Silverlining moitoring function

[becktrev]

In the past, Ozij, SWS and others have referred to Silverlining's ability to record breathing impulses to hard disk when in Data Collection mode. The problem is, when you wake up, you can't look back at the data – three files in the SL directory. The Lab's technical handbook refers to 'appropriate software' to look at it, but doesn't say which.
I have tried my hardest to find out with Puritan Bennett, Tyco Health, even Mallinckrodt (France) who developed the software and had not even a reply.
Customers should use the product, not understand it!

Why should I want to know?

We look at nPAP software results like a school report. 'Only 6 apneas tonight. Brilliant. The machine is set well. Laura tweaks them until she is getting an A+.
So I'm not so tired as before. Good. But that is only the half of the machine's purpose.
We all read the literature. The experts constantly tell us, that the worst result of a long apnea could be a stroke or heart attack as a result of oxygen starvation.
And that only takes one!
Someone suggested a finger oximeter to record oxygen levels. Ok, but they cost.

I said already here, all that is needed on the machines is a signal if an apnea lasts too long. Someone jumped in and remarked, that constantly being awakened defeats the object.
Read it again – I said too long, not 10 seconds.
If an apnea is lasting half a minute, a minute, two minutes, and I am not waking naturally, I want to be woken up! I want a buzzer, bell, cymbals, the roof to fall in. I don't want to wake up playing a harp.
(I won't, cause I'm a born troublemaker and anyway my friends will all be down there in the warm place waiting for me)
But the machines are not equipped with this little so easy but so important facet. They are fitted with every conceivable expensive extra, but not that.

As I say, Silverlining software could show me how long my individual apneas are lasting, but the makers don't tell me how.

I am a tweaker, like many users. It is only in a forum, that you discover that – for example – pressure 'can' induce centrals. If it is possible to tweak the settings so that the length (not number) of apneas can be reduced, then I would like to know about it. And there are enough competent people here to have already looked at this aspect, should the means to check have been available. The labs don't have us with them for long enough to go into it.

For my machine, the Goodknight, here is the solution. (Eat your heart out Ozij)
Screenshots!
When the Silverlining is in Data Collection mode, the computer screen display shows a continual graph of the breathing pattern in 5 second segments – a full screen showing circa half-a-minute's breathing pattern.
There is a software called Timesnapper – freeware.
It takes a screenshot of the Data graph every 'x' seconds and stores it as a graphic file. All night if you want. A 100 KB picture every 30 secs – 12 MB an hour. Not much.
Then there is a replay function to check the pictures as a video.
By comparing the time with Silverlining's own Compliance Data, individual Apneas can be looked at and the exact length identified. Look a little harder and you can even see whether it was central or obstructive.

Simple.
The program needs a few adjustments to make it workable. Should anyone have interest, I could explain more.

[dieselgal]

I just want to know if you would recommend the machine and which one do you have?

[becktrev]

Hello dieselgal,

I think recommendations are a bit taboo here, but will risk it anyway.
I have the 420E APAP.
In Germany we don't have to buy the things and have the chance at the sleep labs or from visiting reps to have a bit of a try before being allocated one, so I looked at quite a few this time.

I had had years of lugging a big heavy machine around and wanted a lightweight one with mains and battery power.
This machine filled the bill. I was a bit sceptical from quality and on the technical side, as in a lot of places you read 'it is OK as a backup'. 9 months later I am sold on it - the thing is top notch.
I pushed to get the software - in Germany it is forbidden. I am pleased I did. I see it as essential to get the most out of the machine.
16 years nPAP taught me though, the major priority is the mask. Get the wrong one and you can forget the whole thing. The world changed when I tried nasal pillows.

Greetings,
Howard

[tangents]

There is a software called Timesnapper – freeware.
It takes a screenshot of the Data graph every 'x' seconds and stores it as a graphic file. All night if you want. A 100 KB picture every 30 secs – 12 MB an hour. Not much.
Then there is a replay function to check the pictures as a video.
By comparing the time with Silverlining's own Compliance Data, individual Apneas can be looked at and the exact length identified. Look a little harder and you can even see whether it was central or obstructive.

