ASV users - which machine?

JohnBFisher wrote:First, that is the result from use of ASV, not untreated...

JohnBFisher - as always you are very informative. I am learning a lot here. My S9 VPAP ADAPT is scheduled for delivery Tuesday. I am very excited.

Here's hoping you will be happy with it. I've been VERY happy with my VPAP Adapt SV Enhanded unit. The S9 should add much more detailed data collection. I just wish they were as open as Respironics on collection and reporting of data. Respironics is headed down the correct path, at least in my opinion. Resmed, by trying to keep the data hidden (and making it harder to get proper reporting by the user) only complicates the situation. But otherwise I am very, very pleased with Resmed.

Updated info... I have still not been able to obtain detailed results from my sleep study (doctor hasn't actually read it yet, apparently, although the initial "scoring" of the study was evidently sufficient for her to write me a prescription for an ASV).

In any event, the DME is suggesting the Respironics model. This is making me nervous, perhaps irrationally, because I've liked so many features of my Resmed S9 Elite.

Can anyone with the Respironics model confirm that it is data-capable-- that I can actually see my nightly AHI results onscreen? And can anyone confirm whether/how software is available in order to access more detailed information?

And is it quiet? As quiet as the ResMed?

The DME is suggesting Respironics because apparently my prescription includes values for EPAP, IPAP, PS, and a backup rate, and only the Respironics model allows for a "backup rate" to be set. I'm told that the "backup rate" means ensuring that you breath a certain minimum number of times per minute. Does this make sense? The DME also said that they are preferring the Respironics because of better/more data that they feel they can get from it-- but most of the items that he listed about data they get from it is information I know I can get from my current S9 Elite, so I'm not sure that made a lot of sense to me.

Feeling nervous... any advice/answers appreciated.

wolewyck wrote:... Can anyone with the Respironics model confirm that it is data-capable-- that I can actually see my nightly AHI results onscreen? And can anyone confirm whether/how software is available in order to access more detailed information? ...

If anything Respironics makes it easier to obtain the data than Resmed. It is fully data capable.

Some reference pointers:

Machine - https://www.cpap.com/productpage/PR-Sys ... anced.html
Software - https://www.cpap.com/productpage/respir ... chine.html
With SD Card Reader - https://www.cpap.com/productpage/respir ... eader.html

They really make it easy in comparison to Resmed.

wolewyck wrote:... And is it quiet? As quiet as the ResMed? ...

Perhaps not as quiet as the Remed unit. But it's still pretty quiet. Besides once you are asleep the noise does not matter as much.

wolewyck wrote:... The DME is suggesting Respironics because apparently my prescription includes values for EPAP, IPAP, PS, and a backup rate, and only the Respironics model allows for a "backup rate" to be set. I'm told that the "backup rate" means ensuring that you breath a certain minimum number of times per minute. Does this make sense? ...

Yes. The Respironics unit has a lot more dials to jiggle than the Resmed. It can be more finely tuned to your needs.

wolewyck wrote:... The DME also said that they are preferring the Respironics because of better/more data that they feel they can get from it-- but most of the items that he listed about data they get from it is information I know I can get from my current S9 Elite, so I'm not sure that made a lot of sense to me. ...

Perhaps was true in the past, but they are fairly equal in the data collection at this point.

wolewyck wrote:... Feeling nervous... any advice/answers appreciated. ...

I used only Respironics for 18 of my 20 years of xPAP therapy. They are true workhorses. I think you will be pleased with either Respironics or Resmed.

Oh, a few differences:

First, it's a small thing, but one my lungs like. You can purchase a fine filter for the Respironics. Resmed does not have anything like that. It seems to help me from getting as many colds. We have a fairly dusty house, so this makes a big difference for me.

Second, the Respironics unit uses straight 12V power. That's cheaper and more effective when away from normal house power. The Resmed unit requires either an inverter (to convert from 12V DC to 120V AC) or a converter (to convert from 12V DC to 24V DC). Either way it's more expensive than just plugging into a 12V DC source.

Third, the Resmed does have a climateline. Nice, but not really necessary in most of the US. If it gets really cold in your area, you may need a hose cover and/or even a heater. But most of the US does not require that.

Fourth, both units can use the same masks. Due to the strong swings in pressure (to sustain your breathing), I recommend (and use) a full face mask. I've used both the Quattro FFM and the Quattro FX FFM. I also recommend a mask liner (either Pad-a-cheek or REMzzzzs). This helps maintain the seal even when the pressure suddenly increases. Without it, the mask starts to leak and awakens me.

Fifth, the Respironics (even with Bi-Flex) is not as smooth breathing as the Resmed. But once you sleep with it for a couple nights you won't notice the difference. And once you are asleep you will not notice the difference.

