Scared and FREAKED OUT about my Bipap AutoSV advanced

I am really scared and a bit freaked out right now because a sleep technician said that by using my Bipap autoSV advanced regularly, I will begin to stop breathing properly myself and my muscles will become so weak, that there will come a point in time that I will not be able to breath unaided. This, he believes, will be caused by the 'ventilatory element' of the machine that I am using and for no other reason!!! A bit like a drug, I will become dependent and slowly the machine will take over, by the sounds of things, maybe the 'alien thing' is true after all.

He then went on to advise me to try and use an auto pap as much as possible, at least a couple of times a week, in order to keep the muscles in good working order.

Personally I feel it is the complete opposite for me, as for the first time in many years, I am having to use my muscles to inhale myself without the assistance of positive pressure of 12-16cm H20 which gives the impression that I am breathing totally unaided, which feels weird to say the least, after approx 20 years or so, of cpap pressure.

Is he correct? Or is it just scaremongery?

Without having spent much recent quality time at a Holiday Inn Express, it seems very unlikely that such a thing could occur.
In the first instance, you spend perhaps 3/4 of you time awake and breathing on your own. That exercises your diaphragm muscles, etc. that you use for breathing. In the second instance, it is likely that you, like me, don't spend more that about 10% of your sleep time in machine initiated breathing. That's just too little time for muscle atrophy.

Calm down and think of what your remarkable machine is doing for you elminating all those CSA's.

Without assuming your sleep tech to be a complete nitwit (may be it was a bad day),
you would do well to ignore this little bit of nonsense; --and perhaps mention it to your doctor.

The tech is an idiot. Plain and simple...doesn't have a clue how the machine works unless he has it totally confused with a straight ventilator like you see on the TV.

First of all even if the machine breathed for you 100% of the night...you would still have the daytime breathing on your own to keep those muscles exercised.
Secondly...the machine just kicks in a little reminder or burst of pressure when it thinks you need it...otherwise it just functions like a regular xpap machine.
And according to your reports..you rarely need the machine to jump start your breathing.

It that tech told me the sun rose in the East and set in the West...I do believe I would have to go look to make sure.

Pugsy wrote: The tech is an idiot. Plain and simple...doesn't have a clue how the machine works unless he has it totally confused with a straight ventilator like you see on the TV.

First of all even if the machine breathed for you 100% of the night...you would still have the daytime breathing on your own to keep those muscles exercised.
Secondly...the machine just kicks in a little reminder or burst of pressure when it thinks you need it...otherwise it just functions like a regular xpap machine.
And according to your reports..you rarely need the machine to jump start your breathing.

It that tech told me the sun rose in the East and set in the West...I do believe I would have to go look to make sure.

EXACTLY! if you want you could increase your lung power with aerobic exercise and stuff like blowing those bottles that they use in the hospitals for people on long bed rest - but as pugsy said, even if the asv machine did 100% of your breathing at night, you have the other 16 hours of the day when it is not

That all sounds very reassuring thank you. I did not think about the day time breathing! Of course we breathe in the day as well.

Say he was having a bad day,why say such a thing? I guess he enjoys the power of frightening people. He is a revolting man, and the doc always backs him no matter what he says or does.They work as a team and the doc needs him and will always cover for him. Before anybody suggests it, unfortunately, I cannot change and go else where.

I was particularly interested in what you said Jds74. Can you please explain further? What tells me when the machine is breathing for me? When you said that it cuts in less than 10% of the time, what numbers were you referring to? Is it the patient triggered breaths?

If I had the answers to the nonsense he is coming out with, and he has done this sort of thing before,the next time I see him, I can prove to him that he is talking through the part of his anatomy that should only use for sitting on.

It would give me so much pleasure to enlighten him with TRUE THE FACTS !

I just wish I knew what they were myself!

That tech's brother was probably the jerk who attended my titration study...what a a$$hole. Total idiot...admitted he had sleep apnea but couldn't stand to use the mask and machine and it's no wonder with his lack of mask fitting skills. Plus a few other seriously wrong information that he gave me all the while acting like he was God's gift to mankind.

Patient triggered breaths are when YOU initiate the breathing...so the higher the better.
I would suspect that everyone might have a few times during the night that the ASV machine might want to kick in on a rare occasion if we were all on ASV machines. So don't be alarmed if you don't see 100% patient triggered breaths every night.

Yes, patient tiggered breaths is the measure and it reports the percentage of breaths that are recorded by the machine firmware that are initiated by the patient. The percentage that are ventilator breaths is 100 minus this number.

I've had my machine for about two months and my numbers have varied from 68% to 95% with the average hovering around 90%.

I use my machine on average 7 hours each day. This is about 25% of the day (yeah I know the real number is different) so one can divide the 10% average by 3 to get the average percentage of ventilator breaths average over the full day.

