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I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Carry duct tape to keep doc's head from exploding when you mention all these things. It may be too much responsibility for their probable side job.

And Happy New Year.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Update:  I saw my PCP about a Cardiologist consult today (and I took a roll of duct tape - Thanks Dave).  I come here every day and at least read all threads/posts on central apnea and asv on the 1st page.  

This past Monday:  The manufacturer of the Astral called me to check on how I was doing.  They call me every 2 weeks.  This time, instead of saying that the machine's rate is much too fast for me and the pressure much too high (which always got the response, "Just use it more during the day to get used to it.); I said I was "hyperventilating" and also talked about hypocapnia and my 2:1 ratio of CSA to OSA.  It got a better response this time.  The manufacturer contacted the RT at my local DME.  

The next day (yesterday, Tuesday) I got a call from the RT saying she was about 30 minutes from my home and wanted to check on me.  She changed the settings for about the 4th time.  I talked to her about hyperventilating and hypocapnia (Thanks Sleeprider), about my 2:1 ratio of CSA to OSA and showed her the interpretation of my polysomnography posted by Sleeprider on this thread.  She read it and agreed.  What she said next though, and I quote, "The Astral is ASV," surprised me.  I thought to myself, that is wrong.  Not correct.  But I didn't feel educated enough to argue about it.  Is she technically correct (the Astral is ASV therapy?)  I have only heard of 2 ASV machines here I think (Resmed and DS).  I may be wrong though.  I then showed her a brochure for the Resmed ASV.  She read it and said, "There are different kinds of ASV."  I felt confused by her statement and not educated enough yet to talk more with her.  But she did say a great thing as she was leaving, "we can probably try the Resmed ASV next if the Astral does not work out."  She would like a few nights of me sleeping with the Astral for data though.  I agreed to that.  I will put on the mask and not take it off all night if I have to stay awake all night to produce some data for her to move things along. 

She mentions my "shallow breathing" a lot I think in an attempt to justify the Astral, too.  Is she correct here?  

I looked on my Astral and it says iVAPS/autoEPAP mode on the front touchscreen.  I guess it is in iVAPS mode.  I have done some research about iVAPS.  But this is not the same as ASV is it?  I know the Resmed ASV is much quicker and flexible with it's algorithm.  Correct?  

I have tried to "throw the Astral fail flag" like you recommended, Dave.  The Manufacturer and the RT from the local DME picked up the flag and handed it back to me.  I will keep throwing it though.  When the manufacturer calls me back in about a week, what should I say this time to get an even better response?  The Astral feels much too slow in changing it's pressures and rates, but the Resmed ASV is supposed to be much quicker responding?  Or something along these lines?  

Today, I saw PCP.  She is consulting her personal Cardiologist for me.  Says will want to probably do EKG or echo (I forgot which one she said) and have me wear a 24 hour monitor for a few days to catch the A-fib or arrhythmia or tachycardia I only seem to experience at night when I wake up (and it goes away in a few minutes after I start breathing again.)  PCP said the "buzzing" I felt in the back of my head and neck was my carotid arteries.  I do not want a blood clot from A-FIB to form and be thrown and go up my carotid arteries and cause a stroke (all from sleep apnea).  Kind of scared me, but gives me motivation to do my pap therapy.

Comments welcome.  Much appreciation for all of the help that has gotten me this far.
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RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
The ResMed Astral and ASV are completely different. One isn't a mode within the other, or anything else incorrect they may try to tell you. ASV should be a quicker response because it's programmed to be that way, quicker than even the Astral I'm pretty sure.

Both are ventilators, but with very different missions.

ASV is Adaptive Servo Ventilator to combat Central Apnea.

iVAPS is a true ventilator mode, the ASV will not have this mode. ResMed ST-A, Stellar, and Astral do. These are respiratory support machines for those with respiratory disease.

I'm guessing the RT and DME will not really get it. But at least the RT mentioned ASV. Keep throwing flags. But give yourself a time limit. If they expires, for them, return the Astral, and hire some other quacks.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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