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NateS · Post by **NateS** » Sun Jun 30, 2013 11:36 am

Just to clarify, those ResScan reports avi found are from a year and a half ago, when I had been on the VPAP for less than a month. My results have been dramatically better than those for quite some time. I have been getting excellent therapy and excellent sleep with my VPAP for quite a long time now, many nights with no apneas at all and just 2-3 scattered hypopneas.

Here's last night for example (machine date always a day ahead):

Also, the difference in appearance of some of those charts posted by avi above is due to the fact that some are Reviews and some are Reports.

Best wishes, Nate

DreamDiver · Post by **DreamDiver** » Sun Jun 30, 2013 11:35 am

It's not that the ASV doesn't detect them - it's supposed to prevent them altogether by recognizing signs and increasing SV as necessary or the machine isn't working properly.

According to Resmed wrote:- The definition of an apnea is a cessation of breathing for greater than 10s, meaning a person's natural breathing rate would have to be slower than <6 breaths per minute for the airway to stay open naturally. This is important due to the back up rate settings

- A servo ventilator treats compSA and CSA by adding in breath support when the central drive slows down below the natural breath rate. i.e. it starts to breathe for you, when you brain starts to slow down.

- If the device inserts a breath and is unable to create flow, the airway is blocked, or an obstructive apnea.

So what this means is that the CAI is always zero on an ASV machine or its not working properly. If the neural drive slows down to pause >10s the machine will automatically insert a breath before the end of that time period before you have a chance to test the airway for being open or closed. If it fails to create flow, it was obstructive.

(My emphasis on the last part.)
Here's a video from this page.

LinkC · Post by **LinkC** » Sun Jun 30, 2013 10:35 am

Having an occasional headache is normal.

Not having one is better than normal.

It's not a difficult concept...

Randyp1234 · Post by **Randyp1234** » Sun Jun 30, 2013 10:09 am

avi123 wrote:This poster with two nights of AHI = 0 results, on VPAP Adapt (mode =ASV), would also be questionable:

In my case I'm on APAP not VPAP.

Randy

avi123 · Post by **avi123** » Sun Jun 30, 2013 9:42 am

Steve of Cornubia wrote:My docs told me that an AHI of 5.0 is 'normal' and that everybody experienced up to that figure. Only when AHI rises above 5.0 is a person diagnosed as having apnea. If that is true, aiming for. achieving 0.0 is a little intriguing, because we're saying less than 'normal' is better than 'normal', which seems unlikely.

See this report about Dr David Rapoport who is amongst the top Sleep Docs in the U.S.

http://tinyurl.com/d3f5x7z

AHIs up to the 20th should be OK.

avi123 · Post by **avi123** » Sun Jun 30, 2013 9:14 am

Papit, thanks for showing the above Stats. If you feel good then it is all that's count.
Your Tidal Volume indicates that you're physically a larger person then I am. You are
taller than 6' 2" and weigh more than 220 lb. So I stay away from you

In above link given by DD post I see this by Nate for his VPAP Adapt ASV:

NO CENTRALS ARE SHOWN

You can see more of Nate's data here:

viewtopic.php?f=1&t=73197&p=674948&hili ... ph#p674948

But the following graph taken from there makes me think that Nate's machine is different from Papit's or the ResScan versions used are different:

DreamDiver · Post by **DreamDiver** » Sun Jun 30, 2013 8:24 am

Pugsy had this to say about the issue.

viewtopic/p800834/s9-vpap-adapt-asv-How ... ctive.html

Steve of Cornubia · Post by **Steve of Cornubia** » Sun Jun 30, 2013 2:48 am

My docs told me that an AHI of 5.0 is 'normal' and that everybody experienced up to that figure. Only when AHI rises above 5.0 is a person diagnosed as having apnea. If that is true, aiming for. achieving 0.0 is a little intriguing, because we're saying less than 'normal' is better than 'normal', which seems unlikely.

Papit · Post by **Papit** » Sat Jun 29, 2013 11:55 pm

avi123 wrote:Papit, as an ex engineer, as you're, I am questioning why the values of any of the Events in your Stats are NOT shown with a number of zero? The AHI is a combination of events which are usually shown in the ResScan Stats with numbers and not hyphens.

Another issue is that ResScan while identifying your machine as an Adapt ASV should NOT have shown in the Stats an entry for Central events.

Could you please show the Stats, with same ResScan setup, for the 3 previous nights?

Hi Avi. I don't know why ResMed decided not to show the numbers separately for CA and OA for S9 VPAP Adapt users (in addition to adding the two and reporting total apnea in AI), but that's how both ResScan and SleepyHead show results on my screen. Here are the ResScan Stats pages for last few nights.

