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An adaptive servo-ventilation (ASV) machine tracks and adjusts its pressure to match the breathing pattern of a person with sleep apnea. Using an ASV machine may help a person with sleep apnea to sleep safely.

An adaptive servo-ventilation (ASV) machine is a noninvasive device to help treat both obstructive and central sleep apnea. They provide an alternative to the more common continuous positive airway pressure (CPAP) machines for people with sleep apnea.

Obstructive sleep apnea is a physiological condition that occurs when the muscles in the throat relax, causing the surrounding tissues to narrow the airway. As a result of this narrowing of the airways, a person briefly stops breathing.

Similarly, a person with central sleep apnea also stops breathing in their sleep. However, this is a neurological problem where signals from the brain do not tell the muscles to breathe.

An ASV machine is a form of BiLevel positive airway pressure (BiLevel) therapy. This means it alternates between high pressure when a person is breathing in and lower pressure when they are breathing out.

By alternating the pressure during inhalation and exhalation, it helps the lungs to operate more efficiently.

The ASV machine tracks a person’s breathing pattern while they sleep and adjusts their pressure to help a person breathe normally during the night.

If a person is breathing normally, the ASV machine will provide very little support. However, if it detects that a person has stopped breathing, it will increase the pressure and support to help a person breathe.

Before a person goes to sleep, they will need to put on a face mask that either goes over just the nose or the nose and mouth. The mask connects to the ASV machine via a flexible hose.

Researchers have documented multiple benefits from using ASV machines, including:

  • lowering the number of times a person stops breathing or has a partial loss of breath during the night
  • reducing sleepiness
  • improving levels of oxygen saturation
  • helping people keep up with their treatment plans

Doctors and healthcare professionals may use ASV machines to treat central sleep apnea and complex sleep apnea.

It is a recently-developed way of conducting positive airway therapy (PAP), and an advanced form of technology frequently used after the more common treatments, CPAP and bilevel positive airway pressure (BIPAP), have not provided an individual with effective relief.

The following people may benefit from using an ASV machine:

  • those with systolic heart failure with Cheyne-Stokes breathing (CSB) with Ejection Fraction of 45% or higher
  • people who develop central sleep apnea after treatment with CPAP, BIPAP, or auto-PAP
  • people with treatment-emergent sleep apnea
  • people who have sleep apnea due to high altitude
  • people with narcotic-induced central sleep apnea

Medical News Today chooses medical equipment that meets the following criteria:

  • Price: MNT chooses products available for a wide range of budgets. Insurance can often cover the price of the products, depending on an individual’s plan.
  • Connectivity: MNT ensures that, where possible, products have a range of connectivity and tracking options.
  • Reputable: MNT chooses products from businesses that, where applicable, require a prescription and adhere to industry best practices, and offer reliable customer service and support.
  • Materials: MNT chooses products that have safe and durable materials that are easy to clean and maintain.
  • User-friendly: MNT selects simple-to-use products that have clear instructions. Where applicable, MNT chooses brands that offer a set-up or advice service.
  • Quality: MNT chooses companies that adhere to high quality manufacturing processes that ensure its products are safe for personal use.

Currently, there are two notable ASV machines available for purchase. However, before making a purchase, a person should discuss this with a doctor or healthcare professional.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

The ResMed AirCurve 10 ASV

This machine is specifically for people with central sleep apnea or treatment-emergent sleep apnea. The manufacturers recommend a person uses this machine alongside their preferred face mask.

The device also has a humidifier that the company claims helps with comfortable breathing.

The AirCurve 10 ASV works in 5 steps:

  1. The machine pushes air along the tube and into the mask.
  2. The mask uses an algorithm to allow pressurized air to enter the airway when necessary.
  3. The humidifier helps moisten the air a person is breathing.
  4. The 90-watt (w) power supply assures continuous power while a person is asleep.
  5. Filters help stop allergens from entering the airflow.

This machine also has an app through which a person can track their therapy.

Below are some pros and cons of the ResMed AirCurve 10 ASV.