That gets you to roughly 97.5% of the time breathing by patient effort. I really doubt that letting you diaphragm rest 2.5% of the time will promote any kind of atrophy at all.

Hope this helps.

For those with calculators, please feel free to recaculate everything .
Assumed is the triggering rate is the same as the night time rate - generally it is slower.
Also assumed is the breathing rate is the same at night as during the day - it really is somewhat slower.

I don't care if you can't change doctors; I wouldn't go back to them because they aren't in their right minds. Ask questions here... at least you'll get factual answers. The fact that they don't have a clue and freaked you out would definitely be enough for me. Something is very wrong with this picture.

sleepinglass wrote:I am really scared and a bit freaked out right now because a sleep technician said that by using my Bipap autoSV advanced regularly, I will begin to stop breathing properly myself and my muscles will become so weak, that there will come a point in time that I will not be able to breath unaided. This, he believes, will be caused by the 'ventilatory element' of the machine that I am using and for no other reason!!! A bit like a drug, I will become dependent and slowly the machine will take over, by the sounds of things, maybe the 'alien thing' is true after all.

He then went on to advise me to try and use an auto pap as much as possible, at least a couple of times a week, in order to keep the muscles in good working order.

Personally I feel it is the complete opposite for me, as for the first time in many years, I am having to use my muscles to inhale myself without the assistance of positive pressure of 12-16cm H20 which gives the impression that I am breathing totally unaided, which feels weird to say the least, after approx 20 years or so, of cpap pressure.

Is he correct? Or is it just scaremongery?

Report the idiot to his boss because he doesn't know what he is talking about and shouldn't be working there.

I'm into several high aerobic sports like mt biking, road biking and rough terrain hiking/running. Not surprisingly, these put a lot demand on my lungs. I've also been on ASV for two-thirds of a year and think I would have noticed if there was any attenuation in my lung power over that period of time since I've been on my S9 Adapt. I am very aware on a minute to minute basis how my lungs and heart are performing while exercising and can say with some certainty that there is no negative affect since starting ASV. Actually, I could make a valid claim that my lungs are in better shape now since I'm sleeping more soundly. Sure, this is all anecdotal info, however I'm sure other exercise buffs will probably have some input to share. Final note: Several forum members are known to drive hundreds of miles to visit a sleep doctor who can understand and handle ASV machines. Some sleep doctors avoid prescribing ASV because it represents A WHOLE LOT MORE WORK FOR THEM AND THEIR TECHS.

I add my voice to the chorus here. That tech was an absolute idiot. If anything, the ASV unit helps train the body to breathe better. Over time you will see your AHI drop as a result of using the ASV unit. Sure, you won't be able to sleep without it. But with it, you will be able to accomplish a LOT more than you could beforehand. This is not just theoretical. This is PROVEN fact by all of us on the forum.

He's completely, and utterly wrong. By the way, if you have central apnea and leave it untreated it is just as damaging as leaving obstructive sleep apnea untreated. I *KNOW*.

I had a hard time getting my doctors to pay attention to my sleep state transition apneas. The programs that score the tests kick out those sleep state transition apneas. Unfortunately, I would stop breathing for more than a minute at a time. I ended up with diabetes, high blood pressure and kidney damage. My nephrologist thinks the untreated sleep apnea and its resulting uncontrollable high blood pressure plus the Ibuprofen I took to combat the morning headaches damaged my kidneys.

You MUST treat the central sleep apnea. I *KNOW* how important that is.

So, if you have central sleep apnea, PUSH for an ASV unit. It can be a godsend. It can take some time to adjust to it. But if you have been using CPAP for 20 years, you will probably find that transition easier. If you doctor and/or DME push against it, ask them if they want to face a medical malpractice lawsuit when you die early or cause a car accident due to untreated central sleep apnea.

Honestly, his statements are just so insane that you really should report him to AASM or whatever organization it is that certifies respiratory therapists in your neck of the woods.

That's really the sort of uninformed gibberish I'd expect from someone with absolutely zero experience or understanding of the subject, the kind of question a lay person might ask when they first hear of it.

(I know I initially wondered whether there were any long-term side effects of CPAP therapy, along similar lines.)

But even the slightest amount of research into the literature would show otherwise, so it's just unimaginable to me that someone who had actually gone to the trouble to be certified could possibly be this ignorant!

Sir NoddinOff I quite agree it is just more work with the asv machines. Maybe that is it you 've hit the nail on the head.

And I really like what you say about the sports aspect of your life and the fact that you would have noticed if something was not right.

One of the most important things that you have said is regarding the benefits of sleeping more soundly.

That is all I want and I am not quite there yet. I also believe that will make a huge difference to my life.

Thank you,Sir NoddinOff very informative indeed.

Be aware that it takes time for your body to adjust to ASV therapy. It took me about three months before I no longer thought the breathing pattern was different than my BiPAP unit. And by that point you should be sleeping pretty soundly.