Newbe with Complex Apnea - Best ASV to get?

[JJJ]

Wish there was a Doctor in the house.
OR a sleep tech.

Even if there were such persons here, it would be a violation of their professional ethics to give specific advice without an office visit and a formal doctor-patient relationship.

But you're welcome to the collective wisdom of the group!

[racprops]

It was just a thought...

My questions do seem to be very deep...

Rich

[racprops]

Thanks Shastzi...

Sad to say that did not really offer any clear winner...between makers, it did clear up some info on some models...

And help explain some of the settings needed...

Rich

[archangle]

Shastzi: That is the big question, does it??

They are so automatic I really wonder if they really need any setup.

Rich

I think they are not "automatic" in the sense of "take one off the shelf and give it to anyone." Even the much simpler APAP machines don't work that way.

There are quite a few parameters that can be set. Many of these parameters have minimum and maximum values and the the machine then makes adjustments to meet those requirements.

New ASV users often have difficulty adjusting to the the machines. It often takes a lot of time tinkering with the parameters to get your body and machine to cooperate.

If they're set to the wrong parameters for the individual patient, you may find you can't sleep because your body is constantly "fighting" the machine about when you want to breathe.

For instance, I believe one of the parameters on some machines is some form of "minute ventilation." This is the volume of air that flows in and out of your lungs per minute. A 100 lb woman will need a lot less air than a 200 lb guy. Forcing the woman to breathe the man's rate would be too much. Using the woman's rate for the guy might leave him starved for air.

[archangle]

From what I have read, it seems hard to get a ASV_CPAP Machine that will read out central apneas.

Just as an FYI... no CPAP, APAP, bi-level or ASV will be able to determine a true central event. Central events are primarily a brain malfunction, where the brain fails to communicate properly with the lungs to "tell them to inhale/exhale". The xPAP machines don't have electrodes hooked up to your head to determine those events properly.

That's why many machines don't list those events as "centrals", but rather "clear airway events" - meaning that the machine had scored an event, but that your airway appears open (not obstructed), so it "assumes" that it's likely a central event, but that determination cannot be made authoritatively without being hooked up in a sleep lab.

Now, some machines may be better equipped to score those events properly (as centrals or open airway events). For that question, we'll need to get some opinions from ASV users...

The uncertainty of a CPAP machine's determination of central vs. obstructive is somewhat overstated in my opinion. Those who profit from in lab sleep tests have a strong financial incentive to disbelieve the data from CPAP machines.

The "standard" definition for defining if it's a central apnea is "respiratory effort." For in lab PSG tests, a chest effort belt is used to see if your muscles are trying to breathe. If the chest effort belt shows no movement, and there is no airflow, it's called a central. The EEG electrodes are not used to distinguish between central and obstructive.

I believe that when a PRS1 or S9 machine says "CA", it IS almost certainly a "real" central and would show up as such with a chest effort belt. I think that it will sometimes show "obstructive" when it's actually "central," however.

One problem is that your airway can be closed while you're having a central apnea. The lack of respiratory effort may lead to airway collapse that will go away when you try to breathe. There might also be some cases where your airway is open, but the machine just can't tell. It's trying to "see" what's happening in your throat, airway, and lungs while "looking" through the humidifier, 6 feet of hose, your mask, your nose, mouth, etc.

In summary, I think if it says "clear airway," it's almost certainly central. If it says "obstructive" or simply "apnea," it might still be "central."

I'm a bit puzzled why S9 ASV machines apparently don't distinguish central apneas from obstructive, but it's my understanding they don't.

[racprops]

"I'm a bit puzzled why S9 ASV machines apparently don't distinguish central apneas from obstructive, but it's my understanding they don't. "

That is one reason I am looking at the Respironics System One BIPAP Auto SV Advanced Machine with Heated Humidifier...it does try to read OAE (Open Airway Events) and reports them as such and grated they may be misreported as you point out...but it is trying...

One disheartening thing I am reading about on these forums is the number of people who are NOT getting major improvement or any improvement using these machines...

I am hoping that will not be my story..

Rich

[archangle]

One disheartening thing I am reading about on these forums is the number of people who are NOT getting major improvement or any improvement using these machines...

I am hoping that will not be my story..

Rich

We all hope to get better, but sometimes it's good to just not get worse. Sleep apnea is sometimes the death of a thousand cuts where each night does a little more damage to our heart, brain, and other parts. Even if you don't heal up, it's good to stop cutting.

Also, the people who use CPAP and get better don't tend to post about their condition a lot. Happy PAPpers also don't tend to find this web site. Those who don't get better search the web for help, find our site, and make a lot of posts as they try to work it out. If they work their problems out, they usually don't post as much, and especially don't post regularly saying "I'm a Happy PAPper."

Then there are the chronic whiners, hypochondriacs and outright trolls.

[SuperSleeper]

If they work their problems out, they usually don't post as much, and especially don't post regularly saying "I'm a Happy PAPper."

Well, I would like to say, "I'm a Happy PAPper."

Wouldn't you like to be a Happy PAPper too?

...sorry, I'm in a silly mood this morning... last night's AHI was 0.2

[Shastzi]

Hakuna Matatta.

[Ugly]

I think they are not "automatic" in the sense of "take one off the shelf and give it to anyone." Even the much simpler APAP machines don't work that way.

There are quite a few parameters that can be set. Many of these parameters have minimum and maximum values and the the machine then makes adjustments to meet those requirements.

I'm still prepared to offer my demands to my DME on Monday.
If she doesn't call me I'll call her. If the AutoSet has come in I'll tell her screw the Wednesday appointment I'll be right over to pick it up.
I've had enough insight to program it myself. 7-14 pressure as prescribed. Currently with the S9 Escape I'm at a self-inflicted level of 11.2 and doing not too bad with it.

She knows I can set the pressure but I told her I do that through ResScan. A little white lie. I didn't think she was ready for a full confession yet (possession of the clinical manual).
Hey I can assume she's as dumb as she thinks I am.