Choosing an ASV machine

moresleep wrote:I like my legacy Respironics ASV. I like its many settings, and its strong motor/blower with air valve--something few (any?) newer machines have. Unlike other machines I have used in the past, I never feel as though the blower slows me down when I take a quick breath. For me, it works significantly better than the Resmed ASV in terms of its breathing algorithym (I realize some others here feel the opposite way). Never having used the new Phillips Respironics System One ASV, the only two features it has that I know I would prefer are: it will run directly on 12 volts, and it records wave-form flow data, which would definitely be nice.

So, from a practical standpoint, the older version is equally as good in it's performance, and we're not really missing out on anything if we don't have the Sys One?

I have the Resmed S9 ASV and love it, wouldn't change a thing, usually sleep 8 to 9 hours a night with a AHI of less than 1. It has learned my sleep pattern and protects me ! Ive heard the Respironics ASV works great if its tweaked just right. More adjustments to play with, more to drive you nuts !

LittleRedTruck wrote:Ive heard the Respironics ASV works great if its tweaked just right. More adjustments to play with, more to drive you nuts !

That's the problem...these machines are awesome and quite complex, but trying to find someone who really knows how to tweak it is next to impossible. When you've got everything but obstructive sleep apnea and instead have other breathing issues (or as the RT told me, I have the whole 'potpourri' ), it's difficult knowing exactly which setting to tweak and how much to tweak it in order handle which particular breathing issues.

Therefore one ends up playing a guessing game and as you say, it drives ya nuts.

ameriken wrote:

moresleep wrote:I like my legacy Respironics ASV. I like its many settings, and its strong motor/blower with air valve--something few (any?) newer machines have. Unlike other machines I have used in the past, I never feel as though the blower slows me down when I take a quick breath. For me, it works significantly better than the Resmed ASV in terms of its breathing algorithym (I realize some others here feel the opposite way). Never having used the new Phillips Respironics System One ASV, the only two features it has that I know I would prefer are: it will run directly on 12 volts, and it records wave-form flow data, which would definitely be nice.

So, from a practical standpoint, the older version is equally as good in it's performance, and we're not really missing out on anything if we don't have the Sys One?

Aside from direct 12-volt capability and full waveform flow data that the Sys One adds, I don't know of anything we're missing out on. In fact, I believe I read that the Sys One AVS does not use an air valve but just relies on speeding up and slowing down the turbine/blower to change pressure, whereas the legacy AVS has a more expensive air valve system, allowing more robust blower performance and faster changes in pressure (since pressure can be changed without changing the speed of the blower). People have said the System One AVS has a breathing algorithym more like that of the Resmed AVS, which some view as an improvement; but for me that would not be a plus. Since which AVS machine works best seems to be such an individual affair, I'm afraid a Respironics AVS user would have to compare the Legacy and Sys One in actual use on successive nights to get a firm grasp on the differences and see which worked best, and even then the next person might not agree. I haven't yet read that kind of comparison report.

I am newly diagnosed with CSA and am scheduled to be fitted with an ASV type machine next week, which I am told will be a ResMed Adapt model machine.

But when I get home and go to the ResMed website, I see two such machines - one an S9 VPAP Adapt and one a VPAP Adapt SV.
Are these both current models or does the S9 replace the other one?
If both are still current, what is the difference in operation, cost, Medicare coverage etc.?

I see the Humidifier snaps right onto the S9 but nothing like that is shown for the other model.
If I am going to want a humidifier, should I insist on getting the S9?

This is my first experience with any kind of PAP machine or any treatment for apnea, so please forgive me if I am not following protocol in joining this board tonight or in the way I asked my questions.

I will be grateful for all replies and/or advice.

NateS wrote:I am newly diagnosed with CSA and am scheduled to be fitted with an ASV type machine next week, which I am told will be a ResMed Adapt model machine.

But when I get home and go to the ResMed website, I see two such machines - one an S9 VPAP Adapt and one a VPAP Adapt SV.
Are these both current models or does the S9 replace the other one?
If both are still current, what is the difference in operation, cost, Medicare coverage etc.?

I see the Humidifier snaps right onto the S9 but nothing like that is shown for the other model.
If I am going to want a humidifier, should I insist on getting the S9?

This is my first experience with any kind of PAP machine or any treatment for apnea, so please forgive me if I am not following protocol in joining this board tonight or in the way I asked my questions.

I will be grateful for all replies and/or advice.

The S9 model is the most current. The S9 model is smaller and easier to transport. It also does not have an extra pressure line to measure the pressure at the mask. That is a good thing. The older model *may* be cheaper. It depends on your DME. Coverage should be the same for both.

Hope that helps.

JohnBFisher wrote:

NateS wrote:I am newly diagnosed with CSA and am scheduled to be fitted with an ASV type machine next week, which I am told will be a ResMed Adapt model machine.

But when I get home and go to the ResMed website, I see two such machines - one an S9 VPAP Adapt and one a VPAP Adapt SV.
Are these both current models or does the S9 replace the other one?
If both are still current, what is the difference in operation, cost, Medicare coverage etc.?

I see the Humidifier snaps right onto the S9 but nothing like that is shown for the other model.
If I am going to want a humidifier, should I insist on getting the S9?

This is my first experience with any kind of PAP machine or any treatment for apnea, so please forgive me if I am not following protocol in joining this board tonight or in the way I asked my questions.

I will be grateful for all replies and/or advice.

