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asv [questions about them]
#1
asv [questions about them]
I am curious as to the experience of being on an ASV machine. My understanding is that it intervenes when you are in Apnea, and attempts to correct Cheynes Stokes breathing. Does this cause any sensation in the patient? Can you feel this machine working? Does it wake you up?

Or does it fell essentially the same as using a APAP?

why do I have to have a new sleep study when all my sleepyheads charts show I need one.? My Dr. told me I need one but I need a study first. Can someone explain to me why?
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#2
RE: asv
The ASV is an amazing machine not even in the same class as an APAP. I love mine. It took me about 4 days to get adjusted to it because I could feel when it ramped up the pressure. It would ramp up very quickly. Now I don't even notice it. I wake up with an AHI of 0 most mornings with an occasional 0.1 or 0.2. The sleep study is to prove to the insurance company that you actually need a ASV because noting else will work. I went through 4 sleep study's and two doctors and about 7 months before getting my ASV. 

Sleep-well
Min EPAP 10
Max EPAP 13
Min PS 3
Max PS 10
Sleep-well
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#3
RE: asv
The feeling of sleeping with an ASV is very different from CPAP / APAP. It actually adjusts the pressure on every individual breath to stabilise your breathing. As airflow is reduced by apnea or hypopnea the pressure support increases. Some people take a little while to adjust, but for the majority it seems to come very naturally. For susceptible patients ASV is a godsend!

From my own limited experience I believe the Resmed ASV is far superior to the Philips and has a far more natural feel.
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#4
RE: asv
Jerry,
It probably has more to do with insurance than anything else. It makes no sense to us but it does to the insurance companies.
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#5
RE: asv
(01-03-2018, 10:57 AM)jerry1967 Wrote: I am curious as to the experience of being on an ASV machine. My understanding is that it intervenes when you are in Apnea, and attempts to correct Cheynes Stokes breathing. Does this cause any sensation in the patient? Can you feel this machine working? Does it wake you up? 

Or does it fell essentially the same as using a APAP?

why do I have to have a new sleep study when all my sleepyheads charts show I need one.? My Dr. told me I need one but I need a study first. Can someone explain to me why?

Probably in part to satisfy insurance requirements. I had to fail CPAP and BiPAP before moving on to ASV. Before each machine was issued, I did a full night's PSG (3 x) and a separate titration for CPAP in 2015. That is 4 total times at the sleep center.

As for an ASV machine, I love it. To me, mine feels better than either the CPAP or BiPAP. Some of that is due to the medical need I have for the ASV. But IMO the ASV algorithm is awesome at adjusting per breath; for me it's a big difference. As for feel, it could be described as basically the same feel as a BiPAP I suppose.

Dave
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#6
RE: asv
I love the results from my ResMed ASV. Finally getting (mostly) refreshing sleep.

As to "feel," it took me a little while for the machine and me to get in perfect sync. It seems like the machine learns one's breathing patterns in addition to one adjusting to the machine.

At the very beginning, the machine would sometimes too hard just at my transition to sleep (disrupting that transition). I'd often do the "blowback" trick, where one exhales with force to reset (lower) the pressure.

However, those quicks have passed. Seems very natural now.

Switching back to a P10 mask (which did not give good AHI results with APAP, for unknown reasons) was a boon with the ASV. It eliminated the body wash of exhaust air I was getting with my N20 nasal mask and makes the experience feel minimally invasive.

Bill
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#7
RE: asv
Yes it will wake you up initially but it beats the alternative; no breathing.  To me it isn't at all disturbing, I notice occasionally as I drift off to sleep and I'm thankful I'm getting that breath, but it is a soooothhhhiiinnggg amount of air coming in, NOT A DRASTIC PULSE of air.

The only time it may disturb me is when I'm moving (rolling over) and I pause my breathing, the machine will kick in.  You learn to stop the machine by just giving a bit of an exhale or just 'living with it' but accepting the breath.
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#8
RE: asv
Honestly, it may feel like the machine is learning. I think it's really your brain that learns the breathing patterns. So that it doesn't trigger the machine, as you go to sleep. It doesn't learn anything from the night before and only follows the last few minutes of minute vent or peak flow, depending on machine.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#9
RE: asv
Jerry

I have been on my ASV machine for over a year.  From day one, I could not tell any difference in the ASV machine from the prior bilevel machine.  You sleep through the event interventions.  There is no feeling of being on a different machine-ie a bilevel machine.  Now, you can clearly tell the difference in a bilevel machine from a constant flow entry level machine.  In the bilevel machine, the pressure increases on the inhale breath.  In the constant flow machine, the pressure decreases slightly  on the exhale.  Before I got the ASV, I thought I would be able to tell a big difference, and it would take some getting used to.  But that is not the case.

I will tell you one thing that might take some getting used to-and that is a Resperonics machine.  Before I got an Rx from my doctor for the ASV, I had to take s sleep test.  The test was done on a Phillips ASV machine.  I had been previously using a ResMed AirCurve bilevel machine and the transition between inhale and exhale  was smooth and seamless.  On the Phillips ASV there was an ever so slight delay before the inhale breath.  When I first started using this machine, I thought it was my imagination.  But as the night went on, I came to realize that the software in this Phillips machine was not quite as smooth on the inhale as the ResMed machines.  It is not a big thing, but still, it bothered me so much so that it kept me awake for awhile.

I think you will be happy with the ASV technology.  It has worked for me.  I average less that 2 AHI per hour.  I keep trying to get it lower, but that range appears to be my set point average.  I have about an equal number of centrals and obstructives.
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#10
RE: asv
I think you may find, the respironics has a manual trigger setting and it wasn't set right for you. I guess in the labs it's easier to get you to suck harder to trigger, than to have the trigger too sensitive and self trigger.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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