Help with Encore Pro Report

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 7:31 am

I just got my card reader and installed it along with the software. Here is a sample report from last night. Can anyone take a look at it and give me some comments on what I should be looking at? Also, it seems weird that the Vibratory Snore index goes way up as the pressure goes to 12 cm.

DreamStalker · Post by **DreamStalker** » Wed Oct 31, 2007 7:58 am

You need to collect a week or two of data before trying to determine what it all means. One night's observation does not neccessarily reflect what happens most of the time.

Having said that, once you do have a report that represents the average of one to two weeks of data ... you want to keep an eye on the leak rate plot. That leak rate curve should not bounce around too much and should ideally (though rare) be flat at about the value that your mask leak rate is designed for at your Rx pressure(s).

Once you have the leak curve with as little variablility as possible, then you start looking at your pressure curves and sleep therapy flags to determine what if any thing needs to be adjusted.

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 8:07 am

I do have several weeks of data. I just didn't want to post all of that information since it is rather large. The leak line is never flat and the snore index always goes way up as the pressure nears 12cm.

Here is more data:

bdp522 · Post by **bdp522** » Wed Oct 31, 2007 8:21 am

You need to be sure you aren't mouth breathing or mouth leaking. It sounds like as the pressure goes up, you may leaking more from your mouth. You gotta fix the leaks before you can work on the snores.

Brenda

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 8:58 am

I suppose I could try taping again, but the leak numbers don't look out of whack and my AHI seems good. I am wondering if it is worth it. My DME told me to not be too concerned with the snore numbers.

bdp522 wrote:You need to be sure you aren't mouth breathing or mouth leaking. It sounds like as the pressure goes up, you may leaking more from your mouth. You gotta fix the leaks before you can work on the snores.

Brenda

DreamStalker · Post by **DreamStalker** » Wed Oct 31, 2007 10:28 am

If your mask is indeed a Swift, as I recall, your avarage leak rate should be in the low 30's (for your 12 cm pressure) ... so 40 is not bad but it could be better.

Yes your AHI is very good ... however your pressure appears to be topping out at your max pressure setting (perhaps improved leak rate could take care of that?) ... of course this is true only if your chart(s) represent average conditions.

If you are feeling OK just enjoy the ride ... there are many others out there who are not doing near as well as you. If you can't keep your grubby hands off the clinician menu then try to perfect the leaks first then fiddle with pressure adjustments.

Wulfman · Post by **Wulfman** » Wed Oct 31, 2007 10:59 am

The curse of the APAP machines.....
Snores and leaks will drive up your pressure.
It looks like you have both.
It's a good thing you have your upper pressure limited.
But, your AHI is good.

Den

mindy · Post by **mindy** » Wed Oct 31, 2007 11:02 am

DreamStalker wrote:If your mask is indeed a Swift, as I recall, your avarage leak rate should be in the low 30's (for your 12 cm pressure) ... so 40 is not bad but it could be better.

The sleep tech who tested my leak rate with Swift II a couple of weeks ago noted leak around 40 for a pressure of 9-14 and he said that was quite acceptable.....

Mindy

Snoredog · Post by **Snoredog** » Wed Oct 31, 2007 11:36 am

My opinion:

1. you don't have a wide enough window to bother with a range, might as well just use CPAP mode if you are going to use those settings. Give the machine enough room to work.

2. Your Auto:Max pressure setting is way too low, why are you limiting the machine's ability to respond? Bump that sucker up to about 15 cm or 16 cm.

3. Depends on how well you tolerate pressure, but you change the way that machine responds to events by having the Auto:Min up so high. You are limiting what the machine can learn from your sleep which can impact how it responds. I would try setting the Auto:Min=8.0 for a night or two and compare your reports. That machine changes the way it responds to events at 6.5 cm, at 8.0 cm and again at 12.0 cm, you've managed to preclude its ability to respond at all settings.
I'd try a range of 8.0cm to 16.0cm and compare your daily reports.

4. Vibratory Snore is what is driving up your pressure, right now it is pegging at the 12 cm self imposed limit. Snoring generally precedes an apnea, if leak goes any higher with the snoring I'd be suspect of mouth breathing.

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 1:18 pm

Thanks for the replies. I think I will take your advice Snoredog and set the auto range as you suggested. I will do it this weekend so that if I end up with a bad night I won't be really tired at work. I initially limited the range because I didn't want the machine waking me up due to pressure changes.

It is very possible that I am puffing air out of my mouth and the machine is cranking up the pressure to respond. I did try taping for a while, but I really don't like it. I have some data when I was taping so I will look over the leak rates during that period.

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 1:20 pm

Very true. I may end up setting it back on CPAP mode at 11 or 11.5, but I want to check out the APAP on the range Snoredog suggested first and see what that does.

[quote="Wulfman"]The curse of the APAP machines.....
Snores and leaks will drive up your pressure.
It looks like you have both.
It's a good thing you have your upper pressure limited.
But, your AHI is good.

Den

mindy · Post by **mindy** » Wed Oct 31, 2007 1:21 pm

Hi Flying Norseman,

Have you tried the Tiara Topaz adjustable chinstrap? My sleep doc just recently switched me to that one and it has reduced my mouth breathing considerably.

Mindy

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 1:29 pm

Hey Mindy.

I don't think that would help because I don't actually breath out of my mouth, but I "puff" air out between my lips sometimes. I don't have to open my jaw to do that.

mindy wrote:Hi Flying Norseman,

Have you tried the Tiara Topaz adjustable chinstrap? My sleep doc just recently switched me to that one and it has reduced my mouth breathing considerably.

Mindy

mindy · Post by **mindy** » Wed Oct 31, 2007 1:40 pm

Well, that was my problem (chipmunk cheeks and air floating out between my lips) and it would wake me up from 3-10 times per night. That was with Tiara Ruby chin strap. With the Topaz, I'm down to typically once per night....

Mindy

Flying_Norseman · Post by **Flying_Norseman** » Wed Oct 31, 2007 4:04 pm

Here is a thought. Could the high number for the Snore Index be caused by the hose moving over my headboard of the bed? I have the hose draped over the headboard and the edges of the headboard a not smooth. Since I think the machine measures the vibrations in the hose could excessive movement cause the snore index to go up?