Simple.
The program needs a few adjustments to make it workable. Should anyone have interest, I could explain more.

More please!! My 420E is arriving today. While I won't use it tonight (I have a big presentation tomorrow, and don't want to make any big changes), this is a fascinating (and brilliant) idea of yours. I'm just not getting it....

Where is the program Timesnapper running, on your PC? If so, then do you have the serial line connected all night?

[becktrev]

Yes, for this mode you connect up to a computer (notebook) for the night to record more detailed data.
But it is not necessary for normal standard readouts.
Leave it 'till you've started working with the software and then you will understand what is meant.

Should you need help getting started, put in Silverlining or Goodknight as a search here. A lot of people have put a lot of good techical stuff in over the years.

H

[Snoredog]

I'm trying to figure out what you are trying to accomplish or see using the monitor feature?

Silverlining gives you a 96-hour detailed event log, much more info than you get from that live monitoring anyway, then it is pretty hard to sleep and monitor at the same time.

[tangents]

Snoredog,

Does Silverlining record your breathing? So can you find out how long the apnea events last just with the Silverlining software?

[Snoredog]

Snoredog,

Does Silverlining record your breathing? So can you find out how long the apnea events last just with the Silverlining software?

No, it does not give you the duration of the event nor does it give you that in the monitor mode either that I am aware of. if an event continues it logs another tic.

[rested gal]

I'm trying to figure out what you are trying to accomplish or see using the monitor feature?

Silverlining gives you a 96-hour detailed event log, much more info than you get from that live monitoring anyway, then it is pretty hard to sleep and monitor at the same time.

What becktrev is talking about is a completely different thing than the way we use Silverlining for a download the next morning. There is a feature of the 420E that allows continuous realtime collection of data if the machine is hooked to a computer during that time. "Data Collection Mode."

It would be as if a person were at the computer actually watching the data that's coming in from the sleeper, continuously, all through the night. It makes a HUGE file, of course. Cannot be read with Silverlining.

Somewhere in the back of my mind I'm thinking the software called "Knightscan" is what's used to read the realtime file, but can't remember.

I never tried a realtime collection with my 420E, but that capability is "in there" as part of what the machine can do.

[Snoredog]

I'm trying to figure out what you are trying to accomplish or see using the monitor feature?

Silverlining gives you a 96-hour detailed event log, much more info than you get from that live monitoring anyway, then it is pretty hard to sleep and monitor at the same time.

What becktrev is talking about is a completely different thing than the way we use Silverlining for a download the next morning. There is a feature of the 420E that allows continuous realtime collection of data if the machine is hooked to a computer during that time. "Data Collection Mode."

It would be as if a person were at the computer actually watching the data that's coming in from the sleeper, continuously, all through the night. It makes a HUGE file, of course. Cannot be read with Silverlining.

Somewhere in the back of my mind I'm thinking the software called "Knightscan" is what's used to read the realtime file, but can't remember.

I never tried a realtime collection with my 420E, but that capability is "in there" as part of what the machine can do.

they had that feature available with the first release of Silverlining. The point is there is no useful data from it outside the lab without EEG & SPO2 to correlate anything seen. So why bother?

I mean if you wanted to record and see what went flying by simply pointing a video camera at the screen and record the events. Still won't be able to make heads or tails from the data seen, but I guess if you are trying to cure insomnia that would do it

[becktrev]

Quote:"The point is there is no useful data from it outside the lab without EEG & SPO2 to correlate anything seen. So why bother?
"Quote:"Still won't be able to make heads or tails from the data seen, but I guess if you are trying to cure insomnia that would do it"

Depends on at what level you want to understand the workings of a machine and with what knowledge basis you approach the 'tweaking it' yourself.
The few little ticks on the graph the next day can totally misrepresent the reality and some of the statements here in the past from some self-styled experts have been made from that basis.

When you look at the flow data directly, for example, you discover that the machine registers an apnea which starts central for a few seconds and then becomes obstructive for a long period as central.
And vice-versa.

