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
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan
Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration
Location: California, USA
RE: HELP BUYING AN ASV MACHINE
Hi. Since Johnny posted his questions to me, I'll go ahead and post my lastest responses.
Take care, all.
vsheline Wrote:Hi John,
The S9 ASV and A10 ASV use the same software algorithms and therefore will behave the same to your apneas. I think treatment with one won't be better than treatment with the other.
Your 750 series machine is a little older than the 760 series machines and does not support a heated tube. But in as far as data is concerned, they both offer a terrific amount of data.
I think probably would be better to wait until you've seen the data your machine can show you, before you buy another machine. An ASV machine is not best for everyone, but if it would be best for you the data in the 750 machine will tell us.
The data in the 750 will also show whether it is adjusted correctly for you, and if it isn't, how to improve the settings for you. If you sometimes feel choked on it, the data will help us see why, and how to improve the settings for you.
If the data shows lots of central apneas, an ASV might help a great deal. But if you are having all obstructive apneas then an ASV might not help. So be patient and wait for the SD card to come.
Johnny Bravo Wrote:Vaughn:
Thanks for writing. I'll try to tell you what i thought of talking on the phone
I'm sorry to know about your hearing condition. I hope you get better or are handling that well now.
>> I'm doing okay. In a couple years I may look into cochlear implants. I'm already using the most powerful hearing aids available.
I read on another thread that there's such a thing as the complete sleep study or titration and that you can ask for it. Not just the report but the actual detailed graphics and charts. I also asked for this but they didn't give it to me, didn't pay attention. I want to have my actual breathing curves to see if some Doctor can look at them and tell me if i have centra sleep apnea (complex) or not.
>> I can help you find SD cards which will work in your present machine, and then you can see whether you have central apneas happening very often. (Nearly everyone gets at least a few per night, usually short, like 20 seconds.)
Also I read that there's another thing called a back up rate that one of the brands have it (Respironics?) and Resmed doesn't. What's this?
>> Both ResMed and Respironics ASV machines have an automatic backup respiration rate (breath rate), which is the speed at which the machine breathes for us when we are having a central apnea and are not breathing on our own. There is no need to set this manually, but if one wants to, only the Respironics lets us set it to a fixed, unchanging rate to use if we stop breathing on our own.
I was hoping we could talk about things like what brand and model of machine to buy, and whether you would help me set the settings of that one.
If i buy your same machine will you please help me set it and use it?
>> Don't buy the REF 36007. The 36037 is newer and better.
Why buy a machine that has the ASVAuto therapy mode (in addition to the basic ASV therapy mode)? I don't know about this, please explain this to me, how would this help?
>> ASVAuto mode will automatically adjust both EPAP (the exhale pressure) and PS (Pressure Support, the amount the pressure is boosted while we are inhaling). Basic ASV mode only automatically adjusts PS. It is helpful to know where the machine's treatment algorithm would set the pressures.
Why do you recommend buying the ResMed ResMed S9 VPAP/BIPAP Adapt SV Auto with Heated Humidifier - REF - 36037? Is there a particular reason for this? Is it because you have it and know have been successful with it and know how to use it?
>> You mentioned Secondwind, and used REF 36037 machines are presently available from Secondwind for a reasonable price. (I copied and pasted the description from Secondwind, of a "gently" used machine.)
I'm afraid if i buy the AirCurve10, although it seems like a better machine (Resmed's last and best model?), i won't know how to use it, or i will but not set it to the right pressure ranges for me.
>> Both the S9 and A10 work the same. No significant difference. The treatment algorithms were not changed between S9 Adapt and A10 ASV. I wouldn't say the A10 is better today, except you would likely be able to get an A10 repaired if it breaks down in a few years, but maybe not if it was an S9.
On the other hand reading from the thread i posted, i feel like this one, the 10, will give me more track records about the different kind of apneas (obstructive, central) and other events like Cheine Stokes, Shallow Breathing, Central Hypopneas, etc? Or will the 9 give me all this information as well?
>> Both S9 and A10 give this info, if you use the free SleepyHead software to read the SD card.
>> This is most important: your present machine can also give you all the same info, so you must get a 2GB full size (original standard size) SD card to put in your present machine, which is a very excellent and relatively new model machine.
I'm so bad at this and have never had a good newer machine that i didn't even know what a Centra Hypopnea was.
>> Hypopneas can be obstructive or central in type/cause.
>> Your present PRS1 BiPAP Auto machine can record waveforms showing every breath you take all night, and will flag/mark most (almost all) of the central apneas which are happening. So you don't need a special sleep study to find out if you are getting an excessive number of central apneas (more than 3 or 4 central apneas per hour of sleep).