NateS · Post by **NateS** » Sat Jun 29, 2013 10:44 pm

JohnBFisher wrote:
avi123 wrote:... Another issue is that ResScan while identifying your machine as an Adapt ASV should NOT have shown in the Stats an entry for Central events. ...
avi123, that is NO LONGER TRUE with the S9 ASV units!! While it's not certain (I don't have the unit to check personally), the clinician's manual notes that the S9 ASV unit records the Central Apnea Index. That is stored in the SD card and accessible on ResScan reports and within the ASV unit itself. It is possible the manual is incorrect, but I would want to confirm it with an advanced data head, who happens to also be an S9 ASV user.

That has not been my experience, John.

See: viewtopic.php?f=1&t=74249&p=682719&hilit=fot*#p682719

and idamtnboy's work on this:

I think I've got it figured out. It's the absence of FOT. Resmed uses what they call forced oscillation technique (FOT) to determine if an apnea is an obstructive or central apnea. I do not see that signal in the Adapt flow graph. You can clearly see the FOT signal on my CA and OA graph segments below but not in the Apnea graph segment from your data.

Maybe papit has a newer model machine with the same name??? Or just a mixed data file?

Regards, Nate

Papit · Post by **Papit** » Sat Jun 29, 2013 10:35 pm

avi123 wrote:
JohnBFisher wrote:
avi123 wrote:... Another issue is that ResScan while identifying your machine as an Adapt ASV should NOT have shown in the Stats an entry for Central events. ...
avi123, that is NO LONGER TRUE with the S9 ASV units!! While it's not certain (I don't have the unit to check personally), the clinician's manual notes that the S9 ASV unit records the Central Apnea Index. That is stored in the SD card and accessible on ResScan reports and within the ASV unit itself. It is possible the manual is incorrect, but I would want to confirm it with an advanced data head, who happens to also be an S9 ASV user.

Comment,

Hi John, I could not find data from such a machine showing values of Central events that were untreated (i.e. to have an entry for CAI)?

For example take this by Papit, from the other thread, that the ResScan Events graph will NOT show CAIs (if Pappit would stick to this ResScan graph for a moment, and expand the Events graph downwards, to show its full hight):

{to see the whole time length of the graph keep your Window un zoomed}

_________________________

Gents, here are the detailed graphs, including Events, for that day (June 26) at full height. ResScan does not break out Apnea on the Events graph; i.e., Centrals and Objectives data are NOT separately quantified -- even though titles for each are shown, on my screen they are always followed by two hyphens for the S9 VPAP Adapt ASV machine. Each "Apnea" is shown on the detailed graphs page in red without distinguishing between the two types and each hypopnea as a small black rectangle. SleepyHead graphs the data in the same fashion for me. The Reports pages report the same way in both software programs.

avi123 · Post by **avi123** » Sat Jun 29, 2013 7:34 pm

JohnBFisher wrote:
avi123 wrote:... Another issue is that ResScan while identifying your machine as an Adapt ASV should NOT have shown in the Stats an entry for Central events. ...
avi123, that is NO LONGER TRUE with the S9 ASV units!! While it's not certain (I don't have the unit to check personally), the clinician's manual notes that the S9 ASV unit records the Central Apnea Index. That is stored in the SD card and accessible on ResScan reports and within the ASV unit itself. It is possible the manual is incorrect, but I would want to confirm it with an advanced data head, who happens to also be an S9 ASV user.

Comment,

Hi John, I could not find data from such a machine showing values of Central events that were untreated (i.e. to have an entry for CAI)?

For example take this by Papit, from the other thread, that the ResScan Events graph will NOT show CAIs (if Pappit would stick to this ResScan graph for a moment, and expand the Events graph downwards, to show its full hight):

{to see the whole time length of the graph keep your Window un zoomed}

DreamDiver · Post by **DreamDiver** » Sat Jun 29, 2013 7:20 pm

Way to go, Papit.

JohnBFisher · Post by **JohnBFisher** » Sat Jun 29, 2013 7:18 pm

avi123 wrote:... Another issue is that ResScan while identifying your machine as an Adapt ASV should NOT have shown in the Stats an entry for Central events. ...

avi123, that is NO LONGER TRUE with the S9 ASV units!! While it's not certain (I don't have the unit to check personally), the clinician's manual notes that the S9 ASV unit records the Central Apnea Index. That is stored in the SD card and accessible on ResScan reports and within the ASV unit itself. It is possible the manual is incorrect, but I would want to confirm it with an advanced data head, who happens to also be an S9 ASV user.

avi123 · Post by **avi123** » Sat Jun 29, 2013 7:04 pm

This poster with two nights of AHI = 0 results, on VPAP Adapt (mode =ASV), would also be questionable:

viewtopic/t82750/finally-on-ASV-0-AHI-but-restless.html

Notice: Max EPAP = -1000000000.00

and in the Sheikh's post there: My AHI is usually at zero too, on the ResMed Adapt. BUT, on the PR AutoSv ASV, I find I have some flow limitation events, a few vibratory snore events and even an ocassional periodic breathing event. These are no worry cuz my O2 stays up above 94% all night. The PR Auto Advanced seems more senstive.

Why show on SH and not on ResScan, since the machine is ResMed's.

Machine	Mask	Humidifier

Additional Comments: 11-14 cmH2O

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