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[Equipment] ST or ASV?? Need Help!
#1
Hi guys,

Wish any of you experienced could give me some suggetions.

Doctor has recommended to use a bilevel machine, and I am lost in making my choice.

Please tell me if I am right,
1. The ST machine is a bilevel machine that operates to set I&E pressure,
2. The ASV machine is a bilevel machine that operates to set I&E pressure, and adjust automatically according to changes and needs of the patient.
3. And, the ASV machine can be used for patients who require ST machine and with more functions
4. Is there any machine with software that will show the Central Apnea rate?

Thank you for your help and efforts.


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#2
ST is a bilevel with fixed IPAP and EPAP pressure. In S mode, it triggers by the users breath. In T mode, it has a timed backup rate for trigger.
The ASV responds on a breath by breath basis to add extra prssure to inflate the lungs if the user has a central apnea.

ASV is more expensive than a bilevel ST machine; but, the ASV is the gold standard for treating central apnea.

The ResMed Aircurve 10 ASV would be a top of the line ASV machine.
There are several software packages for this machine. SleepyHead is one of them.

If you do not have mixed or central apnea, and just need a self adjusting bilevel, then the Resmed Aircurve 10 Vauto would be a good machine.
It hold the relationship: PS = IPAP - EPAP and permits IPAP and EPAP to adjust within preset limits. PS = Pressure Support; and is held constant.
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.
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#3
Hi Patrick. Welcome to the Apnea Board. Both machines will record Central Apneas. You will need to use software to be able to see the different kinds of Apnea and Hypopnea being recorded. I highly recommend installing the Sleepyhead software. You can then download the machines recorded information from the SD card. I answered #4 first because the ASV machine is used primarily to treat Mixed and or Central Apnea. The ST machine provides a Backup Rate for when respiratory stimulation is needed. The ASV machine is much more expensive and in the US because it has the ability to respond to cessations or decreases in respiration. So, the machine you need depends on the type or types of Apnea that you have. Many of our Board members recommend the VAuto machine at a minimum for treating Obstructive Apnea.

It would help if we had more information from you. It appears that you are using a machine now. Download and install the Sleepyhead software and use it to read the information stored on the SD card. Even if your machine is not data capable, tell us about your diagnosis and current experience. We can help you gain control over your treatment.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#4
Hi Patrick Chang,
WELCOME! to the forum.!
Which S9 do you have, there are several in the S9 series of machine.
Good luck to you as you continue your CPAP therapy.
Hang in there for more responses to your post.
trish6hundred
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#5
Hi Rich,

Thank you very much for your reply.
In fact I am iquiring on behalf of my son, 16 yr.
The reason I am stuck on chosing between the ST and ASV machine is that I would like to get the right machine to use for long term, and with extra functions that may be needed in the near future.

My doctor has diagnosed me of mixed apnea, obstructive and central, also with stuffy nose at night, and conditions change often. I have been using a Fisher CPAP machine for over a year, and had already used the sleepy head.

With that CPAP machine, my apnea rate remain very high, over 60.
Recently I have got both ST and ASV machine on loan to try out. And with each machine, pressure set at 16/12, my apnea rate has dropped below 1, and sleep only about 6 hours every day feeling rested well. Before, with the CPAP machine, I could sleep 10 hours and still feel tired.

Is it enough just sleep for 6 hours? Shall I try to sleep longer even I do not feel sleepy or difficult to remain sleeping?


Thanks aagain for your help
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#6
(10-04-2016, 05:23 PM)trish6hundred Wrote: Hi Patrick Chang,
WELCOME! to the forum.!
Which S9 do you have, there are several in the S9 series of machine.
Good luck to you as you continue your CPAP therapy.
Hang in there for more responses to your post.

Thanks,

I have got ResMed S9 ST and ResMed S9 ASV on loan
now I am to chose between these two types of machines.

Patrick
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#7
Hi justMongo

Many thanks for your reply.

I got loan on both ST and ASV machines, and both machine gave pretty close result, apnea rate came down between 0.8 to 1.2

Prices for machine I have found on Ebay, the ASV cost about Eur 200 more than ST machine, which I can afford.

What I would like to confirm is that the ASV machine can do the job of a ST machine, and with more functions when needed.

As I already need to spend the money to get new machine, I would rather spend that extra to get the extra function that may need, rather than when conditions change, and I need to get another machine.
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#8
(10-04-2016, 08:33 PM)Patrick Chang Wrote: Is it enough just sleep for 6 hours? Shall I try to sleep longer even I do not feel sleepy or difficult to remain sleeping.


Hi Patrick Chang,
If you feel good when you wake up after 6 hours, then it is enough for you.
As long as your not tired during the day and you don't feel you need a nap, then
6 hours of sleep is enough for you.

