Auto SV

Please Does Anyone Know The Difference Between The Respirinics Auto SV And The Resmed Vpap Adapt SV
Which Is Better For Central Sleep Apnea
Thanking You In Advance
Mike...UK

Sessnazx wrote:Please Does Anyone Know The Difference Between The Respirinics Auto SV And The Resmed Vpap Adapt SV
Which Is Better For Central Sleep Apnea
Thanking You In Advance
Mike...UK

Mike,

Each is effective in its own way. Unfortunately short of any of us saying other than exactly that, you will be hard pressed to get a meaningful opinion.

Can you ask to trial each machine ?

Good luck

DSM

Sessnazx wrote:Please Does Anyone Know The Difference Between The Respirinics Auto SV And The Resmed Vpap Adapt SV
Which Is Better For Central Sleep Apnea
Thanking You In Advance
Mike...UK

Mike, what type of central apnea sleep problems do you have? More detail can help. I have used (during the titration study) the Respironics BiPAP Auto SV unit. My DME set me up with a ResMed VPAP Adapt SV unit. I now use that quite successfully.

Why did my DME switch? They find most people do fairly well with the ResMed ASV unit. But since they typcially set up a rental to purchase, they will switch to the Respironics if the ResMed does not work.

In my case, the ResMed unit does a great job handling the central apneas. (My last BiPAP titration shows six times the number of central apneas as obstructive apneas). To my knowledge, I do not have any problems with Periodic Breathing nor any cardiac problems. So, the ResMed unit is only correcting the central and obstructive apneas. And it seems to be doing that well.

The Respironics ASV unit has more settings. That can make it harder to "dial in" the proper therapy. But does it work. Yes. As I noted during my ASV titration the lab used the Respironics unit. It worked well.

But the Respironics unit does work slightly differently than the ResMed unit. In essence, the Respironics unit appears to monitor the pattern of breathing and makes certain your pattern does not fall apart. The ResMed unit appears to monitor the volume of air you breathe and helps maintain that. As a result, DSM notes that ResMed unit is more of a task master making certain you breathe. For me with the central apneas, that's just what the doctor ordered ... literally!

Hope that helps.

Short version?

ResMed Adapt SV.

No contest..

Banned

Guest wrote:Short version?

ResMed Adapt SV.

No contest..

Banned

That's ridiculous, imho, unless you're talking only about which one you think suits you better, Banned.

Of the people who really do need SV therapy, some people do better on the Respironics BiPAP Auto SV. Some people do better on the ResMed VPAP Adapt SV.

There's not much way to know which would suit you better, Sessnazx, without having a sleep lab titration night on each of them. Easier said than done, of course.

A trial at home with each for a week or two would be the next best way to find out. Again, easier said than done.

Good luck, Sessnazx!

rested gal wrote:That's ridiculous, imho, unless you're talking only about which one you think suits you better, Banned.

Thank you for the clarification, RG.

Banned

Many, many Thanks for your advise,
Did'nt know there were so many prepared to help a
and advise
Thanks again
Mike (custer)

custer wrote:Many, many Thanks for your advise,
Did'nt know there were so many prepared to help a
and advise
Thanks again
Mike (custer)

Mike,

I plan to write a report on cpaptalk in a few days, with graphs, related to mask leaks and how devastating they are when using the Vpap Adapt SV. It is a good example of a machine that is in my mind the best in the world but only when there are *no* leaks. When there are leaks the machine becomes a problem.

The Bipap Auto SV is good - it is highly configurable but the reality is few of us will ever use the vast array of settings on it & anyone who messes with them runs the risk of losing control of the machine.

Re leaks - Thanks to the cleverness of Karen at PADACHEEK I have found a way to at long last, eliminate them. Karen sent me a sample of a new inexpensive ($10 I believe) add on strap for my quattro mask that has taken me from repeated leaks (despite new seal & new straps) to what is effectively 0 (yes zero) leaking and at last I am getting the real benefits of the Vpap Auto SV machine which when there are no leaks is to me the best therapy machine available.

