What on earth is ASV?

Hi,

What is "ASV?"

Thanks.

ASV Adaptive servo ventilation machine.
Several different modalities...used for special cases where people have a lot of central apnea or all central apneas or a combination of obstructive and central events.
It acts like a ventilator and will actually force a breath if you don't breath on your own. Usually with a big burst of pressure.
Considered non invasive therapy.. Invasive with be the type of ventilators you see in the movies with the machine doing all the breathing through a trach in the throat and hooked up all the time.
ASV machine don't breathe for you unless it thinks you aren't doing good enough job on your own.

One of three basic types of XPAP machines..

tYPE 1 cpap AND autocpap
CPAP is a machine that gives a straight pressure
APAP is an auto CPAP, it adjusts the pressure

type 2 BIPAP autobipap and bipap S/T
BIPAP is bilevel (2) pap.. ONE PRESURE FOR INHALE ONE FOR EXHALE
autobipap is the automatic version
S/T is bipap on a (S) pontanious as well as (T) imes mode it can be either S or S/T... S/T sometimes addresses some central

Except for the BIPAP S/T mode you have to take a breath for the machine to help... it only addresses obstructive apneas..... the S/T is the first one that can deal with a central (you are not trying to breath)

SO now we are at your question ASV

Adaptive servo-ventilation this can look at the different stages of your breath and can adapt..... so it can address items that the others can not....


hope this helps

Pugsy wrote:ASV Adaptive servo ventilation machine.
Several different modalities...used for special cases where people have a lot of central apnea or all central apneas or a combination of obstructive and central events.
It acts like a ventilator and will actually force a breath if you don't breath on your own. Usually with a big burst of pressure.
Considered non invasive therapy.. Invasive with be the type of ventilators you see in the movies with the machine doing all the breathing through a trach in the throat and hooked up all the time.
ASV machine don't breathe for you unless it thinks you aren't doing good enough job on your own.

Thanks for the explanation.

There was a time when I could actually design and build such wondrous mechanisms. I sure hope I can get my mind back.

Maybe I should adopt Ozzy Osbourne's signature line:

"Of all the things I've lost, I miss my mind the most."

The American Standard Version.

Oh, wait, you mean the other one. Well . . .

The following seems to have been written back in the gung ho days when everyone thought ASV was gonna save the world. Things have calmed down a bit these days, I think, but the description here seems mostly on the money for the ResMed version, as best I can tell:

http://thesleepsite.com/content/view/76/91/

jnk, that's a good article .. as you said from the days of the introduction of the units ..

So, why has it not "caught on" for everyone? For two very simple reasons.

First of all, the cost of the unit remains MUCH higher than CPAP, APAP, BiLevel, or AutoBiLevel units. The PR System One ASV is $3,900.00:

https://www.cpap.com/productpage/PR-Sys ... anced.html

The Resmed S9 ASV is $3,400.00:

http://1800cpap.com/resmed-s9-vpap-adapt.aspx

While the prices have come down significantly ... it is almost one half of what it was three years ago ... it remains much higher than the other units.

Secondly .. and probably even more important than the price .. it is harder to adjust to ASV therapy. It is NOT natural to have the machine start to ramp up the pressure and insist that you breathe. It takes a lot to adjust to this. I typically warn new ASV users that it may take them three to four months before that is not annoying. But for some of us an ASV unit is a better option than having to go to a ventilator. And while it takes a long time to adjust, the better sleep is worth the effort.

Hope that helps.

Well said and explained, John, as you always do.

I'll admit that the ASVs intrigue me on many levels. I think the technologies used are amazing. And I think the work of the researchers and engineers is to be applauded as one of the great accomplishments of our time, as far as treating sleep breathing for a segment of sufferers. But the contradiction that fascinates me most is how they seem to be simultaneously overhyped by some docs as what should be the machine of choice of all SDB patients and yet, at the same time, the machines remain so sadly underutilized for, and unknown to, many of the very people who would be most helped. How can both situations exist at the same time?

That's why I am glad this board has been graced over the years with the likes of you, deltadave, and -SWS, among others, who, in such a balanced way, (1) make sure people with certain central-related problems become aware of the machines and yet (2) don't feed the hype of those who try to push them onto every plain-vanilla OSA patient by telling everyone that since CPAP machines aren't the latest technology and ASVs are, everyone with any SDB problem should be on an ASV.

Then again, I guess Dr. K. has (had?) a very different take from mine (ours?), based on his specific clinical and research experiences, or at least that was the case a few years ago . . .

Dr. K. wrote:"We looked at a group of about 50 insomnia patients or anxiety patients who had sleep breathing problems, and these people had failed everything. They couldn't use CPAP; they couldn't use auto-CPAP; they couldn't use BiLevel devices. They could use nothing but this one device that's been on the market a few years. It's called ASV, again - adaptive servo-ventilation - and it just has this incredibly comfortable way of helping a patient to breathe, which is different than the traditional CPAP device. And what we found was that these insomnia patients and these anxiety patients could use the ASV device. They could use it all night long, and they could actually get the benefit. And so now we're beginning to think this is good because at Maimonides we spend a lot of our time working with mental help patients with sleep disorders. That's our specialty, and that makes it of course easy to do research there as well. And what we're seeing now then is we don't put mental health patients with sleep disorders on CPAP any more. We've stopped doing that. We don't think it works for them anywhere near as well as these more advanced devices. -- http://www.sevencounties.org/poc/view_d ... c&id=39747

And:

https://www.youtube.com/watch?v=7fMki3K ... re=related

Wow, this has amounted to more than a simple definition style answer. I'm glad I learned about this ASV business. I think I need to do more learning about my condition now, and find out exactly how well my APAP machine is fixing me.

Thanks for input.

AHI15 wrote:Wow, this has amounted to more than a simple definition style answer. I'm glad I learned about this ASV business. I think I need to do more learning about my condition now, and find out exactly how well my APAP machine is fixing me.

Thanks for input.

Surprisingly, it's actually fun to learn more about how our bodies work (or don't as the case may be) and what we can do to address various problems. For someone that did problem solving professionally for many years, the diagnostic work of sleep medicine is nothing less than fascinating.