Forcing yourself to sleep longer doesn't make sense to me. You will probably just lay there and not really sleep or be anymore rested.
Everyone is different, and you need to do what feels best for you.

For me, I feel best when I get at least 7 hours sleep. If I sleep less than that, I end of wanting to take a nap during the day. Smile

Good luck in choosing your machine.

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#9
(10-04-2016, 08:33 PM)Patrick Chang Wrote: Hi Rich,

Thank you very much for your reply.
In fact I am iquiring on behalf of my son, 16 yr.
The reason I am stuck on chosing between the ST and ASV machine is that I would like to get the right machine to use for long term, and with extra functions that may be needed in the near future.

My doctor has diagnosed me of mixed apnea, obstructive and central, also with stuffy nose at night, and conditions change often. I have been using a Fisher CPAP machine for over a year, and had already used the sleepy head.

With that CPAP machine, my apnea rate remain very high, over 60.
Recently I have got both ST and ASV machine on loan to try out. And with each machine, pressure set at 16/12, my apnea rate has dropped below 1, and sleep only about 6 hours every day feeling rested well. Before, with the CPAP machine, I could sleep 10 hours and still feel tired.

Is it enough just sleep for 6 hours? Shall I try to sleep longer even I do not feel sleepy or difficult to remain sleeping?


Thanks aagain for your help


Patrick, a pressure of 16/12 can be accomplished by regular bilevel or auto bilevel. What distinguishes the ST is the ability to work with both spontaneous breathing (like other bilevels), AND to switch to IPAP when not enough breaths per minute are taken. It is mainly used for restrictive or obstructive pulmonary disease or obesity hypoventilation.

ASV on the other hand, can use auto bilevel with variable EPAP and IPAP as well as variable pressure support (PS). So it uses a minimum PS used for ventilation and comfort, and maximum PS used to overcome central apnea. It generally takes PS greater than 8.0 cm to induce breathing in a central event, so on a breath by breath basis, you might see 20/12 or greater when a central is in progress, and the machine resumes 16/12 when spontaneous breathing is present. The very sophisticated ASV machines today, can run with much lower EPAP pressures, and still resolve OA with variable EPAP pressure, and CA with variable PS. Examples are the Resmed Aircurve 10 ASV and Philips Respironics System One 60 Series SV Advanced.

I doubt that your son requires ST, and the ASV machines are more versatile in dealing with complex apnea and centrals. Any of these advanced machines should be used and setup with professional guidance. While you have been diagnosed with "mixed apnea, obstructive and central, also with stuffy nose", this does not mean your son needs bilevel, ASV or ST. An auto bilevel like the one I use is appropriate and comfortable for obstructive apnea, but unless your son has a complex apnea or other pulmonary issue that has been diagnosed, moving to ASV or ST may be completely inappropriate.
______________________________________________
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Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
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#10


Patrick, a pressure of 16/12 can be accomplished by regular bilevel or auto bilevel. What distinguishes the ST is the ability to work with both spontaneous breathing (like other bilevels), AND to switch to IPAP when not enough breaths per minute are taken. It is mainly used for restrictive or obstructive pulmonary disease or obesity hypoventilation.

ASV on the other hand, can use auto bilevel with variable EPAP and IPAP as well as variable pressure support (PS). So it uses a minimum PS used for ventilation and comfort, and maximum PS used to overcome central apnea. It generally takes PS greater than 8.0 cm to induce breathing in a central event, so on a breath by breath basis, you might see 20/12 or greater when a central is in progress, and the machine resumes 16/12 when spontaneous breathing is present. The very sophisticated ASV machines today, can run with much lower EPAP pressures, and still resolve OA with variable EPAP pressure, and CA with variable PS. Examples are the Resmed Aircurve 10 ASV and Philips Respironics System One 60 Series SV Advanced.

I doubt that your son requires ST, and the ASV machines are more versatile in dealing with complex apnea and centrals. Any of these advanced machines should be used and setup with professional guidance. While you have been diagnosed with "mixed apnea, obstructive and central, also with stuffy nose", this does not mean your son needs bilevel, ASV or ST. An auto bilevel like the one I use is appropriate and comfortable for obstructive apnea, but unless your son has a complex apnea or other pulmonary issue that has been diagnosed, moving to ASV or ST may be completely inappropriate.
[/quote]

Hi Rich,

Indeed my son has got a more complicated case, doctor has been on him for years. He was using a Fisher & Paykel CPAP machine over a year, which he could hardly wear for the full night, and apnea rate remain as high as over a hundred. This problem has severely affected his growth and incurred other physical problems.

Since we got loan of the ST and ASV machines, he could wear both machine over the full night of sleep, aprox 6 hours, and apnea rate comes down between 0.8 to 1.2

It seems either machine helps, and I would like to get the machine that has more function in case his condition changes in the near future.

I have been using SleepyHead, and would like to send you the report, but could not figure out how to
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