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Now having to try a ASV unit
#1
Started with the S9 VPAP Auto. After just several weeks, had issues never experienced before using CPAP. Stopped using machine. While VPAP did reduce OSA, it increased CSA. Now have been diagnosed wih Complex Central Apnea induced by CPAP treatment. Has anyone else been diagnosed with Complex Sleep Apnea and used a Resmed ASV machine?
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#2
Yep! I have the older S9 VPAP Adapt which is a great machine. My untreated AHI was 62 which dropped into the twenties when I tried a Philips ASV and is now consistently under 2, and often under 1, with the Resmed.

The Resmed ASV machines have a limited number of adjustments, basically just setting the pressure ranges and comfort features like the ramp and humidity. They rely on sophisticated algorithms to tailor your treatment to your regular breathing pattern. The Philips machines no doubt have a sophisticated algorithm, but also allow a wider range of manual adjustments.

If you do get the older Resmed (S9) ensure that it has the ASV Auto mode, which allows the machine to vary the EPAP pressure automatically. The older version of the S9 did not have this capability.

In my experience the two machines have a very different "feel". I much preferred the Resmed, while others prefer the Philips. Two different approaches to the same problem.
DeepBreathing
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#3
I am still waiting for paper work and approval to get new machine. Not sure what ASV I will be getting. It seems Resmed is preferred around here. Don't know if it will be an S9 or a A10. Don't think there is much difference in way they function, but Resmed keeps pretty tight lipped on the proprietary info
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#4
(03-08-2016, 06:16 PM)jalexand Wrote: Started with the S9 VPAP Auto. After just several weeks, had issues never experienced before using CPAP. Stopped using machine. While VPAP did reduce OSA, it increased CSA. Now have been diagnosed wih Complex Central Apnea induced by CPAP treatment. Has anyone else been diagnosed with Complex Sleep Apnea and used a Resmed ASV machine?

Hello Jalexand.

Yes - me too. You are not alone!

My diagnostic AHI was 59 (no centrals), down to 3 to 12 on CPAP/APAP. I had CPAP-induced central apnoeas, I couldn't tolerate the high pressures I clearly needed sometimes to overcome airway obstruction, and the fatigue (my principal symptom) barely improved at all.

With Sleepyhead and great advice from Apnoea Board members I could self-diagnose treatment-induced Complex Sleep Apnoea. I saw three sleep doctors with this evidence but they were all clueless so I explained my Sleepyhead charts to a favourite doctor (who is nothing to do with sleep apnoea), and he very kindly gave me a prescription for my machine. He only needed to see proof that I do not have cardiac failure (the current advice is that ASV machines are contra-indicated in patients with cardiac failure who have a cardiac FEV measure of less than 45%)

I use the Resmed Aircurve 10 ASV (it's called the Pacewave CS here in Europe). I thoroughly recommend it - but then I have never tried any other ASV machine to compare it with. It took less than a week to get used to it and I truly love it - very natural and comforting breathing despite my needing pressures sometimes of up to 23.

My AHI is now usually less than 0.5 (even zero three times), I sleep very well, my daytime fatigue has improved enormously, and it is very seldom now that I wake to pee during the night. My oxygen levels (I use a little Contec 50F oximeter once a week) have improved too. Life just generally a whole lot brighter.

I hope it all turns out well for you.

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#5
(03-09-2016, 04:22 AM)Asjb Wrote:
(03-08-2016, 06:16 PM)jalexand Wrote: Started with the S9 VPAP Auto. After just several weeks, had issues never experienced before using CPAP. Stopped using machine. While VPAP did reduce OSA, it increased CSA. Now have been diagnosed wih Complex Central Apnea induced by CPAP treatment. Has anyone else been diagnosed with Complex Sleep Apnea and used a Resmed ASV machine?

Hello Jalexand.

Yes - me too. You are not alone!

Hi Jalaxand,

I have also seen great improvement using my Resmed Aircurve 10 ASV machine. One thing to consider is that you may have been experiencing Central Apneas in the form of Hypopneas from the beginning. Inother words you had Complex Apnea all along. The S9 VPAP Auto just converted the periodic breathing hypopneas to Central Apnea events. The S9 VPAP Auto was actually diagnostic in the sense that it could not control the periodic breathing Central Apnea events. Keep us posted.

Rich
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#6
(03-09-2016, 04:22 AM)Asjb Wrote:
(03-08-2016, 06:16 PM)jalexand Wrote: Started with the S9 VPAP Auto. After just several weeks, had issues never experienced before using CPAP. Stopped using machine. While VPAP did reduce OSA, it increased CSA. Now have been diagnosed wih Complex Central Apnea induced by CPAP treatment. Has anyone else been diagnosed with Complex Sleep Apnea and used a Resmed ASV machine?

