Encore viewer 2 - Interpreting results

[diboja]

I have had the software for my PR1 machine for over 6 months and I remain confused on interpretation of some of the results.

I know that my AHI is great - averaging a .5 but when it gets to the percentage of night in periodic breathing (.3%),Average CA Index (.1), Average OA index (.1),
Average OA index (.1), and then Average Hypopnea Index (.3) as well as the Average AHI (.5) - what the difference between Average Hypopnea Index and the Average AHI - aren't they the same?, Average FL Index (0.0), Average VS Index (2.4) and finally the Average Night in Large Leak (0.0%)

These forums have been a great help to me and its great that people post their results and members with experience provide their comments.
BUT...is there not a chart somewhere that shows what the average should be for these various bits of data. For example I know that your AHI should be under a reading of 5 - anything over this could be considered an issue.
But when it gets into the other data - ? - so, I have a Average CA (clear airway) index of .1, I haven't the faintest idea of what that means and what is the acceptable average.

Can anyone direct me to a printout page that clearly explains these pieces of data and ranges of acceptable readings.....
That way - when I insert my SD card into the computer and get my results and can at least know what I am looking at and be able to interpret with a bit of comprehension......

Thanks for any information that you can guide me to...

[Wulfman]

I regret to inform you that what you seek does not exist. Except for the "standard" AHI <5.0, the other stuff does not.
The old saying that "Everything is relative" applies to each of us as far as our therapy goes. All we can do is strive for the lowest numbers we can. With regard to "Periodic Breathing", I believe that's a new term by Philips Respironics. On the old machines like I have, they had/recorded a category for "Variable Breathing". Nobody was really ever able to find out what Respironics had in mind for that one either and there didn't seem to be any documentation to be found on that category either......but it was being recorded into the database. I've noticed that my VB numbers seem to change according to which machine (and firmware level) I'm using.


Den

[Pugsy]

what the difference between Average Hypopnea Index and the Average AHI - aren't they the same?,

AHI== Apnea, Hyponea index per hour. This will include the CA, OA and HI hourly average.

HI is just the Hyponea index per hour. Hours of sleep divided by number of Hyponeas equals the HI number average.

Average large leak percentage is useless. Look at the leak line itself and the overall average leak to see how your leak is doing.

[diboja]

Thanks for your replies.

What I seem to get out of this is that people who have the software to obtain results look primarily at the AHI reading and everything else brings on a glazed look in their eyes because they are not sure what it all means.
Other than if its low readings its OK plus if there are any repeated deviation spikes then they know that they should consult with their doctor or DME....is that about right?

Having the software is better than not having it because I was truly flying blind with my old M-Series machine which was not data capable. At least I know my AHI reading.

[Drowsy Dancer]

What I seem to get out of this is that people who have the software to obtain results look primarily at the AHI reading and everything else brings on a glazed look in their eyes because they are not sure what it all means.

Well, not necessarily. Your eyes may still be glazing over but there are some very, very knowledgeable people on this board using the software. For myself, although I am a new user and do not include myself in that category of the knowledgeable, I am already using far more than the simple AHI number to monitor my therapy and attempt to optimize it: The wave form reports and the detailed reports are useful. For example, in looking at an AHI it is useful to know, of the apneas, how many are central and how many are obstructive. Of the centrals, it is helpful to know whether they are largely "sleep onset" and therefore of little significance for the therapy.

Also, with the detailed reports it is possible at times to correlate increases in apneas with a particular sleep position. In my case this led to a change in my pressure prescription so that I could sleep in my preferred position. I never would have been able to give the feedback to my doctor that led to this change without the software.

Drowsy Dancer

[Pugsy]

I start with simple stuff first.

Leak number one. If leak line is hugely erratic and often large then we suspect inadequate treatment and maybe invalid AHI numbers.

Leak is okay? Then I look at the event numbers and average.

Then I look at when the events occurred. Groupings of lots of events as opposed to random events? Groups or clusters even with overall low AHI average can impact how a person feels.

Then look at hours of sleep with mask on. Can't expect to feel good with 3, 4, 5 hours of sleep. Need more sleep.

Then finally look at how many nights with good hours of sleep and good numbers and no leaks.

The other stuff that shows on the reports is there to show some light on things but for a beginner getting used to all this stuff, this is all I mention and try to work on or get them to understand. With time and experience and education the other stuff comes together.

