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[Equipment] Adaptive Servo Ventilation
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Louver528 Offline

New Members

Posts: 2
Joined: Oct 2015

Machine: RESMED AIRCURVE 10
Mask Type: Full face mask
Mask Make & Model: QUATTRO AIR
Humidifier: RESMED AIRCURVE 10
CPAP Pressure: 80 * F
CPAP Software: ResScan

Other Comments:

Sex: Male
Location:

Post: #1
Question Adaptive Servo Ventilation


As a new member I am interested in anyone using a ASV device and their experiences with its use. Thank you all
10-02-2015 12:47 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Adaptive Servo Ventilation
Hi Louver528,
WELCOME! to the forum.!
Hang in there for answers to your question and much success to you with your CPAP therapy.

trish6hundred
10-02-2015 02:31 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,294
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #3
RE: Adaptive Servo Ventilation
G'day Louver528, welcome to Apnea Board.

As you're no doubt aware, ASV machines are used to treat central apneas and periodic breathing (eg Cheyne-Stokes respiration). I have mixed apnea (both obstructive and central in about equal proportions) with an untreated AHI of 62. I use a Resmed S9 VPAP Adapt, which was the immediate predecessor of your Aircurve. (I assume you've got the Aircurve ASV?)

Before going on to the Resmed I had a month's trial on the equivalent Respironics machine, but we just didn't get on. It always felt like the machine was trying to force my breathing rate, which effectively prevented me from sleeping properly. I later found out (from this forum) that there are a whole bunch of adjustments that need to be made on the Respironics to fine tune it to your needs. By that time I had gone onto the Resmed and it was love at first breath! The Resmed algorithm is quite different, and (to me) it feels like the machine is following my lead, rather than the other way round. My AHI dropped from 62 untreated to ~25 on the Respironics to below 5 on the Resmed. It's now consistently below 1.5, usually below 1 and I get the occasional 0.0.

Setting the pressure is more complicated on these machines. You need to set the expiration pressure (EPAP) low enough to be comfortable but high enough to control obstructive apneas and hypopneas. The pressure support (PS) is the extra pressure the machine delivers when you inhale. It must be set low enough to be comfortable, but allowed to go high enough to treat central apnea. And your inhale pressure (IPAP) should be set at a maximum which is comfortable but still high enough to treat the centrals. The easy formula is EPAP + PS = IPAP

I note in your profile your pressure is 80 F - this is actually your humidifier temperature. Your pressure will be made up of the EPAP, PS and IPAP as described above.

The fact that the machine can respond extremely rapidly to a cessation in breathing is good, but it can sometimes be enough to wake you. This is annoying but it doesn't take too long to get accustomed. It can also kick in with a pressure burst before you've fallen properly asleep, which is likewise annoying - in this case just blow back hard and the machine will get the message.

I should also mention that Resmed have aborted a long-term clinical trial of their ASV machines due to an increased chance of death for patients with a particular type of congestive heart failure. You doctor should have discussed this with you (mine didn't) so if you have (or think you might have) congestive heart failure, it's time for a deep and meaningful chat with your doc.

If you have any specific questions I'd be please to answer them.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-03-2015 03:13 AM
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pholynyk Offline

Advisory Members

Posts: 306
Joined: Mar 2015

Machine: ResMed AirSense 10 APAP
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: included
CPAP Pressure: 11-17
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Ontario, Canada

Post: #4
RE: Adaptive Servo Ventilation
Thank you, DB, that is an excellent summary. Perhaps it should be made a wiki article, along with similar information about the Respironics ASV which I recall seeing recently.

I confess I haven't spent much time poking around in the wiki...

Phil
10-03-2015 08:53 AM
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Louver528 Offline

New Members

Posts: 2
Joined: Oct 2015

Machine: RESMED AIRCURVE 10
Mask Type: Full face mask
Mask Make & Model: QUATTRO AIR
Humidifier: RESMED AIRCURVE 10
CPAP Pressure: 80 * F
CPAP Software: ResScan

Other Comments:

Sex: Male
Location:

Post: #5
RE: Adaptive Servo Ventilation
Thanks DB, I appreciate your response .. Louver528




(10-03-2015 03:13 AM)DeepBreathing Wrote:  G'day Louver528, welcome to Apnea Board.

As you're no doubt aware, ASV machines are used to treat central apneas and periodic breathing (eg Cheyne-Stokes respiration). I have mixed apnea (both obstructive and central in about equal proportions) with an untreated AHI of 62. I use a Resmed S9 VPAP Adapt, which was the immediate predecessor of your Aircurve. (I assume you've got the Aircurve ASV?)

Before going on to the Resmed I had a month's trial on the equivalent Respironics machine, but we just didn't get on. It always felt like the machine was trying to force my breathing rate, which effectively prevented me from sleeping properly. I later found out (from this forum) that there are a whole bunch of adjustments that need to be made on the Respironics to fine tune it to your needs. By that time I had gone onto the Resmed and it was love at first breath! The Resmed algorithm is quite different, and (to me) it feels like the machine is following my lead, rather than the other way round. My AHI dropped from 62 untreated to ~25 on the Respironics to below 5 on the Resmed. It's now consistently below 1.5, usually below 1 and I get the occasional 0.0.

Setting the pressure is more complicated on these machines. You need to set the expiration pressure (EPAP) low enough to be comfortable but high enough to control obstructive apneas and hypopneas. The pressure support (PS) is the extra pressure the machine delivers when you inhale. It must be set low enough to be comfortable, but allowed to go high enough to treat central apnea. And your inhale pressure (IPAP) should be set at a maximum which is comfortable but still high enough to treat the centrals. The easy formula is EPAP + PS = IPAP

I note in your profile your pressure is 80 F - this is actually your humidifier temperature. Your pressure will be made up of the EPAP, PS and IPAP as described above.

The fact that the machine can respond extremely rapidly to a cessation in breathing is good, but it can sometimes be enough to wake you. This is annoying but it doesn't take too long to get accustomed. It can also kick in with a pressure burst before you've fallen properly asleep, which is likewise annoying - in this case just blow back hard and the machine will get the message.

I should also mention that Resmed have aborted a long-term clinical trial of their ASV machines due to an increased chance of death for patients with a particular type of congestive heart failure. You doctor should have discussed this with you (mine didn't) so if you have (or think you might have) congestive heart failure, it's time for a deep and meaningful chat with your doc.

If you have any specific questions I'd be please to answer them.
10-03-2015 12:35 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #6
RE: Adaptive Servo Ventilation
Hi Louver528, welcome to Apnea Board!

There is a "My Profile" link near the top right hand corner of forum pages. This can be used to easily find where we can edit our Profile.

If you are using the ASV model (or whatever model) would be helpful to include in your profile. For ResMed A10 series machines, the model name is located on the front of the machine.

I also suggest including in your profile the EPAP or Min EPAP setting, the PS or Min PS and Max PS settings, and the Max IPAP setting.

In case you don't know what these settings are set to, you can find the therapy mode and pressure settings in one of the screens/menus on your machine.

The Clinical Guide ("Setup Manual") for your machine gives a good overview of what the various settings mean and tells the secret button press method which will allow you to get into the Clinical Menu area of your machine, to see all the settings.

The Setup Manual can be obtained for free by email request:

http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 10-03-2015 07:49 PM by vsheline.)
10-03-2015 05:23 PM
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