Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
#11
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Waldo, we can see from your results that you can tolerate EPAP pressures below 8-cm and still not have obstructive apnea. The prescription we would suggest for ASV comes from the recommended titration protocol I included below.  Very simple:


Mode Auto ASV
EPAP min 5.0
EPAP max 8.0
PS min 3.0
PS max 15.0

These are the standard recommended starting pressures for a Resmed Aircurve 10 ASV in Auto mode. It is likely that after some brief experience with the machine you will fine-tune the settings according to the protocol.  I don't think you will increase EPAP range, but you might reduce the minimum or maximum PS (pressure support) for your comfort and effectiveness.  These settings work for a majority of individuals with your central apnea profile. These settings are sufficient to prevent obstruction in people with a minimal obstructive apena problem, and can actively induce a breath or increase the volume of a breath to prevent both hypopnea and centrals. 

[Image: attachment.php?aid=4210]
Post Reply Post Reply



Donate to Apnea Board  
#12
RE6: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Thank you Sleeprider :-)  Would you like another challenge?  My wife just got a new AirSense 10 for Her Autoset with the Climate Air hose/humidifier on auto after using a CPAP for ten years set at 8.  Her sleep study showed 8 was still a good setting with both central and obstructive apneas at 7. The new machine was initially setup with a pressure relief of 2 with the attached results.  I decided to try the "for her" algorithm with no pressure relief.  The machine automatically kept her pressure higher than 8 and both attached screenshots show lousy results.  Any suggestion for trying new settings?  She is still trying to get her F20 Airtouch mask to fit correctly which led to the positional air leaks last night.  Sometimes she gets it correct with no air leaks all night.  She is a side sleeper like me.

PS Congratulations on your recent 10,000th post!


Attached Files Thumbnail(s)
       
Post Reply Post Reply
#13
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
That is a pretty good challenge! At 8.0 fixed pressure and EPR 2, she has better results than the Autoset for Her at 8-15 EPR off. Not only are all events at a lower rate, but her tidal volume is a bit higher. I think the EPR is a good addition, and increases in pressure actually bring on quite a bit of mixed apnea. Not much to go on here, but she seems to have a bit of a complex apnea going on. Additional EPR at fixed pressure may increase CA or OA, or it might reduce hypopnea.

It's really hard to advise, but the EPR seems to help hypopnea, while higher pressure reduced OA. The CA events are a wild-card and only slightly higher with the variable pressure. It might be interesting to repeat your 8-15 pressure with EPR 2. I'll be honest, this is not an easy pair of charts to interpret or resolve.
Post Reply Post Reply
#14
RE8: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Join the club.  My wife has always been hard to read ;-)  But I am keeping her after 52 years of marriage.  OK I put the EPR back at 2 and keeping the 8-15 setting with the "For Her" algorithm.  Will post an update in a few days.  Thank you for accepting the challenge.
Post Reply Post Reply
#15
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Quote:Her sleep study showed 8 was still a good setting with both central and obstructive apneas at 7

So that's what is considered good? 

I am really thinking that both of you should be on the ASV.
Post Reply Post Reply



Donate to Apnea Board  
#16
RE9: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
My apologies for not writing clearly on my last post.  With a CPAP pressure  of 7 during titration, my wife had one Central and one Obstructive Apnea in a 78 minute period. With a pressure of 8 over a 126 minute period she only had one obstructive apnea with 100% oxygenation.  With a pressure setting of 10 for 23 minutes she had no apneas but the oxygenation had dropped to 98%.  So somebody decided a pressure setting of CPAP 8 was the best to recommend.
Post Reply Post Reply
#17
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
(05-30-2018, 11:43 AM)JesseLee Wrote:
(05-30-2018, 11:13 AM)waldo1945 Wrote: Thank you for your latest response.  I will take in good faith that my current machine has no central apnea therapeutic effect and will push for an ASV machine.  Yes I was asleep during the reported time period.  I am retired and have no regular sleep schedule. I rarely get more than two hours of sleep at a time and always use my machine unless I accidently doze off for awhile.  All my pulmonary doctor wants to see from me during my appointment next month is my machine.  He does not care about whether it has an SD card or not.  Since the data stored on the machine is just average summary data, my cluster central apneas are going to be buried in the averages.  So it is up to me to bring the screen shots to him and show that my blood oxygen level is dropping below the magical clinical 88% during the cluster apneas and causes me to wake up.  The clusters last from 10 to 30 seconds each one right after the other until I awaken. He already knows about my erratic sleep schedule.  I wear a FITBIT watch which collects the attached REM sleep information which I will add to what I show the doctor. If I can't convince him to prescribe an ASV machine with my acceptable 65% heart ejection fraction, I will ask my long time general practitioner to do so.  Thank you for sharing your expertise and helping me solidify a plan to get an ASV machine.