[Wulfman]

What I seem to get out of this is that people who have the software to obtain results look primarily at the AHI reading and everything else brings on a glazed look in their eyes because they are not sure what it all means.

Well, not necessarily. Your eyes may still be glazing over but there are some very, very knowledgeable people on this board using the software. For myself, although I am a new user and do not include myself in that category of the knowledgeable, I am already using far more than the simple AHI number to monitor my therapy and attempt to optimize it: The wave form reports and the detailed reports are useful. For example, in looking at an AHI it is useful to know, of the apneas, how many are central and how many are obstructive. Of the centrals, it is helpful to know whether they are largely "sleep onset" and therefore of little significance for the therapy.

Also, with the detailed reports it is possible at times to correlate increases in apneas with a particular sleep position. In my case this led to a change in my pressure prescription so that I could sleep in my preferred position. I never would have been able to give the feedback to my doctor that led to this change without the software.

Drowsy Dancer

Please read his first post again.......in particular this......

Can anyone direct me to a printout page that clearly explains these pieces of data and ranges of acceptable readings.....

There are no publications (that I know of) that list any kind of "standards" with regard to the readings produced by these machines and their recorded data.
You basically said the same thing that I did......."Everything is relative".......to YOU (and each and every one of us).

No two people sleep the same. And, for all intents and purposes, no individual sleeps the same night after night.
This therapy is all about "averages" and improving our breathing during sleep (among other things).
These machines use "air flow" and programming to try to interpret what is going on during our sleep. It is NOT infallible. Writing "standards" for the data interpreted by these machines is virtually impossible. Then, each manufacturer would also have their own sets of "standards", too. Not likely to happen or to be found.


Den

[Drowsy Dancer]

The fact that there is no printout page of standards does not mean that the data reported by the software are meaningless.

DD

[Pugsy]

I think OP wanted a set template to use to compare their results with. It doesn't exist. There is no easy to look at graph to compare with. A person must learn what each piece of the data means and what the impact is to their therapy.

So to OP here, if you will elaborate on what is confusing to you we can help. But the reports and numbers are yours to interpret how they impact you. My numbers won't help you, nor Den's, nor anyone else.

[diboja]

I think OP wanted a set template to use to compare their results with. It doesn't exist. There is no easy to look at graph to compare with. A person must learn what each piece of the data means and what the impact is to their therapy.

So to OP here, if you will elaborate on what is confusing to you we can help. But the reports and numbers are yours to interpret how they impact you. My numbers won't help you, nor Den's, nor anyone else.

I think OP wanted a set template to use to compare their results with. It doesn't exist. There is no easy to look at graph to compare with. A person must learn what each piece of the data means and what the impact is to their therapy.

So to OP here, if you will elaborate on what is confusing to you we can help. But the reports and numbers are yours to interpret how they impact you. My numbers won't help you, nor Den's, nor anyone else.

Thanks Pugsy
You say "a person must learn what each piece of data means and what impact is to their therapy". My point is - how do you learn what each piece of data means if you cannot find a simple straight forward explanation? I realize that your numbers are meaningless to me but how can you or others with knowledge obtain your knowledge and how do you know that your interpretation of the numbers is relevant?

What is confusing me.....
Here are the numbers I posted: percentage of night in periodic breathing (.3%),Average CA Index (.1), Average OA index (.1),
Average OA index (.1), and then Average Hypopnea Index (.3) as well as the Average AHI (.5) -, Average FL Index (0.0), Average VS Index (2.4) and finally the Average Night in Large Leak (0.0%)

These numbers are irrelevant if a person does not know what "range" is acceptable and what they should be shooting for. Each person will be different but there has to be an Acceptable range that a person shoots for and if they are not in that range what should a patient do to "tweak" their treatment to get within a range .

I know that each person is different but there has to be unacceptable numbers and acceptable range of read-outs. If there isn't then each knowledgable person has set their own criteria and each is thinking that they are correct....I hope you get what I mean....
Obviously a technologist or a sleep Doctor is using some kind of "range" when they see the hundreds of patients that they do - therefore they are using some kind of "guide" to tell that patient which readings are acceptable and which are not....

[Wulfman]

I think OP wanted a set template to use to compare their results with. It doesn't exist. There is no easy to look at graph to compare with. A person must learn what each piece of the data means and what the impact is to their therapy.