Pros

  • The machine uses an advanced and tested ASV algorithm.
  • It can manage data on the cloud.
  • It has a wider pressure range than standard CPAP machines.
  • It supports a person’s breath with the minimum amount of pressure possible.
  • It is easy to start and stop.
  • The machine has the expanded ability to start the onset of full air pressure.
  • It automatically checks the face mask seal.
  • The lights automatically dim in the dark to avoid sleep disruption.
  • It has a built-in, adjustable humidifier.

Cons

  • Some condensation can develop in the tubing or mask.
  • Users can develop dry sinuses and/or mouth.
  • The package does not include a face mask.
  • Configuring the correct humidification setting may prove difficult.

The Resmed AirCurve 10 ASV costs around $1,770 and is available online. A person should check their medical insurance coverage with their insurance provider as they may reimburse some or all ASV machine costs.

Philips DreamStation BiPAP auto Servo-ventilation system

The manufacturer of this machine refers to it as ‘auto servo-ventilation.’ However, this means the same as adaptive servo-ventilation.

Like the ResMed AirCurve 10 ASV, this machine uses an algorithm to adapt to the person’s breathing pattern to provide support when necessary.

Individuals will need to purchase a compatible mask. However, most CPAP masks are compatible for use with this machine.

The machine can work alongside the DreamMapper app to track breathing and help people self-manage their sleep apnea.

Below are some pros and cons of the Philips DreamStation BiPAP auto Servo-ventilation.

Pros

  • The machine can track breathing to manage sleep apnea.
  • It has a clinically proven algorithm for keeping the upper airways open.
  • It promotes comfortable sleep.
  • Its design has input from users.
  • The pressure automatically adjusts to stabilize breathing with minimum intervention.
  • It has Bluetooth connectivity for people to access and track their breathing patterns.

Cons

  • A face mask is not included.
  • There is a potential risk of side effects, such as mouth dryness.
  • ASV machines may not suit everyone.

The Phillips DreamStation BiPAP auto servo-ventilation costs around $1,495 and is available online. As before, a person should check their medical insurance coverage with their insurance provider as they may reimburse some or all ASV machine costs.

There are a few risks and side effects to consider before using an ASV machine.

According to an article in Respiratory Research, ASV usage has associations with heart complications. For this reason, a person who has experienced heart failure should not use this product.

The American Association of Sleep Technologists also highlights that people with sleep apnea who have the following underlying conditions should avoid using an ASV machine:

According to an article in the Journal of Clinical Sleep Medicine, unintentional leaking from a seal, the mouth, or another issue with the device, may cause sleep disruption and ineffective therapy.

One manufacturer of ASV machines lists the following potential adverse side effects:

However, these side effects are not specific to an ASV and can happen with all PAP machines.

ASV machines provide support to regular breathing and will automatically deliver a breath if a person has not taken one within a certain number of seconds. On the other hand, a CPAP machine maintains a continual, fixed pressure.

Below are some common questions relating to ASV machines.

Is an ASV machine a ventilator?

Yes, an ASV machine is a type of noninvasive ventilator (NIV) that provides ventilatory support at home.

How much do ASV machines cost?

ASV machines vary in cost. However, most health insurance plans will cover this type of expense. However, many companies selling ASV machines will not bill insurers directly. In this case, individuals pay for the equipment themselves and then seek reimbursement from their insurance companies.

Does Medicare cover ASV machines?

Medicare Part B might cover a portion of the cost of ASV machines under the Durable Medical Equipment (DME) coverage rules. The official Medicare website list includes CPAP machines, and this list is not exhaustive. A doctor must prescribe the machine.

A person should review the prescription with their healthcare provider and a representative from Medicare to see if it would qualify for coverage and, if so, how much and for how long.

ASV machines provide breathing support for people experiencing sleep apnea. It uses an algorithm to track and adjust the pressure to match a person’s breathing pattern.

There are currently two ASV machines available to buy. However, anyone considering using an ASV machine should talk to a healthcare professional before purchasing one.