Going in armed with information is critical. I like the idea that you have about asking your general practitioner to write a prescription for you. I find that talking to my family doc is a lot easier than dealing with a specialist. I have written down exactly what I want him to write me a prescription for, and after a brief discussion, he has always written the prescription. If you have your prescription for your CPAP machine, you might consider copying the prescription and making notes on the copy, replacing the details with precisely the machine you would like. For example, "Dispense Resmed Aircurve 10 ASV with heated tubing and humidifier....99 months..." "include mask of choice..." 

Your coverage provider might not pick up the tab on the machine but with some careful maneuvering you may be able to get your equipment provider to accept compliance with the ASV machine and your coverage provider can help with supplies. 

I'm prescribed an auto CPAP and use an auto Bilevel machine that I bought on my own and the supplies are covered by my insurance despite my use of a machine not specifically prescribed.


i was told that the coding for a cpap is the same no matter which machine it is. Is that correct?  if it is then getting the ASV might be easier than not?
Post Reply Post Reply
#18
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
(06-01-2018, 05:55 AM)gramma Wrote: i was told that the coding for a cpap is the same no matter which machine it is. Is that correct?  if it is then getting the ASV might be easier than not?

CPAP and APAP are in one tier of machines; bilevel (BPAP) and ASV are in a higher tier with different HCPCS codes and are more expensive. For bilevel or ASV, you need a prescription that specifies it.

Some of the codes are listed here: https://www.resmed.com/us/dam/documents/...S_Card.pdf
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
Post Reply Post Reply
#19
RE9: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Thank you for mentioning the different HCPCS Codes for PAP machines.  The attached describes how to translate a doctor prescribed HCPCS Code to the various Resmed machines.  In general HCPCS Code E0601 applies to CPAP, E0470 applies to BPAP and E0471 for complex apneas. I am currently looking for an ASV machine which calls for HCPCS Code E0471 on the prescription.


Attached Files
.pdf   Scripted Cpap Therapy.pdf (Size: 691.71 KB / Downloads: 52)
Post Reply Post Reply



Donate to Apnea Board  
#20
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
I don't recall if you had gotten an Rx for ASV yet, but if you haven't, I've created a sample that you can use to help your doctor with obtaining the machine of your choice. It is in this thread:

http://www.apneaboard.com/forums/Thread-...ption-Form
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  ResMed S10 AirCurve ASV Howie51 4 190 10-16-2018, 07:59 AM
Last Post: Glamdrhel
  Switching to ResMed Aircurve 10 ASV Howie51 7 184 10-15-2018, 07:32 PM
Last Post: Howie51
  [ResMed AirCurve 10] OTA SW upgrade: When? How? thibaulthib 7 136 10-15-2018, 02:47 PM
Last Post: SarcasticDave94
  Can you still have central apneas on ASV?? Michaely6 10 252 10-14-2018, 07:05 PM
Last Post: SarcasticDave94
  [split] Discussion on Benefits purpleh2 8 107 10-13-2018, 11:30 AM
Last Post: Mosquitobait
  Does anyone have an tips on self titration for the Resmed aircurve 10 ASV? Michaely6 15 356 10-12-2018, 10:52 PM
Last Post: SarcasticDave94
  ResMed AirCurve 10 VAuto vs AirCurve 10 S Howie51 4 162 10-12-2018, 03:30 PM
Last Post: Howie51


New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.