BiPAP ST vs ASV

[scottrichard]

I have mild CSA (4 events per hour) and moderate OSA (19 events per hour). CPAP made my CSA far worse and my doctor doesn’t consider CPAP to be viable.

My doctor wants to do a titration study on either BiPAP ST or ASV. Both options are available to me. Is there any reason to consider ST, instead of ASV? I’m not concerned about any cost difference, only efficacy and practicality.

I have asked my doctor to have an echocardiogram performed, to ensure I am not in the risk group for ASV side effects. I have no reason to believe it will be an issue.

[SarcasticDave94]

You are attempting to treat mild Central Apnea with the highest possible most expensive machines, and they're likely not required. ST is typically used to treat patients with lung disease. If you have COPD or similar, it might work, but the ST-A is better for those diseases.

This probably is not you, so to treat Central Apnea it might need ASV. You had mild CA in the other thread. You say here 4 CA to 19 OA, I highly doubt insurance covers this one.

I don't know right now what your other thread had, so you need to keep this in one place.

With mild CA you may get decent to get therapy with VAuto, ResMed's Auto bilevel.

[scottrichard]

You are attempting to treat mild Central Apnea with the highest possible most expensive machines, and they're likely not required. ST is typically used to treat patients with lung disease. If you have COPD or similar, it might work, but the ST-A is better for those diseases.

This probably is not you, so to treat Central Apnea it might need ASV. You had mild CA in the other thread. You say here 4 CA to 19 OA, I highly doubt insurance covers this one.

I don't know right now what you other thread had, so you need to keep this in one place.

With mild CA you may get decent to get therapy with VAuto, ResMed's Auto bilevel.

Is there any reason to not go straight to ASV? The doctor didn’t seem too concerned about insurance. I’m guessing the CPAP data he has is sufficient to demonstrate the need for a different machine. Regardless, I would pay out of pocket to not have to deal with the problems I have had so far.

[SarcasticDave94]

That's your choice then. Agreed in this sense, the big blob of purple CA flags will not get better with CPAP. At least not likely for you.

The ASV will likely deliver inhale pressures more abruptly than CPAP, with variable pressures overall if set right.

Are you going to do a Titration including ASV mode?

[scottrichard]

That's your choice then. Agreed in this sense, the big blob of purple CA flags will not get better with CPAP. At least not likely for you.

The ASV will likely deliver inhale pressures more abruptly than CPAP, with variable pressures overall if set right.

Are you going to do a Titration including ASV mode?

The doctor said he wants me in the lab for titration on an ASV machine. ST seemed to only be a fallback if there was some heart issue or I requested ST for some reason.

[SarcasticDave94]

OK thanks for the info. Sounds right. My opinion say no to ST. It's static EPAP, PS, and IPAP. It would be sufficient to treat but it will be less comfortable. And the ASV is designed to treat Central Apnea. It'll get all other Apnea as well.