Buying ASV online without a prescription

[David Clark]

David, in your experience, when someone develops treatment-emergent central apnea, sleep-onset CSA, or periodic breathing pattern, does the person continue to experience the central events or PBP for some time, even when the person sleeps without any PAP device?

That is a great question but my experience is not experienced enough to answer it. I only know the OP sounds a lot like I did when I first started pap therapy. Got my machine, was all happy, downloaded OSCAR and found out...OMG I'M HAVING CENTRALS. 
The longer it went and I was still having some I was dead set that I "needed" an ASV. The sleep dr wouldn't write a Rx for one and I was really thinking I was going to find a way to get one...but I didn't. 
The longer I used my machine the less the centrals got. Now the only time it really flags a central is right after I go to bed which I don't believe are actual centrals and maybe a random one now and then that may or may not be legit. 
If the OP really does need an ASV then I say "go for it" and I hope she finds one but I'd hate to see anyone put out the cash over something that might simply clear itself given enough time.

[DevinJones]

Thanks, David. I noticed that you had many clear-airway events at the beginning of your sessions that you just posted. Could those clusters of many CA events be sleep-onset central apnea events? If so, would ASV be beneficial for those? Have your central events lessened with continued use? Or do you still have them if your pressure settings are not correct?

[David Clark]

That was a one night thing...last night...kind of an experiment.  That was because I turned up the pressure support too high...which can bring on centrals and yes a lot of that was while I was awake anyway.
Normally I don't have NEAR that many centrals flagged. Here is a more accurate picture of what is "normal" and even those few aren't all legit centrals.

[DevinJones]

David, I can see what you mean in your OSCAR screenshot. So I guess you have treatment-emergent CSA if the pressure support is too high and washes out the CO2? Did a sleep study reveal CSA for you? I'm wondering if you would have the same response to ASV.

[David Clark]

I didn't have any centrals in my sleep study and from my understanding it is exactly as you said. CO2 washout from the PS being too high. I should have just left well enough alone but I was trying to fine tune what I perceived to be to many flow limits although the numbers don't look like there are too many.

[JCW888]

I don't know how long you have been on pap therapy but are you sure you have the treatment emergent central apnea that could require an ASV or could you have the type that simply requires time?
I know a fair amount of people develop centrals after they start treatment that they didn't have during the sleep study...I was one of those people...and given time the centrals fade away completely or almost completely without needing an ASV.

I did suspect the same for developing Centrals after therapy. And as for ASV i really don’t think it fits everyone, really need a good period of trial before you buy it if you can rent it first. 

I am the one that go back to VAuto even I got an ASV. Because i don’t even get better treatment changing to ASV since I can’t get enough sleep than original VAuto due to surge of random bumping up/down pressure support. 

So maybe ASV is a good machine, but it’s not for everyone especially for myself. Maybe one can adpat it, or not, it takes a lot of learning and adapting curve for some people.

[DevinJones]

I hear you. Sometimes in the pursuit of perfection, we create additional problems. I mean there's nothing wrong with an AHI under 1.0 and low flow limits, but then we want a 0.0 AHI, right? 

It's good for us, though, to keep in mind what can happen if our PS is too high. Good reminder. Thanks.

[DevinJones]

JCW888, I've been adapting to my ASV, getting more sleep now, and avoiding the frequent pressure surges after greatly reducing my EPAP and PS settings. I'm now gradually increasing the settings.

[JCW888]

JCW888, I've been adapting to my ASV, getting more sleep now, and avoiding the frequent pressure surges after greatly reducing my EPAP and PS settings. I'm now gradually increasing the settings.

Hi Devin, good to know you are adapting well now with ASV. I quit for now because I don’t want to change and match / buy new masks to try with ASV back and forth, it’s really time wasting and costly. I did research before and know most people doing well with ASV are those using FFM at the majority, and quite a few are pillows(P10 or P30i). I happened to be using pillow masks P10 I think you know.

Maybe, just maybe I would start again with no humidifier tank(with side cover) on ASV, since I tried this on VAuto, it felt quite different using same setting, maybe I would apply this to ASV some other time. I think for me moisture may add comfort to nostril but not all good to the whole therapy or lung, but it was just my wild guessing after my own experiment.

[DevinJones]

Thanks, JCW888. Yes, it's a real challenge to adapt to the ASV.

I use a ResMed AirTouch F20 full mask and have to say that it has solved the problem with large leaks, which can't exist if you want effective treatment, and has greatly helped me start to adapt to the device. The nasal masks were a joke. 

I hope you can soon adapt to the most appropriate device for you.