The S9 model is the most current. The S9 model is smaller and easier to transport. It also does not have an extra pressure line to measure the pressure at the mask. That is a good thing. The older model *may* be cheaper. It depends on your DME. Coverage should be the same for both.

Hope that helps.

John, Thanks very very much for your prompt and helpful reply.

A followup question - You say the older model may be cheaper, but that it depends on the DME? Does it depend on the DME or on me? Do I have a right to insist on the newer machine without paying extra for it if it is the most current model? I am on Medicare and have Medigap coverage too.

Best wishes, Nate

NateS wrote:... A followup question - You say the older model may be cheaper, but that it depends on the DME? Does it depend on the DME or on me? Do I have a right to insist on the newer machine without paying extra for it if it is the most current model? I am on Medicare and have Medigap coverage too. ...

You should only be offered the S9 version of the unit. However, if a DME has an older version in stock and offers it to you, you should definitely ask for a MUCH lower price on it. The older units tend to sell for less than $500 if they have been used. I would not expect that a unused older unit should cost more than $2,000. But you would probably need to negotiate with them. If they insist on full Manufacturers Suggested Retail Price (MSRP), then you should insist on a new S9 unit.

In all probability you will be offered the S9 version, since most DMEs do not stock the ASV units (due to the high price). They tend to order them "as needed". Since Resmed (and Respironics) provides their units via overnight delivery, few DMEs see the need to maintain an inventory of these older units.

Still, it would not hurt to ask if there is an older / less expensive unit available if your out of pocket expenses would still be high.

As a caveat, I really don't know what the rules from Medicare might be. They might only pay for a new/current unit, so you might be restricted to the S9 option.

I hope that helps. Do keep us updated. And you've probably seen posts from other ASV users. It can take a while to get adjusted to the ASV unit. I still sometimes struggle with those pressure changes, the loss of seal from the mask, etc. Feel free to come here and ask as you start the process of adjusting your sleep to use of the ASV unit. Best wishes!

I have fairly serious CSA related to congestive heart failure. I tested recently with a RESMED ASV and it reduced my CSA almost to zero. So much for the good news. My HMO prescribed the machine, but when the supplier (APRIA) called I was notified it would be a rental! ..... and at what seems like a pretty high rental rate of $80/month. I would really rather purchase it. I'll go talk with my HMO Monday, but I've been hunting this evening and I can't seem to find anyone that carries a RESMED Autoset CS or CS-A in their catalog so I'm not quite sure of the price (Expecting around $3500) or if I can actually order one. Any help appreciated.

Check with your HMO. It may be that the "rental" comment has to do with a compliance period and not a long term pricing.

Our hosts have Respironics 960 ASV machines for around $3,500 ( I purchased mine there ) but other sites have them for less. The one site I found would not ship direct to me but would send to my sleep doctor who declined to be in the loop for delivery. I don't expect to see the ResMed available anywhere for less that the Manufacturer's Suggested Retail though.

A rental is exactly what I have - for another week. Then I own it. My insurance required a two-month trial to ensure compliance. I pay $125/mo for two months then my deductible on the third (for full) ownership. And yes, my rental was brand new.

I recently start using the Bi-Pap machine, after six long years of the C-pap machine which I hated every minute of wearing those unnatural mask that they sell you for outrages prices. I only had the new Bi-pap for 25 days now the Doctor tells me that after reviewing my new sleep study test she wants me to stop using the Bi-pap and go back to the C-pap, just until she can get a new ASV ordered for me. The Bi- Pap seems to help me much better but I still am awaking every 3 to four hours. These machine are very costly when your only receiving Social Security and just managing month to month. Maybe I can sell the machine on Ebay or something. I would like to know if the new Bi-pap can be used as a ASV if giving the right compatible attachments.

Thaddeus Garfield wrote:I recently start using the Bi-Pap machine, after six long years of the C-pap machine which I hated every minute of wearing those unnatural mask that they sell you for outrages prices. I only had the new Bi-pap for 25 days now the Doctor tells me that after reviewing my new sleep study test she wants me to stop using the Bi-pap and go back to the C-pap, just until she can get a new ASV ordered for me. ...I would like to know if the new Bi-pap can be used as a ASV if giving the right compatible attachments.

no

DonS wrote:I have fairly serious CSA related to congestive heart failure. I tested recently with a RESMED ASV and it reduced my CSA almost to zero. So much for the good news. My HMO prescribed the machine, but when the supplier (APRIA) called I was notified it would be a rental! ..... and at what seems like a pretty high rental rate of $80/month. I would really rather purchase it. I'll go talk with my HMO Monday, but I've been hunting this evening and I can't seem to find anyone that carries a RESMED Autoset CS or CS-A in their catalog so I'm not quite sure of the price (Expecting around $3500) or if I can actually order one. Any help appreciated.

Comment,

Don, are you talking about an S9 VPAP Adapt ASV machine (or similar) b/c of your congestive heart failure? If yes then IMO you need a reliable professional to go with it, be it a physician or an RT Tech who knows how to set it up for your case, and it's most likely not an DME salesman or a poster on this board.

Example: Here is a detail from John Fisher's post (above),

The S9 model is the most current. The S9 model is smaller and easier to transport. It also does not have an extra pressure line to measure the pressure at the mask. That is a good thing. The older model *may* be cheaper. It depends on your DME. Coverage should be the same for both.


my question,

why a machine which measures the mask pressure directly by using a separate hose or electric line is not better than a machine that does not do it? there are other makers than Resmed who make ASV Adapt machines who use such mask pressure sensors.