australian version will sell for less than half the price of a VPAP III S/T.

DSM

An internet provider said they will sell them for around $4200 and they will throw in a free mask.

I forget who it was but they had an idea of the pricing.

Thanks DSM, I didn't know for sure why my old mask wouldn't work, that explains it.

As I said, I would be happy if I could just get a month on it, to see if it would figure some things out. I like the Auto BiPAP just fine, but it is not designed to recognize Central Sleep Apneas, etc.

I see my dr. next week, so I always try to get my facts lined up before I go in.

$AUD4000 was the figure I was given (but being hearsay, I wouldn't swear by it being accurate).

Considering that the VPAP III sells here for $AUD 8,900 (S/T models are dearer again), the new VPAP Adapt seems a bargain price by comparison.

DSM

OUCH!!!

I hope my insurance covers it all. It is the time of the year to pay my deductible, so every day has a surprise.

Take care...

The ASV manual lists masks (ResMed of course) that they recommend with the machine. Several labs seem to have used other masks - dsm has the correct reasoning. The machine algorithm does not handle leaks well and prefers a leak rate below a specific level.

I use the resmed full face mask with the ASV - some nights it fits well, others it does not rate as high (the machine indicates leak rate and just how good the fit is).

Lubman

Lubman, I am not familiar with all the machines Resmed makes, the ASV does not appear to be the VPAP Adapt SV, but the reasoning DSM uses appears to be dead on.....

I would hate to leave Encore Pro. That is why I am going to ask for a 30 day test session. After sleeping over ten hours last night I may have trouble getting it. I am having a bad night (due to pain), then a good night when I take my break thru pain meds.

Thanks for the input...

The ASV is the ResMed Adapt SV (hence "ASV). They are one and the same.

I do miss the type of indices in Encore Pro - but perhaps we can get someone like Derek to do analysis sofware that takes the output of ResLink
and gives some useful indices for laymen who aren't good at evaluating Tidal Volume, etc.

Lubman

dllfo, forgive me for not remembering, but did your sleep study show up a LOT of central apneas as opposed to obstructive apneas?

I was looking at the Encore Pro data you sent me some time ago. It was full of OA's (obstructive apneas) and high AHI's from those OA's getting through. I think we talked about the possibility of GERD interfering with good treatment, and if I recall correctly you've gotten that addressed.

If obstructive apneas, as opposed to central apneas are your main problem, I'm not sure the ASV would be a good machine for you. But heck, a trial with any machine isn't a bad idea...you never know until you try it.

Good luck!

rested gal wrote:dllfo, forgive me for not remembering, but did your sleep study show up a LOT of central apneas as opposed to obstructive apneas?

I was looking at the Encore Pro data you sent me some time ago. It was full of OA's (obstructive apneas) and high AHI's from those OA's getting through. I think we talked about the possibility of GERD interfering with good treatment, and if I recall correctly you've gotten that addressed.

That's a good question about whether more than just a few incidental central apneas might have shown up during the PSG. Because the RemStars will score short-duration central apneas as if they were obstructive apneas.

That's why many people who have used a Remstar Auto and a 420e (such as myself) have noticed the 420e scoring incidental central apneas here and there while the Remstar does not. The Remstars are virtually guaranteed to have undifferentiated central apneas scored in that OA category for quite a few of us.

So Rested Gal's comment about noting exactly what occurred during the PSG by the way of central apneas is really a good point IMHO. However if nocturnal GERD enters the equation, I personally suspect that defensive vocal chord closures manifesting as obstructive apneas just may be happening for at least some of us (during those acid eruption episodes throughout the night). Apnea and acid reflux are, after all, statistically linked in a significant way. It really does get one to wondering...
.

I have/had GERD. I am mainlining Mylanta and taking 80mg of Nexium a day to keep it in check.

At the bottom of the page, under the graphs, it says I was in sleep stage one for 40 minutes and sleep stage 2 for 54.9 minutes. This is confusing to me because in another part of the report he said I slept 86 minutes.

I had 19 OSA, 59 Centrals, no mixed apneas. IS THAT POSSIBLE TO HAVE 59 CENTRAL SLEEP APNEAS IN 86 MINUTES? OR EVEN THE OTHER DATA WHERE I WAS IN STAGE 2 FOR 54.9 MINUTES??? And yes, I am shouting.

"SaO2 nadir of 72 percent from a sleep baseline of 92 percent was oserved. Sleep architecture was severely disrupted due to the frequency of the obstructive respirations and snoring. The overall RAI was 65.2 per hour and the AHI was 65.2 per hour. Frequent EKG abnormalities were observed during the baseline portion of the study in the form of PVCs and possible block (11:57, 12:13, 12:21, 12:52, 1:23). No significant leg movements of sleep were observed."

The data they submitted does not add up to me. Under CPAP Statistics they say I was titrated at 4.0 for 46.5 minutes; then at 6.0 for 65.3 minutes; at 8.0 for 18.1 minutes and 9.0 for 10.4 minutes : YET THEY SAID I ONLY SLEPT FOR 86 MINUTES? SO I WAS AWAKE WHILE TITRATION WAS GOING ON??

I guess they had EKG abnormalities.....I was having real bad chest pains and was afraid of Angina, so I gave myself a couple of hits with Nitrolingual. BUT I told their guy what I was doing. The chest pains went away after that.


SWS - - What would you say about OSA vs Centrals? 59 to 19 in 86 minutes per their written info. Based on that the ASV might be worth a trial. I am not even saying I want to keep it, just try it to see if we are missing Cent. Events because we aren't seeing them.

SWS - -you mention Remstars and I have a Respironics Auto BiPAP. Do you think they read things the same way? Do they share the same algorithms?

I am trying to sleep on my left side. I read that sleeping on your left side makes it almost impossible for stomach acid to move into the Esophagus.
So I am trying just about everything I can to stop GERD. I had some painful attacks a couple of weeks ago and have not had anything like that in the last ten days.

Because of the large amounts of morphine I have been taking, I keep a daily log of medical events, including when I took the nexium. Date, time and dosage for reconstruction, if needed.

By the way, they gave me a Flex Fit mask to use. I think that was the F&P nose mask. They did not mention leaks...that I remember.

I don't know if this is the info you were looking for, but as soon as I figure out how to download the data, I don't mind posting it here. I sent RG some data I had already downloaded to MS Word. I don't know of any other way to download or send it.

Thanks for the help.......

My ASV is costing me $125 a month in the copay (20%) so you can imagine how much they are charging the insurance. The insurance wants a rent for a number of months before purchase, they are so expensive.

About the mask problem in the learn ciruit. I do the LC using a standard vented Vista mask, one of the acceptable ones. Then I attach my nonvented Swift with its CO2 extender tubing and the Whisper vent that it between that and the hose from the machine about 13 inches from the mask, and use that setup.

It doesn't make sense to me to LC with a different mask, and such an extremely different one, but that is what the DME told me to do and Dr Gilmartin was really at a loss about it. I seemed to do okay, so we stuck with it. But haven't done a download or subsequent titration study to really know how it all is working for me. I do feel best with what I have now than any other system/setup.

[quote="dllfo"]IS THAT POSSIBLE TO HAVE 59 CENTRAL SLEEP APNEAS IN 86 MINUTES? OR EVEN THE OTHER DATA WHERE I WAS IN STAGE 2 FOR 54.9 MINUTES??? And yes, I am shouting.


Thanks for the help.......