Table of Contents

Introduction Download Daily Charts Compliance Daily Pressure Daily AHI Daily FLI Daily SI Variable Breathing Time in Apnea Average Apnea Duration Pressure Charts Pressure Distribution Cumulative Pressure AHI vs. Pressure FLI vs. Pressure SI vs. Pressure Daily Report Revisions

MyEncore is a separate program that works in conjunction with Respironics' Encore Pro to display multi-download data in a user friendly format. MyEncore interrogates the tables of the Encore Pro database, and thus requires Encore Pro to be installed on the machine.

When the program is started, the user is presented with the Preferences screen

At this point the program has already loaded all of the necessary data according to the selections on the Preferences form. In the above case the data for Otto Papp has been extracted, and 806 hours of data between 2/11/2005 and 5/26/2005 was found. MyEncore may be customized by changing and saving this set of Preferences.

The set of tabs along the top of the form are the available graphs and charts (see the links to examples of the the charts). The choice of charts may also be customized though the Select Charts button. For example, since Encore Pro does not record Flow Limitation data for the REMStar Auto when operating in CPAP mode, if desired, the two charts related to Flow Limitations (Daily FLI and FLI vs. Press) may be optionally hidden through the Select Charts button.

The charts for MyEncore are based on (a) daily sleep therapy details, for example "Daily AHI" (apnea/hypopnea index) where the daily indices are plotted for the specified range of dates, or (b) pressure data, in which therapy data is collected between a given range of dates, and plotted against treatment pressure. For example the "AHI vs. Press" plot collects all apneic events for the specified date range, and plots the frequency of occurrence of apneas and hyponeas against the treatment pressure at which they occurred.

In addition, MyEncore allows the printing of single, or multiple (two per page), charts, zooming-in on charts to examine details, and interrogation of points on the charts. Charts may be saved in a number of image formats (jpg, gif, png, bmp, tif). To zoom-in you simply left-click and hold while you drag a rectangle defining the area you wish to examine. To unzoom, save an image, or examine points you simply right-click on the chart and select the desired action from the menu.

See the examples of charts for more details.

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Instructions for Downloading and Installing MyEncore

Installation: Please read the next paragraph on preparing for installation. MyEncore is distributed as a Microsoft Installer (.MSI) file. Installation is very simple - download the file Myencore.msi to your desktop(or to a folder), and double-click on the icon. MyEncore will be installed, and a desktop icon and entry in the Start Programs menu will be created. You may then delete the MyEncore.msi file.

Preparing for Installation: MyEncore is written in Visual Basic under Microsoft's Visual Studio .NET 2003. .NET (pronounced "dot-net") is Microsoft's new structure for software development. For .NET programs to work, the so-called ".NET Framework" must be installed on your computer. Future versions of Windows will contain the Framework, but is is likely that your computer does not currently have it installed. The MyEncore installer will not let you proceed with the installation until the correct version of the .NET Framework is installed. (You can have multiple versions of the .NET Framework co-existing on your computer)

If the installer finds that you do not have Version 1.1 of the Framework installed, it will take you to the MIcrosoft download site, where you can download the Framework as an installation file dotnetfx.exe. After you download the file (it is 24 Mbytes in size!) to your desktop, double-click it to start the installation. When the installation is complete you can delete the dotnetfx.exe file. You will then need to run the MyEncore installer again.

Uninstalling MyEncore: MyEncore may be uninstalled from the Start --> Control Panel --> Add or Remove Programs window. This does not remove the .NET Framework.

Click here to download the MyEncore Installer (Ver. 1.5b7) (451 Kbytes)

Note: The new version is not fully compatible with Encore Pro 1.6. However, many users are able to retrieve core data using this file and so we list here it. James Skinner has also written a clone of it that works full with Encore Pro 1.5, 1.6 and 1.7 http://james.istop.com/EncoreProAnalyzer/

Click here to see the changes made since the original release.

Known Issues:
1) Daily plot x-axis scaling gets a bit "messy" when only a few days are selected: This is handled automatically by the plotting software package (Zedgrah) used to generate the plots. I'm looking into how to clean it up, but haven't been successful so far.
2) Making pdf plots of charts does not work properly on some computers: If you have Adobe Acrobat installed, using the Adobe PDF writer (in the printer selection) to create pdf files of charts works properly on some computers but not others. For example, I have two identical computers with the same Adobe software and identical printer settings. On one computer pdf plots are produced in landscape mode correctly, while on the other plots are produced in portrait mode with an assumed paper size of 3.5" x 4.5", and only a corner of the chart is shown. It appears that the paper size is being interpreted in cm. instead of inches. I have spent hours unsuccessfully trying to chase this down.
Workaround: It appears that if you go to the printer "Properties..." on the Print Dialog form, and make a change (for example select "Paper Size"), the problem is resolved.