Good luck on your quest.

DSM

I was originally put on a bipap AVAPS which is similar to the Adapt SV using the volume as the mean point.. I was failing on that machine. It could / would not keep up with my central apnea..


I was switched to AutoSV, what a difference.. THis is night and day... even using the machine to me is more comfortable and easy going. It seems to understand how i breath and dosnt force me to breath just helps.. It also knows when something is coming something in the algorythm detects an oncoming event and eliminates it.. my last machine i was still having central apneas on par of 100 times an hour... down only from 131 an hour before the machine... now on the AutoSV its down to 2 - 7 an hour... AMAZING difference... it took many setting changes and had to monitor the data almost nightly for a few weeks before this was done properly...

Ipap max 20 Ipap Min 12 epap 7 BR 13

Now keep in mind this was for my unique situation... and the best way I have found to deal with anything that includes sleep apnea, is to try and experiment. I made my insurance company go through 4 masks before I found the Swift FX and its the most comfortable thing ever.... same with the machine, the first just didnt cut it and I would have never known till i tried it...


Good luck.

I really like the "feel" of the therapy I got on my Respironics Bipap Auto. I also like the treatment on my Bipap S/T.

I haven't had a chance to try a Respironics Bipap Auto SV, but I look forward to it.


Edit - removed irrelevant mumble ...

Best,
Michael

doughsthoughts wrote:... I was originally put on a bipap AVAPS which is similar to the Adapt SV using the volume as the mean point.. ...

Actually, they are not alike at all. The Auto SV unit uses the volume to try to stabilize breathing (to avoid the cycle of hyperventilation, then hypoventilation). It addresses problems related to central sleep apnea.

The AVAPS is designed to help maintain volume to a sufficient level. It attempts to maintain volume to help those with restrictive lung disease (such as due to obesity or COPD). It does not track the breathing cycle other than to track the volume.

So, they are both respiratory tools. One is a hammer. The other is a saw. They are both hand tools, but otherwise they are quite dissimilar.

doughsthoughts wrote:... I was switched to AutoSV, what a difference ... It seems to understand how i breath and dosnt force me to breath just helps ...

Exactly. It does not guarantee the volume. Instead it tries to maintain the volume enough to help maintain a normal breathing pattern. It helps avoid the cycle of hyperventilation / hypoventilation associated with central apneas.

doughsthoughts wrote:... It also knows when something is coming something in the algorythm detects an oncoming event and eliminates it ...

Think of it rather a using an ounce of prevention to avoid a pound of cure. Rather than addressing the central apnea, it tries to smooth the normal breathing cycle. By stabilizing the breathing the central apneas are eliminated.

But it's good to hear that this therapy works well for you.

Thanks John, that is a nice explanation of the differences!

I'm afraid I was a little fuzzy last night. Posting after I took Sonata .... not a really good idea. Even I'm not always sure what I am trying to say.

Which brings up a question for ya'll. The last two nights when I have taken Sonata at bed time. After I fall asleep, I have a group of apneas and hypopneas during the first hour of sleep. Then I am back to my "normal" AHI level on the VPAP ASV, which is a handful of hypopneas through the night. Last week I went 6 days with no apneas.

For example, last night I had 5 apneas and 15+ hypopneas in a 45 mionute period, starting about 15 minutes after I fell asleep. It was not related to position, as the only position I can really lie in comfortably with the "double hose" on the VPAP is my left side. I sometimes switch to my right side, but I don't stay there long, due to mechanical pain in my neck when I lay on my right side.

I even bumped up my EPAP and maximum PS by 1.0 last night from the night before to try to compensate. I know Sonata is short acting, and I assume it wears off after that first hour or so (I actually took it about 1 hours before I lay down and went to sleep I think.) Then I don't have as many apneas for teh rest of the night - I think 2 hypopneas a few hours later.

