Advice needed.

[Realtor 1]

I recently switched to Resmed S9 Auto Set and my data has seen tremendous improvement.
I have been using it for almost a month and my AHI is Continuously under 0.5. with almost zero Hypopneas & 3 to 5 Centrals per night.

Strangely for me i still feel terrible all day , extremely Sleepy(but still cannot get good sleep at all) and Fatigued with headaches with no energy.

My question is that I have noticed someone locally selling a couple of yrs old Resmed S-9 Vpap Adapt for dirt cheap. I have read that the ASV feature improves the quality of sleep ( My sleep quality is terrible and on the previous studies I got mostly stage 1 & 2 sleep with no Slow Wave sleep and 5-7% of REM sleep.
What are the advantages or disadvantages of the ASV machine ?
Should I go for it or not.
I don't know if I need a VPAP or not but here My doctor will make me wait maybe another year for that test and I don't think that I can wait that long. After my 1 year of complaining they sent me for an Autopap test.(I started using the Autopap a few days before the test) BTW, I am a 44 yr old Male.

Advice will be greatly appreciated.

[Sleepster]

Nothing you've said indicates that a VPAP will help.

However, if you're often reaching your maximum pressure it could be that flow limitation might be interfering with your sleep.

The other thing is that a VPAP makes exhaling more comfortable, and that alone might help.

The extra features of the VPAP Adapt are not likely to help any more than a VPAP Auto, but if the price is right it may be worth a try. I believe the VPAP Adapt can be placed in VPAP Auto mode, or even fixed CPAP mode, but someone else will have to verify that.

Those few centrals that you're having. How long do they last?

[Realtor 1]

13 to 30 seconds so not very long. I have set my max to 14 but it usually peaks at around 11.95 . a few days it did hit 13 but never higher.
It might be an idiotic question but why do people need A VPAP a part from comfort.
Price is very tempting almost the same as what I paid for my New Autoset recently.

[diamaunt]

the vpap adapt shouldn't have much of an effect on you if you don't have centrals, compsa, or csr... since that's what it's designed for.

[justMongo]

I do not think what you're experiencing would be helped by a different machine.
The S9 VPAP Auto can run to a higher pressure (25 versus 20) maximum.
The VPAP permit a greater split between Ipap and Epap pressures that aid some people.

Not getting to slow wave sleep is not necessarily an apnea problem.
Old people like me seldom hit slow wave sleep.

[diamaunt]

I believe the VPAP Adapt can be placed in VPAP Auto mode, or even fixed CPAP mode, but someone else will have to verify that.

the vpap adapt can *not* be placed in vauto mode.

the 36007 offers cpap and asv mode, the 36037 offers cpap, asv and autoasv modes.

[Realtor 1]

the vpap adapt shouldn't have much of an effect on you if you don't have centrals, compsa, or csr... since that's what it's designed for.

[Reference removed by Moderator]

Are there any disadvantages of using the Vpap Adapt machine instead of the regular CPAP ?

95% of my Apneas happen as clusters in REM sleep. the Old F&P Icon was not capable of showing Centrals & use to record them as Hypopneas. I was not aware of the centrals. like last night I had 7 central events this morning between 5 to 7am. No event before that. All centrals between 15 to 27 seconds.

@ Just Mongo: I am 44 yrs old and should get at least some slow wave sleep.

[robysue]

I recently switched to Resmed S9 Auto Set and my data has seen tremendous improvement.
I have been using it for almost a month and my AHI is Continuously under 0.5. with almost zero Hypopneas & 3 to 5 Centrals per night.

3-5 centrals per NIGHT does NOT even come close to satisfying the usual criteria for being switched to a very expensive ASV machine. With these kinds of numbers it is unlikely that an ASV machine would do anything for you that the PAP machine is not already doing And it can be even harder to learn to sleep with an ASV machine when the machine decides to trigger inhalations ...

Strangely for me i still feel terrible all day , extremely Sleepy(but still cannot get good sleep at all) and Fatigued with headaches with no energy.

CPAP does not fix bad sleep; CPAP fixes OSA and nothing else. If the bad sleep is being caused by things other than and in addition to untreated OSA, CPAP will only fix the OSA problem; the other causes of bad sleep remain and still need to be investigated and "fixed".

So the question becomes, what else might be causing your bad sleep now that the OSA is properly controlled by your PAP?

You may need to start with a plain old physical with your PCP. Make sure the problem is not caused by something else: Thyroid problems often manifest themselves with fatigue, headaches, and bad sleep. So do certain vitamin deficiencies. So do a lot of other health problems that are not directly related to sleep. As a male, you might also need your testosterone levels checked out.

Lifestyle can also lead to bad sleep and daytime fatigue issues: Are you getting enough physical activity every day? Are you overdoing the exercise and/or exercising too close to bedtime? Are you eating a decent diet? Are you consuming too much caffeine or alcohol, particularly too close to bedtime? Are you under a great deal of stress?

Sleep hygiene also comes into play: Do you have a regular sleep schedule? Do you have trouble getting to sleep? Staying asleep? Or waking up too early?

In other words, it's not all about tweaking the PAP therapy by changing machines or settings on a machine. Sometimes we need to investigate other causes for on-going daytime fatigue and sleepiness.

And finally, as discouraging as it is to say: There are a few unlucky PAPers who never feel much better even though they use their machine all night long, every single night and have low AHIs and good leak numbers. The docs don't really understand why this happens, but they do know that it does happen to a small number of PAPers. Perhaps the damage from the years of untreated OSA just doesn't heal fully. In cases where residual daytime sleepiness and fatigue is an ongoing and relentless issue for a compliant PAPer, occasionally sleep docs will turn to treating the daytime sleepies with stimulants such a s Nuvigil. But that approach has its own problems.

[archangle]

Are there any disadvantages of using the Vpap Adapt machine instead of the regular CPAP ?

I believe the VPAP Adapt will do ASV modes and manual CPAP modes.

It will not do Auto CPAP or Auto bilevel/Auto VPAP modes. The ASV modes are "rougher" or "more controlling" to many people. If you don't actually need the special "central apnea" treatment the ASV gives, a normal APAP, bilevel, or auto bilevel machine will probably work better for you.

[Sleepster]

I was not aware of the centrals. like last night I had 7 central events this morning between 5 to 7am. No event before that. All centrals between 15 to 27 seconds.

That's not a clinically significant series of events, in my opinion. It just means that your breathing paused 3 or 4 times per hour for a few seconds.

If there are other issues, such as poor sleep quality, then this might be a concern you can discuss with your doctor.

CPAP machines are not reliable discriminators between central and obstructive events. It's possible that they are just hypopneas, but as I said, if they're interfering with your sleep it's something to discuss with the doc.