Do you know what kind of SD Card does each one of these machines need? How many Gigas or Megas? My old Bipap only works with one that has to be of 2 Gigas and i haven't been able to get it cause they don't make them that small anymore.
>> They still make them that small. The newer machines can use the old 2GB and also higher capacities, but 2GB is large enough to use on the A10 series.
I've never been able to keep this apnea track records myself, and i need to do it. I think it's time, but i have to solve this SD card thing, or even better to get this newer better servo maching with a better newer SD Card system. I downloaded SleepHead but don't know how to use it, i've never used it.
>> After you get an SD card to put in your machine, there is a very good introductory beginner's guide to SleepyHead available on Apnea Board.
Can you post the apnea track records of SleepyHead or other software, the one you recommend using here, on this forum?
>> I recommend using SH with your present machine, and either SH or ResScan if you get a ResMed machine.
As for the AHI records of my machine, i don't have one. I've never done that. That's how bad of a user of cpap i am, how much i don't know. All i know is when i used to go to my last doctor he just took my machine and gave it to his secretary, who took the info out (not via SD Card) and so he knew about my apnea track records but never told me about them, just changed the settings of my machine every time.
>> It is easy to get the data off the SD card and into Sleepyhead software, which will plot the data for you/us to see.
What does it mean on your profile where it says Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)?
>> It means there are 3 models of S9 ASV machines, and I only recommend the later two, which I think are about equal.
Do you think it would be a good idea to buy both one machine by Resmed and another one (back up) by Respironics just to try both brands and therapies and see what feels better? Or probably buy the 10 and the 9 by Resmed? It will be more expensive, but it's my life and i know i'll eventually probably have to invest on this with time. But i don't know if for now that will be too much. I don't even know if ASV is for me. This will be a self titration thing.
>> Self titration is especially easy with ResMed ASV. I suggest getting only one, to start. If you like it, I suggest a second of same type, as a backup.
I've had a lot of trouble and bad luck with doctors here in Colombia, and I now what happened was i had to go through a normal cpap titration procedure cause i asked and that was their protocole. The only way to get a titration on a Servo machine was if i took a normal titration with cpap and they couldn't treat muy apneas with it. Then i would be prescribed with a servo titration with a special sleep technician who was the only one who knows how to do it at that sleep clinic.
I go to a sleep clinic that i have to pay out of pocket with where they kind of listen to me (even with all that trouble) cause the bureaucracy through my enssurance was even worse. I was several months trying to get the sleep study and titration and just couldn't get it.
And it's in general bad and not specialized like that the medicine for sleep apnea in sleep clinics here in Colombia. They don't consider my long difficult history with apnea, i'm just a difficult patient who doesn't wanna use cpap. That's why i wanna go back to the US and take a yet new sleep study if i'm lucky enough to find a good sleep clinic where they take into account my history and give me a detailed, full sleep study (with the graphs and charts) to rule out central sleep apnea and see what's really happening with my breathing (centrals, hypopneas, central hypopneas, complex, cheyne stokes, shallow breathing, etc).
>> Your present machine has central apnea detection. It can tell you whether you have mixed (central plus obstructive) sleep apnea.
Why do you you doubt they would see something overlooked previously?
>> Usually sleep apnea is only problem.
>> Before getting another sleep study or titration, it is impotent for you to look at the data which can be gotten from your present (very excellent) machine, using an SD card.
Are the latest ASV machines so smart that they give you different kinds of apnea track records that not even a sleep study does? Can a good machine replace a sleep clinic?
>> A sleep study is just one night. If sleep apnea is the main problem, a few weeks of data from a auto-titrating machine will usually be better than an overnight lab titration.
I don't need my health insurance to cover an ASV machine. As i said i'm doing all this on my own and out of pocket cause i haven't gotten any answer or treatment from doctors. That's why i go to a private sleep clinic where i don't need a prescription to get a sleep study and just ask for it and pay. I'm getting the ASV machine to try to self titrate and help myself.
>> First, important to look at the data your machine can show you/us.
I don't use the mask liners cause we don't have them here in Colombia, though i know i could buy them online. I do have leak issues with the Simplus, although it's been a good mask (the only one i can stand). What website do you buy these from?
>> RemZzzs. A "30-day supply" lasts me nearly a year.
I'm sorry for this long message.I hope you can give me answers to all my questions. Thank you for you time.
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: 10-22-2016 12:56 PM by vsheline.)