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How/When do you know you need a BiPAP or ASV
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Rcgop Offline

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Machine: Resmed AirSense 10 autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
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CPAP Pressure: 6.0 - 10.0 / EPR 2
CPAP Software: SleepyHead

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Sex: Male
Location: Orlando Fl

Post: #1
How/When do you know you need a BiPAP or ASV
If I needed a BiPAP or ASV machine how would I know? What would be the signs or symptoms?

I don't think I do but after 6 months, I don't think I am there yet. My sleep has gotten much better and probably as good as it is going to get. Daytime naps are a thing of the past. But, my AHI is still erratic. On any given day it can be as low as 0 and as high as 7. I have not had a single obstructive event in months. Maybe I am a bit impatient but I would like to know why BiPAP or ASV?

HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
08-12-2016 08:21 AM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
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Post: #2
RE: How/When do you know you need a BiPAP or ASV
Given your second paragraph, you appear to not need one.

The ASV would be for a person who cannot get good results due to central or mixed apnea.
They are expensive; and the insurance companies generally make a person fail on every other therapy mode.

Bilevel is used for people who require higher pressures and need more than 3 EPR; or those with other problems like COPD.
At your pressure, you would not need a bilevel.

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.
08-12-2016 08:52 AM
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Sleeprider Online
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Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #3
RE: How/When do you know you need a BiPAP or ASV
Based on your profile, you have EPR switched off. If you were to increase minimum pressure as needed to prevent OA, and turn EPR to 3.0, you would get a sense of what bilevel is all about. Bilevel and ASV are two different animals. An adaptive servo ventilator uses a higher EPAP to cause a breath when a central apnea occurs. Most insurance will not approve reimbursement for ASV unless CAI is regularly over 10. BiPAP / VPAP or bilevel is simply pressure support that makes pressure more tolerable and comfortable. It might be justified for people with aerophagia, or those who don't tolerate CPAP because they feel stressed by exhaling against pressure. It is also prescribed when CPAP pressure is relatively high. I got mine because it's more comfortable, and it actually reduces RDI (RERA) for me. It does not resolve CA, and is still mainly an obstructive apnea treatment device.

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08-12-2016 09:22 AM
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Marthajoy7 Offline

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Machine: aircurve 10 auto set to bipap S mode
Mask Type: Full face mask
Mask Make & Model: resmed mirage full face or Clear view full mask
Humidifier: Resmed built in humidifier
CPAP Pressure: 18.4/12 clearview or 18/13 mir
CPAP Software: ResScan SleepyHead

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Location: Seattle

Post: #4
RE: How/When do you know you need a BiPAP or ASV
I spent almost a month in the hospital with an ASV bipap. It will force you to breathe even if experiencing central apnea's. My pressures in the hospital were 15 inspiration and 5 expiration. Beside the pressures it also monitors time since you last breath and after a set period will force you to breathe. The hospital thought I needed an ASV for use at home but now doing well with just a type S bipap, which is just an advanced cpap. it does not force breathes.
08-18-2016 01:24 AM
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LadyAyel58 Offline

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Joined: Aug 2016

Machine: Unsure
Mask Type: Nasal pillows
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Sex: Female
Location: United States

Post: #5
RE: How/When do you know you need a BiPAP or ASV
The doctor who ordered your study would be one to tell you if you needed a therapy change. that would be the place to start.
08-21-2016 03:39 PM
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PaulaO2 Offline
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Location: western NC, USA

Post: #6
RE: How/When do you know you need a BiPAP or ASV
Bilevel PAPs are machines that go higher than 20 and can have exhale pressure difference greater than 3. Other xPAP machines only have an exhale difference of 3 or less. BPAPs are best for those with lung conditions such as COPD.

ASV PAPs are for those with Central or Mixed apnea. They are not for those who only have obstructive apnea.

Both of these kinds of machines are very expensive. A person has to "fail" using CPAP before most insurance will pay for a BPAP. Usually the failure is due to non-compliance due to not being able to breathe against the pressure.

It is fine if your AHI is still unstable after 6 months. It can take a while for everything to settle down. If you are fiddling with the pressure settings, stop. Pick a setting based on your data and leave it. Leave it alone for at least a month, maybe more. Continue to gather data. Continue to watch the AHI and the 95% and all that. And monitor how you feel each morning, during the day, and before you go to sleep. Start a sleep diary. There are so many factors that go into sleep besides the pressure on your machine. Become aware of those other factors while your body and brain adjusts to that.

The problem would be if the AHI is regularly, more than 5 nights a week, over 5. One or 2 nights, not a problem at this point.

I doubt any of us have the same AHI night after night. We have ranges and trends.

PaulaO2
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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.
08-21-2016 05:42 PM
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green wings Offline

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CPAP Software: SleepyHead

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Post: #7
RE: How/When do you know you need a BiPAP or ASV
When your AHI is 7, is that all clear airway events?

(08-12-2016 08:21 AM)Rcgop Wrote:  But, my AHI is still erratic. On any given day it can be as low as 0 and as high as 7. I have not had a single obstructive event in months.
08-21-2016 06:52 PM
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Rcgop Offline

Advisory Members

Posts: 215
Joined: May 2016

Machine: Resmed AirSense 10 autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: installed
CPAP Pressure: 6.0 - 10.0 / EPR 2
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Orlando Fl

Post: #8
RE: How/When do you know you need a BiPAP or ASV
[quote='green wings' pid='173361' dateline='1471823546']
When your AHI is 7, is that all clear airway events?

Probably 50%

HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
08-21-2016 07:05 PM
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richb Online

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Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
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CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #9
RE: How/When do you know you need a BiPAP or ASV
(08-21-2016 07:05 PM)Rcgop Wrote:  [quote='green wings' pid='173361' dateline='1471823546']
When your AHI is 7, is that all clear airway events?

Probably 50%

My guess is that the "other" 50% are hypopneas. It would be interesting to see a SH printout showing your flow pattern and events. You might have too much differential between EPAP and IPAP. This can cause an increase in CA type events.

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
08-21-2016 07:58 PM
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