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The charts in MyEncore can be divided into two groups: those which provide a summary of the daily sleep therapy details, and those which summarize sleep disturbance events as a function of treatment pressure. In addition there is a Daily Report which provides a text based summary of the therapy details for any day/noght in the dtatabase.

The following are examples of the MyEncore charts:

Daily Compliance: This is a graph of the recorded daily hours of use for the date range selected on the Preferences form

Note the user name in the upper-right corner and the average hours/night for the selected date range in the lower-left.

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DailyPressure: This chart shows the daily pressures used in treatment. The data shown depends on the treatment mode; for APAP the minimum and maximum device settings, the average pressure and the 90th percentile pressure are shown.

In CPAP only the treatment pressure is shown, in BiPAP the IPAP and EPAP pressures are displayed.

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Daily AHI: This chart is a "stacked" bar chart showing the nightly apnea/hypopnea indices. Each bar has three components: the Non-Responsive Apnea/Hypopnea Index (NRAHI), the Hypopnea Index (HI), and the Obstructive Apnea Index (OAI). The AHI is the total of all three.

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Daily Flow Limitation Index: A flow limitation is a reduction in inhalation/exhalation volume and has an asymmetric flow pattern. It is considered to be a pre-apneic condition. This graph shows the daily index (events/hour)

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Daily Snore Index: This graph shows the number of snores recorder each hour

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Fraction of Time in Variable Breathing: "Variable breathing" is defined as the situation when a person is not undergoing the quiet steady breathing of several stages of sleep. In particular, according to the Respironics patent" it happens during wakefulness, distress, and REM sleep. This chart may be taken as an indication of how "peaceful" a night was. Since REM sleep is a desirable state, some variable breathing is obviously a good thing.

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Seconds in Apnea: This chart displays the nightly time spent in apnea

The heavy lines shown for some dates indicate that no apneas were detected that night.

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Average Apnea Duration: This chart computes the average length of apneas occuring each night by dividing the total time spent in apnea by the recorded number of apneas.

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The pressure based charts plot sleep disturbance and therapy details against treatment pressure. Although these plots are most useful for APAP therapy, they can be used to interpret the effects of varying CPAP pressures on a night-to-night basis.

For Bi-PAP therapy, the treatment pressure is taken as the IPAP pressure.

The date range used to construct these plots, and the range of pressures displayed may be chosen on the Preferences form.

In addition, error bars showing +/- one standard deviation of the estimate of the true value may optionally be displayed. These error bars are computed based on modeling sleep disturbances as a Poisson process. Note that this is a rather strong assumption and may not be justified for many individuals.

Pressure Distribution: This plot shows the total hours (within the date range selected for pressure plots on the Preference form) at each treatmeny pressure.

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Cumulative Pressure Distribution: This plot is most useful for APAP treatment. It basically contains the same information as the straight pressure plot above, but adds the hours spent at the given pressure and all pressures below that pressure, and then expresses the answer as a fraction of the total number of hours in the date range. The plot is similar to the one generated in the Encore Pro report. It may be used to find the average treatment pressure (50%) and the ninety percentile pressure (90%).

From the above plot we can see that 90% of the time the APAP pressure was below 10.5 cm, and the average pressure was about 8.5 cm H2O.

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AHI vs. Pressure: This graph (which the author considers to be important) plots the long-term AHI against treatment pressure.

The above plot shows that for this patient, over a period of three months on APAP, there was a distinct minimum in the recorded AHI at a pressure of 10 cm H2O. Below this pressure the sleep disturbances are almost entirely hypopneas, whereas above this pressure there is a rise in obstructive apneas and hypopneas.

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Flow Limitation Index vs. Pressure: This plot shows how treatment pressure affects the occurence of flow-limitations.

The above graph shows a distinct minimum in the area 9 - 10 cm. H2O.

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Snore Index vs. Pressure: Similar to the above two charts, this plot shows how the frequency of snores is affected by treatment pressure

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The Daily Report provides a summary of the sleep disturbances and treatment paramenters for any day with data stored in the Encore Pro database.

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The following table summarizes the changes made to MyEncore since the original release. The version number is shown in the lower right corner of the Preferences form.

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