So to OP here, if you will elaborate on what is confusing to you we can help. But the reports and numbers are yours to interpret how they impact you. My numbers won't help you, nor Den's, nor anyone else.

I think OP wanted a set template to use to compare their results with. It doesn't exist. There is no easy to look at graph to compare with. A person must learn what each piece of the data means and what the impact is to their therapy.

So to OP here, if you will elaborate on what is confusing to you we can help. But the reports and numbers are yours to interpret how they impact you. My numbers won't help you, nor Den's, nor anyone else.

Thanks Pugsy
You say "a person must learn what each piece of data means and what impact is to their therapy". My point is - how do you learn what each piece of data means if you cannot find a simple straight forward explanation? I realize that your numbers are meaningless to me but how can you or others with knowledge obtain your knowledge and how do you know that your interpretation of the numbers is relevant?

What is confusing me.....
Here are the numbers I posted: percentage of night in periodic breathing (.3%),Average CA Index (.1), Average OA index (.1),
Average OA index (.1), and then Average Hypopnea Index (.3) as well as the Average AHI (.5) -, Average FL Index (0.0), Average VS Index (2.4) and finally the Average Night in Large Leak (0.0%)

These numbers are irrelevant if a person does not know what "range" is acceptable and what they should be shooting for. Each person will be different but there has to be an Acceptable range that a person shoots for and if they are not in that range what should a patient do to "tweak" their treatment to get within a range .

I know that each person is different but there has to be unacceptable numbers and acceptable range of read-outs. If there isn't then each knowledgable person has set their own criteria and each is thinking that they are correct....I hope you get what I mean....

I would have thought that you've been a member of this forum long enough by now to know some of these things......

What you should "shoot for" are ZEROES.


Den

[diboja]

I would have thought that you've been a member of this forum long enough by now to know some of these things......

What you should "shoot for" are ZEROES.


Den

Thanks Den...I have been a member for some time but only have time to periodically get on the forum as I have a life outside of the forums which takes up most of my time.
Your answer is the best I am going to get and I thank you........I had not realized that my question was so difficult.
Dave

[Pugsy]

The generally accepted "adequate" treatment number in the medical community is an AHI of less than 5.
They don't tell us the breakdown of which or what needs to total less than 5. It could be all OAs or all hyponeas or a mixture of all the things that give us the AHI.

No large leak is acceptable. Large leaks will impact therapy.

What you are wanting does not exist. The medical community doesn't break it down any further than AHI less than five.

There are many who would give their right arm to have numbers as good as yours. If our explanations aren't sufficient to set your mind at ease and let you move on, then please take your reports to your doctor and see what he says. Maybe he has different information or can explain it better.

Or work towards zeros then you will have an absolute value that you can understand easy enough.

[Wulfman]

No problem.
Just keep in mind that there are thousands upon thousands of CPAP users out there who have "dumb" (non-data-capable) machines.......and go through their lives "oblivious" to the fact that these data-capable machines even exist. Obviously, they have no idea how how their therapy is working. Many of them have been cut loose (or forgotten) by their sleep doctors or only find out if they have additional sleep studies years later. Heck, even the doctors and many DMEs don't want the patients to have data-capable machines......it cuts into their business income.......and most don't trust the recording capabilities of the data-capable machines. So, while there is the "AHI < 5.0" standard for achieving adequate therapy, many of us try to do better than that.
To sum it up, we try to achieve the best numbers we can at the lowest pressure we have to endure or get by with.

Best wishes and don't stay away so long.


Den

[HoseCrusher]

Dave, if you want absolute numbers, pick up a pulse oximeter. Keep your SpO2 above 90% while you sleep.

However, if you live at 6000 feet, you can drop to 88%.

The machine scored data can change from year to year, and from manufacturer to manufacturer, as different algorithms are incorporated into the machines. When you have a sleep study done, the score from the sleep study shows that all is well if the AHI is 5 or less. The machine score may, or may not, score the same as a sleep study, so the machine data is used for trending.

One way to set up for trending is to record your daily numbers and then look at how they compare to 7 day and 30 day averages. To get a closer look you can do a 3 day moving average. Keep in mind that the actual numbers don't tell you much of anything, but if the trend is going up, you should be having more difficulties during your sleep. If the trend is going down, then according to what the machine is looking at, you should be not having difficulties during your sleep. If the trend is flat, you are stable.