Anyone who says 'I had x centrals' or 'x obstructives' and bases his adjustments on that may be going from the wrong assumptions.

Also you discover the machine already classes an Apnea at 5 seconds and not the usual 10.

Just some aspects which have never been mentioned here.

Here is an example of what came out last night, taken from the screenshot programme.

Central (You see the heart impulses. What they claim seems to be true)
Obstructive An even line.
snore
Hypopneas

And snoredog - there is an old maxim. Don't knock something unless you have tried it yourself.
You write 'there is no useful data.'
How do you know that? Telepathy?

[tangents]

Thanks for the graphs, Howard, they're very educational. Is it difficult to time-tag the Silverlining data with the real time screen captures?

Cathy

[becktrev]

Hello Cathy,

The screenshots are auto-filed with a name which contains the exacts time (to a fraction of a second)
The progs replay also has a time scale, a bit like a Windows media player - you see it at the top of the 'central' shot and the file name at a 'pause' is shown.
As the top data of the snapshot is exactly the same as the normal Silver Data graphs, it is easy to match up.

It is fascinating to watch in video mode, how the machine's pressure in APAP mode reacts to the breathing pattern. You can come to understand the complexity of the algorythm.

I imagine the data has also a relevance to CPAP settings - I don't know though - too much thought at the moment about the need to cut the lawn.

Greetings, Howard

[Daffney_Gillfin]

Thanks for sharing this, Howard. I think it just may be the incentive I need to get my hard drive changed out this weekend on my laptop. I've been dreading it, and was likely to put it off. Now I have an even better reason to get it done -- as if only having 865MB of free space wasn't enough.

[Snoredog]

Quote:"The point is there is no useful data from it outside the lab without EEG & SPO2 to correlate anything seen. So why bother?
"Quote:"Still won't be able to make heads or tails from the data seen, but I guess if you are trying to cure insomnia that would do it"

Depends on at what level you want to understand the workings of a machine and with what knowledge basis you approach the 'tweaking it' yourself.
The few little ticks on the graph the next day can totally misrepresent the reality and some of the statements here in the past from some self-styled experts have been made from that basis.

When you look at the flow data directly, for example, you discover that the machine registers an apnea which starts central for a few seconds and then becomes obstructive for a long period as central.
And vice-versa.

Anyone who says 'I had x centrals' or 'x obstructives' and bases his adjustments on that may be going from the wrong assumptions.

Also you discover the machine already classes an Apnea at 5 seconds and not the usual 10.

Just some aspects which have never been mentioned here.

Here is an example of what came out last night, taken from the screenshot programme.

Central (You see the heart impulses. What they claim seems to be true)
Obstructive An even line.
snore
Hypopneas

And snoredog - there is an old maxim. Don't knock something unless you have tried it yourself.
You write 'there is no useful data.'
How do you know that? Telepathy?

I just have better things to do with my time then go over hundreds of screen snaps pictures looking for squiggly lines that have already gone by. There are only so many things you can adjust on the machine, once you have exhausted those you have to rely on the algorithm. So an apnea lasts 48 seconds and another one lasts 37 seconds, the goal is to eliminate both if you can.

Are you going to change how the algorithm responds other than FL1 and FL2? I doubt it.

When you look at the flow data directly, for example, you discover that the machine registers an apnea which starts central for a few seconds and then becomes obstructive for a long period as central.
And vice-versa.

Yep that event is called a "Mixed" apena, also easily seen below on the Detailed report highlighted in green.


If the event is logged in monitor mode it will also be logged in the Detailed report page, all you are doing is exploding the data down to the second vs the condensed version shown on the reports.

Also you discover the machine already classes an Apnea at 5 seconds and not the usual 10.

(cough more BS) Apnea isn't determined by the 10 second duration rule to begin with only Hypopnea are.

Apnea is complete cessation of air flow. With the sensor in the machine detecting an open vs. closed airway and cardiac oscillations I suspect it can detect an apnea easily within 5 seconds.

You show a Central in that epoch, so what can you do about it?

Absolutely nothing is my guess.