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Central Sleep Apnea not given an ASV
Central Sleep Apnea not given an ASV
Hi, from my sleep study my script was supposed to be an ASV but was given an AirCurve 10 STA.  I've asked a bunch of questions and still concerned I am not receiving the best treatment.  The RT worked with Resmed because my pressures were so high and thats why they recommended the machine I got.  The pressures were 17-25 with PS 8.  Its now been lowered to 20 because I couldnt tolerate it.

I have a meeting with the sleep specialist this week and just trying to understand what's happening.  I understand the recall has affected alot of things but concerned that the AirCurve is not going to give the same level of treatment as the ASV.  

Anyone understand the differences between the machines enough to help me?  I guess its better than no machine but dont want to be stuck with the wrong machine for 5 years because of insurance.  If I had the money I would buy my own but not an option.
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RE: Central Sleep Apnea not given an ASV
Please post a redacted copy of both your sleep Studies. These should Include charts and tables in addition to the narrative. This is the info a machine is chosen from.

We don't even know the breakdown of events you had. We. Need something more than they said ASV then gave you an STA. BTW the ASV is also an AirCurve.

Lacking additional information I'm inclined to go a long with their choice of the STA without info to possibly indicate otherwise.

Do you have any other conditions that may influence the decision. Do you have any other cardio or pulmonary issues, use pain killers especially opioids real or synthetic? Any neuromuscular issues, strokes, brain injuries, etc.

Using an ASV may be contra indicated depending on the cause of your centrals.
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RE: Central Sleep Apnea not given an ASV
If you have not been dispensed the prescribed machine, you should immediately change DMEs. You have no obligation to this provider. Have your doctor transfer the prescription to any other DME that is covered by your insurance. In most cases like this, the DME is the problem and will try to convince you the ST-A is equivalent. The ST-A is a fixed pressure bilevel machine with a timed backup to trigger IPAP. This reference details the intended uses of each of Resmed's machines and describes how they work and are titrated. https://document.resmed.com/en-us/docume...er_eng.pdf The ASV is on page 28 and the ST-A is on page 37.

Note ASV is for treatment of Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
ST-A is for COPD, NMD, OHS and other respiratory conditions
This are the manufacturer recommendations, not my words. Ask anything you need to know, but ASV usually works at a very low pressure setting to keep the airway patent, then uses adaptive increases in pressure support to trigger breaths when they are not taken spontaneously. To be honest, you prescription sounds messed up for ASV, so the information requested by Gideon is going to help.
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RE: Central Sleep Apnea not given an ASV
You did have some words that indicated you may already have the machine, if so please provide a screenshot of both the standard and advanced daily charts. View/Reset Graphics/Standard or Advanced

That will Tess us what is going on.
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RE: Central Sleep Apnea not given an ASV
I do not have any of the medical conditions that Gideon referenced that would make sense for the STA.  I do have an AV heart block first degree but was medically cleared by my cardiologist and sleep doctor for ASV.  I have a mild case of asthma but dont think that is significant enough to change the type of machine.  I have an inhaler but it is seldom used as i havent had an attack in a long time.  I just assumed the centrals might be caused by CPAP usage over 15 years with pressure at 15.  

I've attached the reports from both of my sleep studies so hope that will give you a better picture.  I do have a meeting with my sleep specialist today to discuss the latest results from the SD card.  I hope he can send me a report.  Unfortunately, I only have a work computer and they have it locked down so I can't download OSCAR but hoping I can get a personal computer in the future.  

I am limited on the number of attachments but here's my first sleep study results.  I will reply to the post adding the results for my second sleep study.


Here are the results from my second sleep study.

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RE: Central Sleep Apnea not given an ASV
That is such an incredibly small amount sleep time for a polysomnogram.  Seems hard to get anything worthwhile with only 71 min and 0% REM.
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RE: Central Sleep Apnea not given an ASV
I suspect your providers selected the Aircurve ST-A based on the very high prescribed EPAP = 17. The maximum EPAP available on the Resmed ASV is 15cmH2O. Given the very short period of actual sleep during your test, one wonders if that's a valid prescription, but it's probably the best they could do.

It seems that all your apnea occurs while sleeping on your back - you should look at ways to avoid this. You can get little backpacks specially designed to promote side-sleeping.
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RE: Central Sleep Apnea not given an ASV
I just had a second RF ablation today. The anaesthetist came by and told me something new...to me. After 45-ish, our lungs tend to sag flat inside the pleural cavity when supine. By 60 or so, they will do the same when we are reclined at 45 deg. By 70, where I am..... I can’t say this is relevant, but it might have a modicum of relevance to supine apnea.
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