Odd data last night - plus centrals deconstructed...

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DreamDiver
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Odd data last night - plus centrals deconstructed...

Post by DreamDiver » Mon Mar 15, 2010 11:59 am

Part 1 - weird stuff...
I got some odd data last night.
The first thing that hit me was the gap I don't remember. That would be the first gap in red below. Oximetry shows that the gap exists, yet, I must have just been sitting doing nothing in bed. I think I would have remembered that. I do remember the second gap in green. I wonder if this has anything to do with daylight savings time -- except there's the oximetry. I watched tv for about 20 minutes at the second gap so my apneas would be less pronounced when I got back to sleep.
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When you look at a closeup split of the gap, the data match up as to height and delta. That's weird.
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This was an example apnea, 14 second duration.
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This apnea appeared in the events graph, but not in the flow pane. Nada. This is the first time I've actually seen one graph not completely agreeing with another graph.
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For this night, there is a thirty second lag between pressure and flow at the beginning of each mask event as denoted by the red shading...
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And consequently at the end of each mask event (also red shading). So the system isn't perfect.
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Part 2 - central apnea deconstruction...
In an effort to understand when an apnea starts and stops visually, I set up an example measuring stick for a 25 second apnea. Once I had a yard-stick to work with in pixel width, I did a ratio to get the correct size width for other apneas. I set the yardstick at the very center of the apnea event, as shown by the crosshair.
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This is a similar example for a fifteen second apnea.
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What I'm calling an 'ideal' example of a central apnea.
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Another ideal example. Sorry - i don't get obstructive apneas, so I can't show you those!
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This one is less than ten seconds, so it doesn't count here.
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This one is either darn close, or the system just didn't pick it up.
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This one looks like the event is shifted from the flow data.
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This one looks like it should count, except there is the tiniest bump of flow in the center. Go figure.
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Pulling back to a one-minute time frame, this is a view two near apneas with one software-acknowledged apnea.
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Getting closer again, here's an 11 second central with the measurable quantity in green.
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Another 11 second central with the measurable quantity in green.
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That's pretty much what I'm looking for in a central. So when I apply understanding that to other areas, I'm sometimes finding clumps of 'almost' apneas. I'm not really sure what all of this means, but it does show a few things. One of them is that the system is not perfect. A ten-second limit as to what counts as an apnea could miss a whole night of nine-second apneas. Some centrals show up for no apparent reason in this software. Others don't seem to be picked up. Hypopneas still somewhat elude me in terms of picking them out in a graph, even if I get the gist of a verbal definition.
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That's all my musings for this time. Hope it helps somebody.

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jmelby
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Re: Odd data last night - plus centrals deconstructed...

Post by jmelby » Mon Mar 15, 2010 12:24 pm

Hmm... the 2am to 3am thing sure looks like daylight savings time, but that should have happened a night earlier. My S9 did NOT adjust itself... did yours? I changed the time this morning after I realized my data was an hour off.

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DreamDiver
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Re: Odd data last night - plus centrals deconstructed...

Post by DreamDiver » Mon Mar 15, 2010 12:53 pm

jmelby wrote:Hmm... the 2am to 3am thing sure looks like daylight savings time, but that should have happened a night earlier. My S9 did NOT adjust itself... did yours? I changed the time this morning after I realized my data was an hour off.
I changed mine yesterday after the data download. So yeah. Weird. It's also odd that I have oximetry data for the gap, if it were from DST. If my oximetry data were an hour short, I'd reconsider DST as an answer.

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DreamOn
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Re: Odd data last night - plus centrals deconstructed...

Post by DreamOn » Mon Mar 15, 2010 1:16 pm

That's very helpful, DreamDiver! Thanks for taking so much time to create and post the graphics too!

I agree that the data gap does look like it's due to the time change since it was exactly an hour long and started at 2:00 a.m., but that would be on the wrong day, as jmelby said. Perhaps the machine was programmed incorrectly or if the S9 records noon-to-noon as a "night", as the S8 does, that may have something to do with it? But this doesn't explain why the oximeter did continue with data recording through that period! It appears that you have about 8 hours recorded in both ResScan and the oximeter, including the data gaps. Very odd. It'll be interesting to see if anyone else reports the data gap, especially for the nights recorded around the time change.

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Re: Odd data last night - plus centrals deconstructed...

Post by Arizona-Willie » Mon Mar 15, 2010 1:39 pm

As to your question about the 10 second apnea that didn't get called, I think it wasn't 10 seconds.

