Differences between VPAP and ASV

I have copd but was given an Aircurve 10 ASV machine. I now see that ResMed has a VPAP machine which is supposed to be for copd patients. Can anyone explain the difference or do I need my pulmonologist to answer that?

andycole wrote:I have copd but was given an Aircurve 10 ASV machine. I now see that ResMed has a VPAP machine which is supposed to be for copd patients. Can anyone explain the difference or do I need my pulmonologist to answer that?

Have you tried going to Resmed.com and looking at their explanation? Both are for COPD...One is newer than the other.

ResMed website is no help - here is what they say about the machine I have (ASV) and the one suggested for copd (VPAP).

Aircurve 10 ASV
The AirCurve 10 ASV bilevel machine offers truly personalized therapy for central breathing disorders, such as Cheyne-Stokes respiration (CSR), central sleep apnea (CSA) and associated obstructive events. Featuring the most clinically-studied and proven ASV algorithm, AirCurve 10 ASV is the only adaptive servo-ventilator that targets the patient’s own recent minute ventilation.

ASVAuto mode
In ASVAuto mode, this bilevel machine not only responds within the breath, adjusting Pressure Support to stabilize respiration, it also automatically adjusts the expiratory pressure in order to provide the minimum pressure required to maintain upper airway patency. It analyzes the state of the patient’s upper airway on a breath-by-breath basis and delivers expiratory pressure within the allowed range.

VPAP COPD
If you have COPD, you have specific needs to ensure you receive optimal ventilation and comfortable therapy. ResMed’s VPAP™ COPD is a noninvasive ventilation (NIV) device that can help you comfortably manage your condition in your own home. Designed specifically to treat COPD, it incorporates the stylish design and sophisticated comfort features of the S9™ platform to help you stay on track with therapy.

andycole wrote:I have copd but was given an Aircurve 10 ASV machine. I now see that ResMed has a VPAP machine which is supposed to be for copd patients. Can anyone explain the difference or do I need my pulmonologist to answer that?

the ASV *is* a VPAP.

A VPAP (or generically, a bi-level) is simply a machine that operates with different pressures for inhale and exhale. there are many different types of VPAPs, the ASV is one of them.

the VPAP ASV is targeted at a specific type of sleep apnea, that being central apnea, it monitors *and responds* breath by breath, so when you start to have a central apnea event, it will increase pressure *immediately* on the next breath. other VPAPs (and other brand bi-level machines), operate on a running average of breaths and respond after the fact to most things... some brands more promptly than others.

the VPAP COPD is really just a VPAP S model with and alarm module added, as well as presents that are appropriate for COPD patients... from the clinician manual:

ResMed wrote:Starting COPD patients on noninvasive ventilation (NIV)
The VPAP COPD is targeted at treating COPD patients with and without supplemental oxygen, and
therefore, has the values of the key settings already preset to commonly used clinical values. This
allows you to start treatment quickly with appropriate settings for this group of patients (see “Modes of
operation”). You can then adjust the settings as necessary.

sorry for delay in responding. I think pulmonologist ordered the 3rd sleep study about the same time as he came up with copd diagnosis. I have significant other issues such as reflux, sinus problems, and 3 1/2 yrs lung cancer in remission (but too much radiation). It was the study doctor who recommended the ASV so I guess I'm on the right machine. Thanks for helping clarify.

andycole wrote:It was the study doctor who recommended the ASV so I guess I'm on the right machine.

maybe, maybe not. find out if you have a lot of central apnea issues...

doctors make mistakes, and some aren't as competent as we wish they could be... that's why this forum exists.

My centrals dropped to zero when I went on ASV. SleepyHead confirmed it and now it's some UA's or HA's. AHI is >1.0! So I would say this doctor got it right. I'm still struggling with leaks and back on my original F10 FFM after trying several others including 1 hybrid.

andycole wrote:My centrals dropped to zero when I went on ASV. SleepyHead confirmed it

wellllll, it's not that simple.

the resmed asv machines don't report centrals, since they don't *allow* you to have centrals.

at the first sign of you having a central, either your breathing volume tapering off, or you just suddenly stopping breathing, it springs into action and raises the pressure enough to ventilate you.

and, since a central is you not breathing, and not trying to breath... given that the machine is breathing for you, it's not really a central.

you can see it working it's magic on the mask pressure chart (the blue one):