AirCurve vs AirSense

Kind of an off-topic thread, but I was wondering if anyone was familiar with the internals of these two machines in comparison with each other. In the tech industry it's fairly common for two products to be exactly the same internally, but have different software that limits features on the cheaper one. Does the AirCruve have the same internals (especially the blower) as the Airsense, just with more features driven by software? They seem to use the same humidifier tank and same body, so that makes me curious.

And second question - is there any benefit to using an AirCurve ASV even if you don't need the higher pressures? They say it "automatically adjusts the expiratory pressure in order to provide the minimum pressure required to maintain upper airway patency", which seems like it would be more comfortable than normal APAP with basic EPR. If money were no object, would the AirCurve ASV be the best machine to get?

juaquin wrote: ↑

Fri Dec 14, 2018 11:23 pm

Kind of an off-topic thread, but I was wondering if anyone was familiar with the internals of these two machines in comparison with each other. In the tech industry it's fairly common for two products to be exactly the same internally, but have different software that limits features on the cheaper one. Does the AirCruve have the same internals (especially the blower) as the Airsense, just with more features driven by software? They seem to use the same humidifier tank and same body, so that makes me curious.

I haven't disassembled any Air machines, but I have disassembled a variety of S9 machines, and they all use the same internals: https://imgur.com/a/S0ojG

I believe I've heard from people that the air10 lines are the same, the only difference being the plastics, and the firmware.

juaquin wrote: ↑

Fri Dec 14, 2018 11:23 pm

And second question - is there any benefit to using an AirCurve ASV even if you don't need the higher pressures? They say it "automatically adjusts the expiratory pressure in order to provide the minimum pressure required to maintain upper airway patency", which seems like it would be more comfortable than normal APAP with basic EPR

Er, actually, that *IS* normal APAP with EPR.

palerider wrote: ↑

Sat Dec 15, 2018 2:16 am

Er, actually, that *IS* normal APAP with EPR.

My understanding was that the "EPR" on the ASV could go much higher than 3cm, and it could be varied based on need at that moment rather than set to a static value. The marketing says it "responds within the breath" so I'm assuming that means it's varying pressure at a much more granular level than the Airsense Autoset, which only varies the pressure over many breaths, rather than within each individual breathe.

From everything I've read, ASV is only used after bilevel and CPAP/APAP prove to be insufficient, probably because of the cost. But beyond the cost, I'm not sure what the downsides would be - it seems to be a much smarter and possibly more gentle algorithm, monitoring each breath and providing support exactly where necessary.

Interesting to hear that (at least most of) the necessary hardware is in all of the machines, considering the massive price difference between the APAP and bilevel/ASV models.

I have used ASV only because I wanted to try it and I don't need it as I don't have issues with centrals.
The faster response to obstructive stuff will allow a person to set a lower EPAP baseline than they might use on an apap or regular bilevel and still get good results.

Pretty sweet really...the pressure changes (some pretty substantial and quick when I would have a random sleep onset central) I slept right through them.

juaquin wrote: ↑

Sun Dec 16, 2018 4:39 pm

palerider wrote: ↑

Sat Dec 15, 2018 2:16 am

Er, actually, that *IS* normal APAP with EPR.

My understanding was that the "EPR" on the ASV could go much higher than 3cm, and it could be varied based on need at that moment rather than set to a static value. The marketing says it "responds within the breath" so I'm assuming that means it's varying pressure at a much more granular level than the Airsense Autoset, which only varies the pressure over many breaths, rather than within each individual breathe.

You quoted "automatically adjusts the expiratory pressure in order to provide the minimum pressure required to maintain upper airway patency",

And that is *exactly* what an APAP does.

An ASV has no EPR, (EPR is a pressure DROP from the set pressure). but you weren't talking about pressure changes during breathing, you specifically quoted the adjustment of expiratory pressure, ie EPAP, and that behavior is the same as an APAP.

Now, when you get into the breath by breath variability of IPAP (and the consequential variability of Pressure Support, then yes, that is completely different.

palerider wrote: ↑

Sun Dec 16, 2018 5:19 pm

Now, when you get into the breath by breath variability of IPAP (and the consequential variability of Pressure Support, then yes, that is completely different.

Great! Now that we're on the same page, I'm hoping you or more people (thanks Pugsy!) have input on the differences between the two systems. I'm curious if ASV is a "better" algorithm for many people but we only get APAP because it works well enough and it's cheaper for the insurance companies.

juaquin wrote: ↑

Mon Dec 17, 2018 1:26 am

palerider wrote: ↑

Sun Dec 16, 2018 5:19 pm

Now, when you get into the breath by breath variability of IPAP (and the consequential variability of Pressure Support, then yes, that is completely different.

Great! Now that we're on the same page, I'm hoping you or more people (thanks Pugsy!) have input on the differences between the two systems. I'm curious if ASV is a "better" algorithm for many people but we only get APAP because it works well enough and it's cheaper for the insurance companies.