Hello Jalexand.

Yes - me too. You are not alone!

My diagnostic AHI was 59 (no centrals), down to 3 to 12 on CPAP/APAP. I had CPAP-induced central apnoeas, I couldn't tolerate the high pressures I clearly needed sometimes to overcome airway obstruction, and the fatigue (my principal symptom) barely improved at all.

With Sleepyhead and great advice from Apnoea Board members I could self-diagnose treatment-induced Complex Sleep Apnoea. I saw three sleep doctors with this evidence but they were all clueless so I explained my Sleepyhead charts to a favourite doctor (who is nothing to do with sleep apnoea), and he very kindly gave me a prescription for my machine. He only needed to see proof that I do not have cardiac failure (the current advice is that ASV machines are contra-indicated in patients with cardiac failure who have a cardiac FEV measure of less than 45%)

I use the Resmed Aircurve 10 ASV (it's called the Pacewave CS here in Europe). I thoroughly recommend it - but then I have never tried any other ASV machine to compare it with. It took less than a week to get used to it and I truly love it - very natural and comforting breathing despite my needing pressures sometimes of up to 23.

My AHI is now usually less than 0.5 (even zero three times), I sleep very well, my daytime fatigue has improved enormously, and it is very seldom now that I wake to pee during the night. My oxygen levels (I use a little Contec 50F oximeter once a week) have improved too. Life just generally a whole lot brighter.

I hope it all turns out well for you.

Thank you for the info. and some confidence that this time it will work out. My AHI level was consistant with yours, but because of the apnea and blood clots in the lungs, my heart has begun to fail from being stressed for so long. Not sure what my options would be should this not work out.
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#7
(03-10-2016, 01:10 PM)jalexand Wrote: Thank you for the info. and some confidence that this time it will work out. My AHI level was consistant with yours, but because of the apnea and blood clots in the lungs, my heart has begun to fail from being stressed for so long. Not sure what my options would be should this not work out.

Hello Jalexand,

I'm a bit concerned that you say 'my heart has begun to fail'. Obviously I can't offer any opinion as regards any cardiac condition but there are currently thought to be some risks with some people who have cardiac failure (which I understand is a specific diagnosis - typical symptoms, and specific sorts of results on an echo-cardiogram test, & etc) and who are using ASV machines.

You might find this patient information leaflet from the American Thoracic Society to be helpful - 'Use of ASV for people with heart failure and trouble sleeping':

https://www.thoracic.org/patients/patien...es/asv.pdf

and discuss this with your sleep doctor and cardiologist before they and you make any decisions about the type of CPAP therapy that is the most appropriate for you.

The guidelines do helpfully say though that 'there is no good reason at this time to stop using ASV' if someone is already being treated with ASV because of (for example) Complex Sleep Apnoea.

Best wishes
Asjb

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#8
I have had all the pulmonary and heart function testing, which is how I know I have heart failure. It is the left ventricle dysfunction that is a problem. I am told this has been caused by untreated apnea. But my ejection fraction is at 73, which is normal, so using an ASV unit is ok. Less than 45 is the cutoff for use. One of those cases of treatment overrides the risks.
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#9
(03-11-2016, 02:38 PM)jalexand Wrote: I have had all the pulmonary and heart function testing, which is how I know I have heart failure. It is the left ventricle dysfunction that is a problem. I am told this has been caused by untreated apnea. But my ejection fraction is at 73, which is normal, so using an ASV unit is ok. Less than 45 is the cutoff for use. One of those cases of treatment overrides the risks.

Hello again - I also haven't read anywhere that ASV is contra-indicated with HFNEF so I hope you get the ASV machine you want.

I still like my Resmed Aircurve 10 ASV very much - it even gave me an AHI of zero last night, with a very splendid night's sleep.

best wishes, asjb
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#10
(03-08-2016, 07:48 PM)jalexand Wrote: I am still waiting for paper work and approval to get new machine. Not sure what ASV I will be getting. It seems Resmed is preferred around here. Don't know if it will be an S9 or a A10. Don't think there is much difference in way they function, but Resmed keeps pretty tight lipped on the proprietary info

The older S9 VPAP Adapt model sold in the USA with only ASV mode (without ASVAuto mode) has REF# 36007 on the back of the blower unit.

A newer S9 VPAP Adapt went into production in November 2012. It had the same model name, but the REF# on the back of the blower unit changed to 36037 for models sold in USA. An even newer S9 VPAP Adapt model sold in USA has REF# 36067 on back of the blower unit.
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