If you look closely you can see a little black marker at each 5 second mark. I've extended those marks and put ellipses between the marks and the beginning and end of the apnea. You can see that the ellipse at the beginning is bigger than the one at the ending which shows the apnea didn't last the full 10 seconds.
Actually that is a confidence builder == we can see that the machine is very accurate== it won't take 9.75 seconds, it has to be EXACTLY 10 seconds or more or the machine will not call it.

I don't know why you have a gap for daylight saving time ... I didn't have any gaps.
But I'm in Arizona where we don't have DST so maybe that's why.

Did other people have a gap for DST?
===================================
Image

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Re: Odd data last night - plus centrals deconstructed...

Post by Nord » Mon Mar 15, 2010 1:52 pm

DreamDiver wrote:
jmelby wrote:Hmm... the 2am to 3am thing sure looks like daylight savings time, but that should have happened a night earlier. My S9 did NOT adjust itself... did yours? I changed the time this morning after I realized my data was an hour off.
I changed mine yesterday after the data download. So yeah. Weird. It's also odd that I have oximetry data for the gap, if it were from DST. If my oximetry data were an hour short, I'd reconsider DST as an answer.
According to ResMed Data Management Guide pdf in the "Updating Settings" section... the only things it cannot update: it cannot update the "date" or "language setting" on the machine via the SD card... the change has to be made at the machine itself. Maybe that's the answer to the disappearance of exactly 1 hour. It's trying to compensate between the computer date at the next download date.

Nord

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Re: Odd data last night - plus centrals deconstructed...

Post by DreamDiver » Mon Mar 15, 2010 2:59 pm

Nord wrote:According to ResMed Data Management Guide pdf in the "Updating Settings" section... the only things it cannot update: it cannot update the "date" or "language setting" on the machine via the SD card... the change has to be made at the machine itself. Maybe that's the answer to the disappearance of exactly 1 hour. It's trying to compensate between the computer date at the next download date.

Nord
I like the logic, but how do you account for the extra hour of oximetry? Wouldn't the oximetry be an hour short in this case? It's not.

Wow, thanks everyone for these ideas. I think I need to digest some of this. Again, cheers.

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Re: Odd data last night - plus centrals deconstructed...

Post by KatieW » Mon Mar 15, 2010 8:22 pm

DreamDriver, your graphs are amazing. I need to study them more.

You have Oximetry data? Is that a Resmed accessory? Where did you get it, and what did it cost? Thanks.

Katie

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DreamDiver
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Re: Odd data last night - plus centrals deconstructed...

Post by DreamDiver » Mon Mar 15, 2010 9:04 pm

KatieW wrote:DreamDriver, your graphs are amazing. I need to study them more.

You have Oximetry data? Is that a Resmed accessory? Where did you get it, and what did it cost? Thanks.

Katie
Thanks KatieW,
I bought the Contec CMS-60D. It not a resmed accessory, but it's easy to line up with resmed graphs. I got it for $250, but I hear it's now available for under $200 at semedicalsupply.com. It's as accurate as some of the others favored by hospitals, according to some of our members.

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Re: Odd data last night - plus centrals deconstructed...

Post by KatieW » Mon Mar 15, 2010 9:17 pm

Ok..... I got all excited because I thought you had a Resmed Oximeter. I looked on-line but didn't see them on sale anywhere.

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Re: Odd data last night - plus centrals deconstructed...

Post by KatieW » Mon Mar 15, 2010 10:10 pm

DreamDiver, your graphs clearly shows that happens to Flow during your Centrals. Thanks.

Was there anything interesting in your Minute Ventilation or Flow Limitation graphs at the same time. I'm trying to understand how all this data works together, to give a total picture of what's happening. Or do you think flow is the most important indicator?

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Re: Odd data last night - plus centrals deconstructed...

Post by DreamDiver » Tue Mar 16, 2010 5:54 am

KatieW wrote:DreamDiver, your graphs clearly shows that happens to Flow during your Centrals. Thanks.

Was there anything interesting in your Minute Ventilation or Flow Limitation graphs at the same time. I'm trying to understand how all this data works together, to give a total picture of what's happening. Or do you think flow is the most important indicator?
Minute ventillation seems to be more of a confirmation tool for flow, but might be more useful for obstructive apneas - I'm not sure. Flow limitation has a definite effect on my pressure. Like you, I'm still trying to piece it all together. I keep poring over the graphs, trying to gain further insight via osmosis. We'll see how that works.

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