Any ideas as to why the VPAP doesn't keep them under control during taht first hour though? Maybe I'll try my Bipap Auto with Biflex (not the SV) the next time I take a Sonata.

Also, a little OT: Is there anyone who would want to trade a Bipap Auto SV for a ResMed VPAP ASV? Maybe even on a temporary basis? I have been thinking about trying out the Respironics.

Thanks!
Michael

unadog wrote:... The last two nights when I have taken Sonata at bed time. After I fall asleep, I have a group of apneas and hypopneas during the first hour of sleep. Then I am back to my "normal" AHI level on the VPAP ASV, which is a handful of hypopneas through the night. Last week I went 6 days with no apneas. ...

Perhaps I should find a program to paste common notes into this forum. This one comes up really frequently.

The following article explains WHY you experienced what you did:

Ventilation is unstable during drowsiness before sleep onset
http://jap.physiology.org/cgi/reprint/99/5/2036

Note that Sonata might contribute to this, as it (and other sleep medicines) can act as a mild central nervous system depressant. So, the Sonata could actually help amplify this instability during sleep onset. Fortunately, Sonata has a short duration of impact on the body.

Of course, remember that I just offer this as another fellow sojourner trying to puzzle out sleep issues.

Thank you John, that is interesting. I am aware of sleep onset central apneas.


Edit:

It is curious, though, that I **don't** get apneas at that same time without the Sonata. In fact, I went a full 7 nights last week, just prior to these 2 bad nights, with only 2 apneas **total** during that period. That is through all phases of being awake, sleep transition, sleep, and periods of insomnia! I was also on opiates at my full dose during that time.

I also thought the ASV would do a beter job of preventing/treating those apneas? It didn't seem to help much at all during that period? The AI during that 1/2 hour is about 10, the HI is about 40, and the AHI is about 50! That is about the same as when I had my titration study with a CPAP only at 12.0, prior to going on Bipap or ASV.

I thought an ASV would do a better job of controlling this? It would be really helpful to know if those were centrals.

It would also be interesting to repeat that experiment with a Bipap ASV, assuming that it is easily repeatible by taking Sonata. It seemed to occur in the same pattern 2 nighst in a row. I will see what happens tonight without Sonata.


During the previous 7 days, on average I had about 5 hypopneas per night. I had an HI around .6, an AI of 0.0 - except for two isolated apneas on two different nights - and no clear relationship of the hypopneas to sleep stage. That has been my usual pattern since going on the ASV after the first few nights of titration, resolving leaks, etc. I would have an apnea here and there, but usually isolated with no specific correlation.

It is quite interesting, too, because my neurologists recommended the Sonata to **decrease** central apneas caused by arousal and sleep fragmentation from pain. Unfortunately, the VPAP ASV can't discriminate between central and obstructive apneas (I don't have a ResLink, so no flow data), as we have discussed before. But in any case, the Sonata seems to have had the opposite effect! They recommended the Sonata because it wears off more quickly tahn the Lunesta or Ambien that I used to take.

I think a lot of what we know from the past counts as "urban myth", because it is based only on isolated lab sleep studies, with multiple variables. Now we have a wealth of detailed data that we collect day after day, so we can isolate smaller changes.

hi unadog, you're the first other person i've ever met that actually uses Sonata! Anyway, when I take Sonata I usually find that I sleep better, but I think that's because (I think) it stops my nightime (spontaneous?) arousals. I haven't checked to see how it affects my AHI.
But I can see how it would affect (depress) your nervous system to cause more central's.

Sonata is only supposed to last for 4 hours in the body, and from what I've read it's good take when you have trouble getting to sleep but it doesn't help maintain sleep. I can imagine that the strongest effect would be in the first hour.

Hey as to your offer to trade, I've got a Puriten Bennet 420E if you wanna trade I've been dying to try out something else besides a CPAP/APAP to see if it helps improve my sleep.