0.0

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.

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.

Pugsy had this to say about the issue.

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

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:

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 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

Having an occasional headache is normal.

Not having one is better than normal.

It's not a difficult concept...

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.

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 wrote: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.

Resmed Spokesperson 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.

Well, that might be the Resmed Spokesman's definition of no central apnea, but if you have serious enough problems, a central apnea WILL occur. I offer my own example. This was from a PR System One ASV unit, which does not pretend that no central apnea occurs.


Sure, even when I stopped breathing there was some air movement because the unit quickly ramped up the air pressure. But the point is that my body was not responsible for that. I was in the middle of a series of central apneas.

Congrats!

JohnBFisher wrote:...
Well, that might be the Resmed Spokesman's definition of no central apnea, but if you have serious enough problems, a central apnea WILL occur. I offer my own example. This was from a PR System One ASV unit, which does not pretend that no central apnea occurs.

IMAGE
Sure, even when I stopped breathing there was some air movement because the unit quickly ramped up the air pressure. But the point is that my body was not responsible for that. I was in the middle of a series of central apneas.

JohnBFisher, I am unfamiliar with some of the stuff I'm seeing on the PR graph you provided. Excluding wave forms, which ticks/markings depict centrals? Also, am I right in seeing that you have large leak all the way through? Is the quattro fx comfortable on the nose bridge for you?

[quote="JohnBFisher

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.
[/quote] (My emphasis on the last part.)

Well, that might be the Resmed Spokesman's definition of no central apnea, but if you have serious enough problems, a central apnea WILL occur. I offer my own example. This was from a PR System One ASV unit, which does not pretend that no central apnea occurs.

Comment,

Well, that's what I been saying all along, that Resmed would not let CAs to show, untreated, from a machine that was designed to eliminate them. To check the reliability of those Resmed VPAP Adapt ASV machines you need a third party to do it. Something like the Consumer Reports but for CPAP users.

avi123 wrote:... Resmed would not let CAs to show, untreated, from a machine that was designed to eliminate them. To check the reliability of those Resmed VPAP Adapt ASV machines you need a third party to do it. Something like the Consumer Reports but for CPAP users.

Technically, we should be able to do it by looking carefully at the graphs. CA's are fairly easy to spot in a 10-minute window or 5-minute window, confirmable in a minute/thirty-second window.

avi123 wrote: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 . . .

That's funny, Avi. Actually I'm under 5' 10" and weigh 165 so no need to keep your distance!
Re. Centrals data on my graphs and reports, there are none shown. Centrals and Obstructives are combined and shown as AI. My graphs (except for the appearance of Flow Limitations), data, reports, and machine are exactly like Nate's. I wish they broke out CA and OA as they do on the AutoSet as viewed in ResScan and SH, but the machine keeps my total AHI under 5 almost every day, usually well under 5, so I'm a happy camper.