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Man, I just hate hearing stories like this.

1+ to almost everything said in this thread, very effectively and multiple times. The two types of machines are not similar in function or therapy.

Can DMEs be sued for malpractice? Maybe they should be.

I have the ResMed S9 VPAP ST and am a bit confused as well. How exactly does it work for me. I have severe central apnea and absolutely no Obstructive Apnea dose the machine I have breath for me when I do not take a breath on my own?

squid13 wrote:You might call your Doctor and tell them there trying to make a change from his script. If they don't want to give you an ASV find another DME that deals with your insurance. Call your insurance and find out what DME'S are available to you that you can deal with. I trust a DME about as far as I can throw my house. It's your health get what your suppose to get. There's quite a price difference between those to machines.

+1

If you have lots of CA relative to OA, in your shoes I would cancel the present order right away. I have the same unit as Squid. My centrals were triple my OA and I wasted a year with AHI averaging 14 before I got my ASV. Fortunately I found a doc who would prescribe the S9 VPAP Adapt ASV (36037). It totally wiped out all CA, as well as OA, and brought my average AHI down to ~1.0. All that was left were a few hypopnea, and it did this from the first night. Amazing machine.

Hey folks...old thread resurrect by

Hilbobil wrote:I have the ResMed S9 VPAP ST and am a bit confused as well. How exactly does it work for me. I have severe central apnea and absolutely no Obstructive Apnea dose the machine I have breath for me when I do not take a breath on my own?

so no sense in talking to the OP in this thread...I don't think they will be around.

To Hilbobil:...yes, in ST mode your machine will breathe for you if you don't. It has a timed breath function so it will push some air at you depending on whatever parameters it is set at.

Pugsy wrote:To Hilbobil:...yes, in ST mode your machine will breathe for you if you don't. It has a timed breath function so it will push some air at you depending on whatever parameters it is set at.

I don't think they "breathe for you" in the sense that they would keep you breathing if you had something like a severed spinal cord. They change the pressure and encourage you to breathe, but it is trying to trigger your brain to work your breathing muscles and breathe, not actually inflate and deflate your lungs.

The devices that actually "breathe for you" are called "ventilators" and use higher pressures.

Despite the adaptive servo "VENTILATOR" term, the A10 ASV is limited to 25 cmH2O pressure and isn't like "real" ventilators.

Even the ASV or ST machine can still "fail" to fix central apnea if you brain refuses to get triggered into breathing for you. However, I think it's pretty rare for the brain to fail to be triggered into breathing by max ASV therapy.

archangle wrote:I don't think they "breathe for you" in the sense that they would keep you breathing if you had something like a severed spinal cord. They change the pressure and encourage you to breathe, but it is trying to trigger your brain to work your breathing muscles and breathe, not actually inflate and deflate your lungs.

I wasn't referring to ventilator. Timed breath mode pushes air if the person doesn't breath on their own. I think that is what I said. Don't recall mentioning ventilator or expanding the lungs or what you are referring to above.

I believe these models fall into the NIV category...Non Invasive Ventilation
http://www.resmed.com/us/en/commercial- ... ap-st.html
which is essentially the newer model of the S8 based VPAP ST III
http://www.resmed.com/int/products/vent ... clinicians

Note the asv cost about $3000 more than a bipap st

Peyton7769 wrote:Note the asv cost about $3000 more than a bipap st

yeah, no.

DMC wrote:(Feb 2013)...Medical equipment supplier is ordering BiPap St and insist it is the same as ASV and I should relax they have been doing this a long time and know what they are doing...

The only thing that come to my mind is: "Is this DME still doing it after 2 years and a half?" If they are, they've been doing it wrong for a very very very long time...

archangle wrote:The devices that actually "breathe for you" are called "ventilators" and use higher pressures.

Despite the adaptive servo "VENTILATOR" term, the A10 ASV is limited to 25 cmH2O pressure and isn't like "real" ventilators.

Archangle, you normally provide very good information, but I'm afraid I have to disagree with you on this one.

ASV and ST units DO provide noninvasive ventilation pressures. The maximum IPAP of noninvasive ventilators is 20-25cm. To quote emedicine:

Maximal IPAP limited to 20-25 cm water (avoids gastric distension, improves patient comfort)

Or from a LOT more technical article (Adaptive support ventilation: State of the art review):

The ASV is a ventilatory mode that adapts to patient respiratory effort. Depending on the spontaneous RR, ASV can work as PCV, if there is no spontaneous breathing; as pressure SIMV (P-SIMV), when patient RR is lower than target; or as PSV, if the RR is higher. Pressure level is then adapted to attain the target VT (within limits imposed by pressure alarms). Cycling off criteria is flow based in the case of assisted ventilation or time based for mandatory inspiration. To summarize it, any changes in respiratory mechanics and effort of the patient is accompanied by a dynamic pattern of breathing that gradually guides the patient to the new goal where there is a higher energy efficiency with minimal effort.

So, essentially if my TIDAL VOLUME falls below the average of the last few minutes (the number of minutes varies slightly by manufacturer), then the ASV unit rapidly increases the IPAP. The pressure swing can go all the way to 25cm H2O within a breath or two. It does sustain respiration and is considered a form of ventilator.

I meant what I said and I said what I meant.

Caution! I have had an ASV machine for 5 years and just went through two sleep studies in order to get a new machine. I have almost 14,000 hours on my old machine. The reason for the second sleep study is that after I received my new machine, which is a BiPap St, my AHI went 29. It had been around 3.5 and 4 but became 29 with the new BiPap St machine. I called my doctor and they told me I must use the new machine for 7 nights and then have another sleep study with the ASV machine, which I did. During this time period, the 7 necessary nights of usage with the BiPap St, I was exceptionally tired and almost could not finish a round of golf, just as it had been 5+ years ago when they were diagnosing my Apnea problem. I thought I was going to die. When I went back on my old ASV machine, it only took a couple of days for me to regain my health. Don't let any one tell you that they are the same machines. It is very dangerous to use a BiPap St if you do need an ASV. My last report with the old ASV machine, my AHI was 3.5 not 29.3 that I had with the new BiPap St. I will be getting my new ASV machine on Monday. I will never be using a BiPap St machine no matter what.