Anyway, I hope that helps.

So, this is not so good. Just got a machine, and what I was given is this:

http://bipapautosvadvanced.respironics.com/

This is different from the two machine models that you posted about, John B...? I've had only one night on it, but compared with my S9 Elite, it is really noisy. Worse, as far as I can tell, it won't show me my own data. I was told that it would do that, but following the DME's instructions does not show me any AHI figures, and I have my doubts since the DME by his own admission wasn't fully sure how to set it up anyway. AARGH.

see if you can get a PR S1 version (newer equipment)... that'll show you more data on screen, and allow you to use some of the new tools being developed by folks on the board. Should be quieter as well.

wolewyck wrote:I'm looking for people's recommendations on ASV machines. I know I certainly want something data-capable and quiet. I've been very happy with the Resmed S9 Elite (except of course that it hasn't treated my centrals). Is there a similar model that has ASV capability? Or do people suggest something else for whatever reason? Thanks so much!!

(I'm sure some thoughts are in the archives, somewhere --- I've done a little poking around but didn't find a hit easily, and and since a new machine is being ordered for me really soon, want to suggest something to my doctor before it's a done deal.)

Reply:


Here is a recent comparison between Resmed VPAP-AdaptSV and Respironics BIPAP-AutoSV:

If I was you I would consider purchasing the original report for $31.50.
(and post it here for our comments)

http://www.sciencedirect.com/science/ar ... 5711001092

wolewyck wrote:So, this is not so good. Just got a machine, and what I was given is this:

http://bipapautosvadvanced.respironics.com/

This is different from the two machine models that you posted about, John B...? I've had only one night on it, but compared with my S9 Elite, it is really noisy. Worse, as far as I can tell, it won't show me my own data. I was told that it would do that, but following the DME's instructions does not show me any AHI figures, and I have my doubts since the DME by his own admission wasn't fully sure how to set it up anyway. AARGH.

As cflame1 notes, you may be able to strong arm the DME to get the PR System One AutoSV unit. But baring that, you should be able to get the data from your machine using the Smart Card included with it. The data can be read using the Encore Viewer and a Smart Card reader:

https://www.cpap.com/productpage/respir ... eader.html

My DME passed the "older" machine off on me too, after the newer System One ASV had been announced. My suspicion is that you'll have a hard time getting them to agree to do a swap now that you've used it for home -- but there's no harm in trying. Let us know how it goes!

Even if they don't, the differences between the two are functionally rather minor. The newer one is smaller and doesn't have the same bulky power supply setup. And it can produce waveform reports, which are neat but in most cases non-essential. But you're going to get good therapy (and the same basic type of therapy) from either unit, so I wouldn't lose sleep over it. No pun intended!

Great news. I was able to get a different machine-- the other option was the ResMed VPAP, which as I mentioned, I was kind of interested in anyway because of things I'd liked a lot about the Elite (QUIET, heated tube, small size for travel...). Anyway, they just dropped it off. I obviously haven't slept with it yet, but my initial impression is MUCH better. It's whisper-quiet, like my CPAP so I can actually now hear the birds in the morning again instead of a vacuum cleaner. And, based on a few minutes of testing, it does not seem do something annoying that the other machine was doing (both the Respironics machine used during my sleep study and the Respironics unit they initially gave me). Basically, while I was trying to fall asleep, most of the time (but not always) while I would exhale, it would suddenly ramp up the pressure-- against my ongoing exhale. This was disconcerting to say the least, and it made it much harder for me to actually fall asleep-- not something I typically have problems with (luckily!). The ResMed machine was not doing that, at least based on the short initial test.

My theory is that this has to do with the backup rate setting, which is a setting that the Respironics machine has, but the ResMed doesn't. My understanding is that the backup rate setting means, X breaths per minute. It's supposed to ensure that you really keep breathing enough. Maybe the backup rate setting was the right one for when I was actually asleep, but my guess is that it was trying to make me breathe in accordance with a particular frequency while I was still awake (trying to fall asleep), and that my natural breath rate while falling asleep may not really be the same as when I am asleep, and thus the sensation that I was fighting the machine while trying to fall sleep. I am hoping that
this will not be the case with the ResMed, given that it doesn't have this "feature".

Also in good news, I get to keep my original S9 Elite (yay!!). Since the same humidifier works with both machines, I didn't get a new humidifier-- but at least I can keep the CPAP a backup.

avi123 wrote:

wolewyck wrote:I'm looking for people's recommendations on ASV machines. I know I certainly want something data-capable and quiet. I've been very happy with the Resmed S9 Elite (except of course that it hasn't treated my centrals). Is there a similar model that has ASV capability? Or do people suggest something else for whatever reason? Thanks so much!!

