encore pro lessons

Maybe others can help this thread along with examples. This will help those new to trying to interpret their graphs/data.

My example - snores on the graphs don't necessarily mean snoring takes place.

This was a few weeks ago. What happened was a major leg cramp at the 4:30 am (5 hour) mark. In dealing with this cramp I grabbed for my bottle of Magnesium on the shelf running parallel to my bed and the hose kept hitting the shelves and/or edge of the bed and vibrated. Notice that the pressure went up (to the max allowed) in response to this.

Yes, that happens, and a little water in the hose making noise will do the same. I've wondered about noises in the room (TV), can't confirm it. I have one mp3 of a thunderstorm that the louder thunder seems to get picked up, but not all the time. The one I run with the fireplace popping isn't loud enough to trigger it. Jim

I set my APAP so it can't go higher than I need.

When my Quattro leaks badly, the graph shows snores!

m

Cool thread, Jules...examples!

Ok, here's one I like. It's someone else's data, not mine.



I think that's a good example of using an autopap with the minimum pressure ( 6 ) set too low and the maximum pressure ( 12 ) not set high enough.

Not that there was anything wrong with setting it 6 - 12 to begin with, but now that data has been downloaded for several nights and is repeatedly showing this kind of pattern of pressure use, it's time to try a different range of pressures, in my non-doctorly opinion.


In my layperson's opinion, I think this person should raise both the minimum and maximum pressures considerably, given that the machine is running right up to the ceiling of 12 most of the time. Several other nights of data were showing the same thing, by the way.

I'd suggest trying 10 - 20 for awhile instead of the 6 - 12 that autopap is currently set for.

Or, if they don't want to set it 10 - 20, at least try 10 - 15 for a few nights.

If the machine runs up to a new higher ceiling most of the time, it could be an indication that a lot more than just "OSA" needs to be investigated. Centrals too brief to be marked as "NR"? GERD interfering with treatment?

I'd give the machine its head for a few nights to see what it does.

Despite the occasional leak spikes, the leak rate looks good, imho. The brief spikes could be mask getting dislodged a bit from time to time, or a brief mouth puff occasionally. Doesn't look like "leaks" are anything to worry about there.

rested gal wrote:Cool thread, Jules...examples!

Ok, here's one I like. It's someone else's data, not mine.



I think that's a good example of using an autopap with the minimum pressure ( 6 ) set too low and the maximum pressure ( 12 ) not set high enough.

Not that there was anything wrong with setting it 6 - 12 to begin with, but now that data has been downloaded for several nights and is repeatedly showing this kind of pattern of pressure use, it's time to try a different range of pressures, in my non-doctorly opinion.


In my layperson's opinion, I think this person should raise both the minimum and maximum pressures considerably, given that the machine is running right up to the ceiling of 12 most of the time. Several other nights of data were showing the same thing, by the way.

I'd suggest trying 10 - 20 for awhile instead of the 6 - 12 that autopap is currently set for.

Or, if they don't want to set it 10 - 20, at least try 10 - 15 for a few nights.

If the machine runs up to a new higher ceiling most of the time, it could be an indication that a lot more than just "OSA" needs to be investigated. Centrals too brief to be marked as "NR"? GERD interfering with treatment?

I'd give the machine its head for a few nights to see what it does.

Despite the occasional leak spikes, the leak rate looks good, imho. The brief spikes could be mask getting dislodged a bit from time to time, or a brief mouth puff occasionally. Doesn't look like "leaks" are anything to worry about there.

I think your right about the pressure, I wouldn'rt bump the top more than 1 but I'd close the gap. What bothers me is the FL, anytime I go past 1 I'm out of luck. I think tonights going to be one of those nights too. Jim

bumping this up for others to add good examples -

ww - yours would be great !

other feel free to add on to this too as we want newbies to get some help they can find out of these lessons

Thanks to all the wonderful members in this forum that helped me so much over the past 4 months!!!

For anyone new to CPAP wondering what a good leak line looks like on Respironics software in straight CPAP mode, this is the first all night "almost perfect" leak line achieved in over 100 nights of slow and steady progress!!

This data was using the Nasal Aire NAII MP pillows with Slumbergear Headgear.

Does anyone know what causes the downward blips in the leak line? Something woke me up many times during the night and I wonder if that was what caused the blips?



Previously (for the chart below) I had been told that I needed to fix the leaks, but I was not sure what a good or bad leak line looked like (but now I do).

For reference, this was one of my first leak lines that Snoredog called a "train wreck" It was using the Respironics Optilife Nasal Pillow Mask Med pillows and straight CPAP mode.

Without software and this forum, I would never have realized the extent of the leak problem, much less have been able to correct it! Thanks again for the help from everyone!

Random thoughts.......

Leaks and snores can drive an APAP crazy chasing either/both. Nasal congestion can "sound" like snores to these machines, too. If you can't control the leaks and snores, APAP may not be for you (or at least a wide pressure range).....CPAP doesn't care, it just reports what it senses.

I ignore the "Max Leak" numbers and focus on the "Average Leak". The "90% Leak" usually follows pretty close to the "Average Leak" in my case.

"Long Term Trend Report" is pretty meaningless, too.

There is an extensive "Help" menu in Encore Pro that will answer many questions. I'm not sure whether Viewer has it, but I would assume so.





Den

My opinion:

Remstars have alway been very sensitive to snores as with most machines, snoring has a specific frequency that shows up so the machine can easily distinguish it to SDB events. Flow Limitation is another that is easy for the machine to spot.

Granted you may be able to trigger the machine into picking up a snore by dragging a ribbed hose over the edge of the bed or table, it is pretty hard to simulate that throughout the night.

Jules knows what her snore looks like after reviewing numerous reports and can easily identify the cause of the snore seen on her report, but on RG's example, you can see snore was seen through out the night, it is probably what drove pressure up where it remained most of the night.

Jules: But if you slice up that 1 hr period in half, then in quarters, where the snore exists, does that mean you moved that hose around for nearly 15 minutes?? (you can take the 5th on that one, just don't give Babs any ideas )

In RG's example, I agree 6 cm is a bit too low for that person viewing the results from the report, 9 or 10 obviously would have been a better starting pressure, but we don't know the other factors either, if that patient has insomnia or aerophagia, that would have been a valid reason to use 6.0 cm starting pressure.

If the patient can tolerate the added pressure then by all means bump it up, but many don't have the luxury of the reports and those just give up on therapy vs knowing they can start lower and still receive adequate treatment.

Even in RG's example shown where the consensus is pressure is too low, the patient's AHI is only 3.3. That is a lot better than we see them leaving the lab with on fixed pressure.