Going from Bipap to ASV

[jacklogan]

My doctor is putting me into an ASV machine because I am tired all the time.

I told him a year ago that I was always tired even after sleeping for 10 hours. I would then have my breakfast and go back to sleep.

He put me on a Bipap machine for 7 months. I was still tired all the time. The Dr. then put me on Modafinil. I took as he instructed me to---still tired.

Had another sleep study--He said I needed an ASV machine.

I have to go to class on Thursday to learn how to work it.

Can anyone tell me what is different about the Resmed 9 asv??

thanks

[DeepBreathing]

G'day Jacklogan

I went from an S9 Autoset via a Philips Respironics Bipap ASV to a Resmed VPAP Adapt. I've got to say I love the Adapt!

ASV machines are prescribed when you have a large number of central apneas which don't respond to normal CPAP or APAP. Centrals occur when the signal from your brain stem to your breathing muscles is interrupted and you literally forget to breathe. Normal machines can detect and flag these apneas but have no way to treat them. An ASV machine responds by increasing the inhalation pressure to force you to breathe, a bit like a hospital ventilator (but much gentler).

You'll notice a very different "feel" with the ASV - there is a very distinct increase in pressure on every inhalation, so you can feel the machine helping you to breathe. This can be unsettling for some people and takes a bit of getting used to, but I found it wasn't too much of a problem and quickly adapted.

When it is noticeable is during the transition to sleep, when your breathing tends to get a little ragged and the machine intervenes to keep your breathing regular. Sometimes you need to override the machine by breathing out strongly when it's trying to force an inhalation - it's actually easier to do than describe.

ASV machines have three basic settings - EPAP (exhalation pressure, which prevents obstructive apneas), PS (pressure support, which is the increase in pressure applied at each breath), and IPAP, which is the inhalation pressure. IPAP = EPAP + PS. you'd normally set EPAP at the lowest range required to control obstructive apneas and hypopneas (maybe 6 to 10) then PS somewhere between 3 and maybe 10. Unless told otherwise, set the max IPAP to around 20. The machine can go up to 25 which is almost guaranteed to wake you up.

I found the VPAP Adapt made a huge difference to my results, dropping my AHI from an untreated 62 to less than 1 most nights. The best I could achieve with a Autoset was in the 20s. The pressure variations can be a bit disturbing, but you'll get used to them and sleep like a baby.

[trish6hundred]

Hi jacklogan,
Good luck with your new machine.
Hang in there for more responses to your post.

[jacklogan]

Thanks for your info.

Hope I do okay. I have my AHI's anywhere from .06 to 12.6. I'm still tired everyday.

[DeepBreathing]

If you're constantly tired even with low AHIs there may be other things going on. It could just be that your body is catching up from many years of abuse by apnea. Alternatively it might be that factors other than apneas and hypopneas are preventing you from getting thoroughly rested. Eg, frequent mask leaks can stop you getting into deep sleep. If you haven't already done so, why don't you download Sleepyhead software and use that to monitor all the things that don't show up in the AHI numbers.

In addition, I assume you've had your blood levels checked, especially iron and vitamin D. If not, you should probably discuss these with your doctor.

[quiescence at last]

@jacklogan - do you remember having dreams during a lot of your nights, or is it seldom, or never? REM sleep, where most dreams happen, should comprise about 20% of your sleeping. Well being seems to spring from that part of our sleep. Physical stamina seems to spring from the correct level of Deep restorative sleep, or Slow Wave Sleep (SWS), not associated with dreaming.

QAL

[truetopath]

Best of luck with your therapy. Hopefully they can figure out what's going on, and you can find the energy your looking for!

[squid 77]

If you haven't had your thyroid checked you should cause it can cause you to have that tired feeling all the time. When I was checked for sleep apnea they also checked my thyroid and I had sleep apnea and thyroid problems. Everything now is working as it should and my sleep apnea is under control.

[Nyre]

I too am being put on an ASV machine and I wish you luck with the new machine and I hope it solves your tiredness all the time. Keep us informed on how it works for you.

[jacklogan]

I am not computer literate, so I don't know how to get into sleepyhead or any other programs.

They sound so simple but ????????????????

Thanks for your help.

All my bloodwork is good, so I will see about ASV.

I have been on Cpap and Bipap for the last 20 years or so.

Thanks again. Will update in a few weeks--after I have been on ASV for a week or so.

Jack