(I'm sure some thoughts are in the archives, somewhere --- I've done a little poking around but didn't find a hit easily, and and since a new machine is being ordered for me really soon, want to suggest something to my doctor before it's a done deal.)

Reply:


Here is a recent comparison between Resmed VPAP-AdaptSV and Respironics BIPAP-AutoSV:

If I was you I would consider purchasing the original report for $31.50.
(and post it here for our comments)

http://www.sciencedirect.com/science/ar ... 5711001092

I have free access to the article:

http://www.4shared.com/document/z-Y-6PZu/asv.html

-A

wolewyck wrote:Great news. I was able to get a different machine-- the other option was the ResMed VPAP, which as I mentioned, I was kind of interested in anyway because of things I'd liked a lot about the Elite (QUIET, heated tube, small size for travel...). Anyway, they just dropped it off...
Also in good news, I get to keep my original S9 Elite (yay!!). Since the same humidifier works with both machines, I didn't get a new humidifier-- but at least I can keep the CPAP a backup.

wolewyck - great news for you! Did you get the ResMed vpap adapt?

I have had mine for 2 weeks now and absolutely love it! When I first got hooked up, I thought "oh my gosh, what have I gotten myself into?" but that feeling passed within minutes. Results are great, zero ahi and zero centrals. I am also monitoring spo2 and the desats <88% are totally eliminated although I am hoping to get average spo2 above 91-92%. I will see what my doc says at follow-up. Feeling good too.

I did do one bad though - the first night I tried my Swift FX and got bursts of air into my cheeks which awakened me. I switched over to Quattro FX BUT forgot to change the machine from "pillows" to "mask" - I had it that way for 9 nights and it was not great. Big face farts - I told my DH that I was learning to play the bagpipes. Much better after I realized the error and changed the machine. The Q FX was "ok" but leaky. Last night I switched to the Mirage Quattro and could not believe the difference. Absolutely no leaks awakening me! I also noticed that the airflow in the mask seemed quite different - the pressure felt not so "puffy" - I don't know how else to describe it. But overall, breathing with the machine is so smooth! Anyone else experience that kind of a difference with different masks?

I also have my S9 autoset as a backup, but I have wondered if it would be better to sell that and find a used asv for backup. What are the opinions of the rest of you ASV'er's? I really like the fact that humidifiers and climatelines are duplicated so I really have a good backup with keeping the autoset, but it is not an asv... Comments from others?

Good luck with your new vpap!!

My first night on the new machine (yes, ResMed VPAP Adapt) produced goose eggs-- you got it, an AHI of 0.0! This has never happened before-- my all-time low previously was 0.7, and over the past nine months, about 1.5% of my numbers have been below 1.

The experience of falling asleep was harder than usual, but mostly not due to the machine. I was up way, way too late last night and consequently had a bit of insomnia... True, the machine was less comfy than the CPAP I've been used to, but its "breathing" style was much less annoying than the one they had in the sleep lab (and the one they had initially given me). Overall, I do not anticipate having significant problems adjusting. Also, my pressure setting is a bit higher. This makes my mask (Swift FX) a bit more prone to being leaky, which is annoying, although I was able to readjust it reasonably after some tweaking. The other minor downside is aerophagia, but hopefully that will go away with more use... A really good first night!

Hope things continue well for you.

Another user noted, and I tend to agree, the Resmed ASV units are real "task masters" when it comes to breathing. So, if your breath becomes shallow, slows, or stops, it WILL compensate. You WILL breathe. But that enforced breathing means that once I get to sleep it helps me maintain my breathing. It acts rather as a breathing pacemaker.

Of course, that also means that the pressure changes are constant and can cause almost any mask to leak. But you will adjust to that. With nasal and full face masks, I recommend the addition of a mask liner to help the mask maintain a better fit.

As you also noted, the Resmed ASV machines employ a unique "Easy Breathe" waveform to make it easier to breathe using their machines. You can read more about it at:

http://www.resmed.com/au/products/s9_vp ... s/asv.html

Hope you continue to adjust and enjoy your new unit.

JohnBFisher: Since you're the resident expert with experience on both brands' ASVs, I have a follow-up question for you. You've laid out the differences in the machines and how they behave pretty clearly. However, is there any way for a prospective patient to deduce which might offer them better therapy? For example (and I'm just spitballing here), does one brand respond better to traditional CSB? Or ComplexSAS? Or hypopneas?

My question is not entirely academic. There's an outside chance I might get to play switcharoo on my own ASV, so given that the non-System One Respironics ASV hasn't gotten me under control yet, I'm trying to ascertain whether I'd be better served getting the new System One (which I've gathered has some slightly different algorithms) or switching to ResMed.