(05-25-2016, 12:05 AM)ronsch00 Wrote: If the bi-level or ASV device is more comfortable and ultimately controls the apnea levels, is going to bi-level or ASV ultimately going to make the condition worse compared to using a simple CPAP?
As others have said, bi-level gives two levels of pressure. The higher IPAP pressure when you inhale, and the lower EPAP pressure when you exhale. The difference between the two levels is called the pressure support. Having too high of a pressure, or too high of a pressure support, can lower the carbon dioxide level in your blood. It's the high carbon dioxide level that triggers the brain to call for a breath, so without this trigger the body doesn't breathe. When this happens for at least 10 seconds, a central apnea is scored. The central apnea index is the average number of central apneas per hour.
It appears you have central apnea, how much of it is there naturally and how much of it is caused by the CPAP or the bi-level therapy, is unknown. Most people get adapted to the therapy and the central apnea index drops on its own. If it doesn't then you need a machine that will initiate breathing on it's own. Bi-level CPAP machines can be set in a mode that allows them to do this, but ASV machines have more flexibility in the way they can be adjusted to do this. Of course, the greater flexibility means it's also more difficult to get the adjustment right.
This is where a good doctor comes in. Usually insurance companies direct the doctor to try the lower priced machines first, and when they don't work then you're switched to the more expensive and harder to adjust ASV machines.
If I had to guess, I'd say they'll start you out on a bi-level machine, and if it doesn't work you'll be switched to the ASV machine. If that's the case, I highly recommend that you push for an auto-adjusting bi-level machine. For example, the ResMed AirCurve 10 VAuto.