Do I need an ASV machine?

Hi everyone,

I was so happy I found this forum. Reading all the posts here has educated me about sleep apnea more than my sleep doctor. Anyway, last month I got 2 at-home sleep studies from 2 different hospitals (just to compare the results). Both results came back positive for severe sleep apnea (AHI 30.9/hr), and they both show all of the events were Obstructive Apneas + Hupopneas, 0 Central Apneas. So I got the BiPAP ResMed AirSense 10 and have been sleeping with it for almost a month now. The treated AHI I got from OSCAR has been around 2-3, sometime 4. So I guess the treatment is working. However, in the event flags panel, 90% of the events were flagged as Central Apnea on pretty much all nights over the past 30 days.

Do I have CA? Should I get an ASV machine instead (cost is not an issue)? Why didn't the two at-home sleep studies detect CA? Should I go check for any heart condition to be safe to use ASV? I'm a 29-year-old healthy and fit male. Thanks a lot in advance!

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Do I have CA?

No.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Should I get an ASV machine instead (cost is not an issue)?

No

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Why didn't the two at-home sleep studies detect CA?

Because you don't have it.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Should I go check for any heart condition to be safe to use ASV?

No

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

I'm a 29-year-old healthy and fit male.
Thanks a lot in advance

Congrats.

Turn down your PS.

I would first try reducing the pressure support to 2 as the pressure support could be causing the CA’s I dont see enough CA’s to justify the ASV

Those graphs resemble mine during my first few months of CPAP therapy.

1. I was not diagnosed with Central, no signs of it during my Sleep Study.
2. When I first started, a few CAs started showing up, not a lot, and not a lot to be concerned about.
3. Many of them:
   • SWJ - Sleep Wake Junk
   • Erratic Breathing
4. Over the next few months they gradually went away, now maybe I'll get one to two a night, just as often none.

I think some people just get a spike in CAs when they start and are adjusting. I don't see anything you should be overly concerned here. You've got a terrific machine, stick with it and use this thread to start dialing in your treatment.

Thanks everyone for the insights. Maybe I'll try to turn down PS to 1 or 2 to see how it goes.

So my current machine is Auto BiPAP, which means EPAP and IPAP are auto-adjusted during the night, but PS is constant. Can I use an ASV machine as an Auto BiPAP with Auto PS? I read in the ASV manual that this machine can auto-adjust PS throughout the night. Is there an option to turn off ASV feature if I don't need it. That way I don't have to worry about adjusting PS and let the machine handle it. To be honest, I could get this ASV machine for cheap through my insurance, so I need to make the decision before the year ends.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 4:25 pm

Thanks everyone for the insights. Maybe I'll try to turn down PS to 1 or 2 to see how it goes.

So my current machine is Auto BiPAP, which means EPAP and IPAP are auto-adjusted during the night, but PS is constant. Can I use an ASV machine as an Auto BiPAP with Auto PS? I read in the ASV manual that this machine can auto-adjust PS throughout the night. Is there an option to turn off ASV feature if I don't need it. That way I don't have to worry about adjusting PS and let the machine handle it. To be honest, I could get this ASV machine for cheap through my insurance, so I need to make the decision before the year ends.

Why would you want an asv machine ? They are very specifically for people with issues. I had 141.3 events per hour and I did have centrals in my sleep study and they didn't recommend a asv. The only reason I got even a bilevel is because my pressure needs were higher than a regular cpap would go.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 4:25 pm

So my current machine is Auto BiPAP,

No, it's an Aircurve VAuto. "BiPAP"s are made by a different company.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 4:25 pm

which means EPAP and IPAP are auto-adjusted during the night, but PS is constant. Can I use an ASV machine as an Auto BiPAP with Auto PS? I read in the ASV manual that this machine can auto-adjust PS throughout the night. Is there an option to turn off ASV feature if I don't need it. That way I don't have to worry about adjusting PS and let the machine handle it. To be honest, I could get this ASV machine for cheap through my insurance, so I need to make the decision before the year ends.

If you want to buy an ASV, buy it....

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Should I get an ASV machine instead (cost is not an issue)?

palerider wrote: ↑

Fri Nov 15, 2019 1:30 pm

No

Dog Slobber wrote: ↑

Fri Nov 15, 2019 2:47 pm

You've got a terrific machine, stick with it

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 4:25 pm

To be honest, I could get this ASV machine for cheap through my insurance, so I need to make the decision before the year ends.

Sorry I'm new

You can dumb an ASV machine down and make it work like any number of other machines.
The variable PS is what is used to deal with central apneas though...it can make some rather large and quick changes in PS when there is a range of PS (minimum and maximum) but you can make the minimum equal the maximum if you wish and then the ASV essentially becomes an auto bilevel like you have now.

If money is no object and you are curious and you can get your hands on an ASV....go for it.
I did it and I have never had any issues with centrals....I just stumbled across an ASV from a forum member at a price I couldn't pass up.
I rather liked it. I didn't even dumb it down. It won't do the big PS jump unless you really need it anyway.
I eventually sold it to someone who really needed it and I didn't really need it and my used ASV was all she could afford and didn't have insurance.

You most likely wouldn't qualify for insurance paying for an ASV though. Not enough centrals all the time....assuming they are real and not awake false positives.
Reducing or turning off PS may or may not reduce the centrals....it works for some people and doesn't work for others. Might be worth trying if they bug you too much.

mason.smith1975 wrote: ↑

Fri Nov 15, 2019 1:02 pm

Hi everyone,

I was so happy I found this forum.

welcome to the zoo! when you get the chance, would you please fill out your equipment profile? once you do, it will show up at the bottom of each of your posts, as mine does below.

thanks and good luck!

I was put on an Autoset by my doc. Still felt awful, so they put me on an auto bipap (Phillips), and it flagged me for Periodic Breathing of 15-20% every night and I still felt awful. I found an ASV on Craigslist, and have not looked back. According to every doc, I didn't 'need' it, but I sure felt a lot better every day using an ASV. I especially like the breath support as it forces a breath. That is different than an auto-bilevel.

Personally - if you can get it approved, I say try it. It made me feel better, and honestly, was worth the money I spent.