The ASV was designed to breathe for you when you didn't try to breathe (central apnea) and to normalize breathing when there were central apneas present.

So, no, it's not "better" for many people. Now, if you have some type of central apnea, then, yes, it's 'better' for you.

It's not necessarily "better" when you don't need to use something but you do go ahead and use it like I did with my ASV use.
It's just a different way of getting a job done.
If you don't mind super fast switches in pressure (i.e I sleep right through them) then ASV will let you use lower pressures for baseline EPAP because it doesn't need as much of a head start for obstructives in some people.
ASV can be used for just OSA...doesn't have to be limited to people with centrals if they don't mind forking over the big bucks out of their pocket because no way will insurance or a doctor ever prescribe or pay for it unless there is a problem with centrals.
I bought my machine privately....just to try it for grins because someone else tried one and they didn't have centrals either but they liked it.

I actually have the opinion that all machines should have all the various capabilities out there and people should get to play with them all and see which one they do the best with in terms of sleep and therapy. There are such machines out there but the cost is prohibitive for most of us and they are extremely hard to find.

I am back to using regular apap now...wanted to try the AirSense/AirCurve model...and my S9 Adapt (the ASV) was getting long in the tooth and a ran across a forum member who really needed the central addressing part of things so I sold it and got AirSense/AirCurve.
I do just as well on regular apap...still get great numbers...still get decent sleep considering other health issues...still get to use relatively low baseline EPAP and have the machine do a great job.

palerider wrote: ↑

Mon Dec 17, 2018 3:03 am

The ASV was designed to breathe for you when you didn't try to breathe (central apnea) and to normalize breathing when there were central apneas present.

So, no, it's not "better" for many people.

Surely you can see how a more adaptive algorithm could be better even for OSA users. It is designed for people who have centrals on APAP, yes, but of course it still treats OSA, and I'm thinking potentially better than APAP depending on the user. Just like some users here prefer the "For Her" mode even if they aren't women. The world is not black and white.

I'll keep an eye out for a good deal on a used ASV model and maybe give it a shot. Appreciate the constructive input Pugsy!

juaquin wrote: ↑

Mon Dec 17, 2018 10:53 am

palerider wrote: ↑

Mon Dec 17, 2018 3:03 am

The ASV was designed to breathe for you when you didn't try to breathe (central apnea) and to normalize breathing when there were central apneas present.

So, no, it's not "better" for many people.

Surely you can see how a more adaptive algorithm could be better even for OSA users.

NO, you just don't understand.

It's not a "more adaptive algorithm", it's a mix between the exact same algorithm and a completely different algorithm. It's not apples to apples, or even apples to oranges, it's apples to a steam locomotive.

If you get a S9 VPAP Adapt REF 36007, then you've gotten yourself a *plain fixed pressure machine* as far as obstructive apnea is concerned. If you get a S9 VPAP Adapt REF 36037, then you've got an APAP, because it has a mode that will vary the EPAP, like an auto machine.

However, unlike an auto, it will vary the PS on a breath by breath basis, and that may help with flow limitations, snoring and hypopneas. It can vary the PS *violently*, depending on setting, potentially going from 0 one breath to 21 the next, which can take some getting used to. Will it harm you? no, will it benefit you, maybe.

juaquin wrote: ↑

Mon Dec 17, 2018 10:53 am

. It is designed for people who have centrals on APAP, yes, but of course it still treats OSA, and I'm thinking potentially better than APAP depending on the user.

No, not at all. It's designed for people that have *centrals* period, apap or not. People that don't have any legitimate centrals will see very little, if any benefit from the machine, though it will probably show a lower AHI, since it doesn't record centrals, and it has enough PS to make many/most hypopneas a thing of the past.

juaquin wrote: ↑

Mon Dec 17, 2018 10:53 am

Just like some users here prefer the "For Her" mode even if they aren't women. The world is not black and white.

No, the world isn't black and white, that's a ridiculous thing to say, but you absolutely do not understand what you're talking about. the "for her" mode is nothing more than a slightly tweaked standard Autoset algorithm, the pressure differential between inhale and exhale *does not vary*, unlike in an ASV.

juaquin wrote: ↑

Mon Dec 17, 2018 10:53 am

I'll keep an eye out for a good deal on a used ASV model and maybe give it a shot. Appreciate the constructive input Pugsy!

Go ahead, there's no harm in it.

palerider wrote: ↑

Mon Dec 17, 2018 11:53 am

Will it harm you? no, will it benefit you, maybe.

That's a lot of words just to say you agree with me. Appreciate the input!

juaquin wrote: ↑

Mon Dec 17, 2018 12:33 pm

palerider wrote: ↑

Mon Dec 17, 2018 11:53 am

Will it harm you? no, will it benefit you, maybe.

That's a lot of words just to say you agree with me. Appreciate the input!

No, I don't agree with the things you've said, because they're wrong, and you don't understand what you're saying, and I don't want other people to be mislead.

You're free to think whatever you want, but others shouldn't be led astray.

Juaquin may be PR's new DH.