ASV vs APAP?
Hi,
I’m a bit puzzled and I would like to know if my understanding is right.
I did some reading to find the difference between an APAP machine and an ASV machine.
Is it true to say that we would all be better with an ASV machine because it can adapt the pressure for each of our breath BUT that our sleep doctors don’t prescribed them first because of the cost difference?
If someone has the money, would he benefits from getting an ASV machine? Any bad side effect i don’t understand?
Thanks!
RE: ASV vs APAP?
The primary purpose of ASV is to provide non-invasive ventilation of an individual having a central apnea. Other than that functionality, it is similar to an auto-bilevel (BiPAP/VPAP). While I think these machines are under-prescribed to those that could benefit, I would not encourage anyone without a need to get ASV. As you probably know, we can set up ASV to function as a CPAP, auto CPAP, auto bilevel and of course with a backup rate and pressure support for centrals. I don't think most people have the desire or expertise to deal with ASV, and there are no studies that would support a doctor in prescribing ASV for someone that does not need it. For the few that might pursue it on their own, I don't think there would be much, if any, harm; but why?
RE: ASV vs APAP?
That is one point of view.Relative prices from 1 supplier
ASV $2999 CPAP, ASV, ASV Auto
VAuto $1766 CPAP, BiLevel S, VAuto (Auto-BiLevel)
Autoset $ 883 CPAP, Auto CPAP
Each machine has different modes, different algorithms with which to maximize treatment.
Insurance wants to spend a minimum to treat you. (Minimizes cost)
DME wants to provide the cheapest allowed. (maximizes profit)
The Dr. wants something that treats you effectively (AHI under 5.0)
RE: ASV vs APAP?
Hi vinhuard,
WELCOME! to the forum.!
Good luck to you with CPAP therapy.
trish6hundred
RE: ASV vs APAP?
(05-29-2017, 08:13 PM)Sleeprider Wrote: As you probably know, we can set up ASV to function as a CPAP, auto CPAP, auto bilevel and of course with a backup rate and pressure support for centrals.
Is this true of the ResMed AirCurve ASV? I thought it did only straight CPAP if you chose not to use the ASV capability ...
RE: ASV vs APAP?
It can be setup with CPAP setting, but the auto-CPAP and auto bilevel are end up having limited pressure support, but the pacewave continues to trigger IPAP. Jesse Lee tried to do this and ended up going back to the Aircurve 10 Vauto. It is a different feel from the CPAP and VPAP without backup rates. In his case, he did not have any central apnea, and that is why the experiment does not really apply to your situation. In any event, I learned from JesseLee's experiment, and have not made this assertion again.
RE: ASV vs APAP?
IDK if the aircurve 10 asv can be made to work like apap but the modes offered are cpap, asv and asv auto.
as often as it's been explained, I still find the naming similarities between the asv and vauto(?) to be very confusing, as are the different types or modes of the non-asv bilevel (since I haven't used those machines).
RE: ASV vs APAP?
I ask because I'm trying to decide whether to pick on an ASV that I've found for a reasonable price, in the hopes that it will improve my CAs. But if it doesn't work, and it turns out I'd be better on VPAP, I'm outta luck. (I assumed that I would sell my VPAP machine if I got an ASV).
08-28-2018, 09:42 AM
(This post was last modified: 08-28-2018, 09:44 AM by Sleeprider.)
RE: ASV vs APAP?
Allan, what I've seen is that the modes the ASV can deliver will work just fine for you. It can work as a bilevel, but you can't turn off the automatic backup rate and it won't work with less than 3 or 4 cm of pressure support. I think you can use EPAP min of 4 to 15, and PS from a minimum of zero, but you have to use a PS max of 3 or 4 cm higher than the minimum. What we know about your therapy, is that if this is a Resmed machine, you're going to use the initial settings for ASVauto mode of EPAP min 5.0, EPAP max 15, PS min 3.0, PS max 15.0 and just go from there to optimize once you are used to it. Your AHI is probably going to be near zero from the start, but there may be some residual hypopnea or if you have residual obstructive apnea, the EPAP min is going to have to go higher.
I have only known of two people that chose not to continue with ASVauto once they tried it, and one of those didn't need it. That individual traded his ASV through Supplier #2 for a Vauto. In other words, if you have a good deal, there is no risk.
RE: ASV vs APAP?
Thanks Sleeprider!
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