Encore Pro reports and questions

[linda b]

If I am interpreting the Encore Pro data correctly, I think these numbers look pretty good. The expert opinions of more experienced forum members would be very much appreciated. I am wondering if I should raise the lower pressure setting.

Titrated pressure: 12
APAP pressure range: 7 - 15
C-Flex: 2
Heated humidifier: 1 or as passover

Averages for 6 weeks:

90@ 9.1
Avg. pressure 7.7
NR A/H 0.0
Flow Limit. 0.6
Obs. Apnea 0.7
Hypopnea 2.7
Vib. Sounds 1.5
Avg AHI 3.3
Highest overnight pressure avg: 10.3

Highest daily during 6 week period:

90% 11.3
Avg. pressure 8.5
NR A/H 0.0
Flow Limit. 1.4
Obs. Apnea 2.2
Hypopnea 5.7
Vib. Sounds 15.9
Avg. AHI 7.9
Highest overnight pressure: 14.0

One thing I have noticed in the “Sleep Therapy Daily Details” reports is that on ALL of them, 6 weeks worth, the pressure has not increased during the first two hours of sleep -- not once. And there have been several days showing tick marks during those two hours for obstructive apneas and many days with bunches of hypopnea tick marks. Any ideas on why this is happening and if it means something is wrong with the machine?

Another question: The daily reports provide info as to the number of apneas and hypopneas occurring at the various pressures, the majority of which occur at or below the 90% number. Is this, then, the ideal bottom pressure number so that all those events don't occur in the first place?

Much thanks for any help and comments.

[Goofproof]

You look like you are doing pretty good. I would raise the bottom 1 CM and lower the top 1 CM. 8 cm to 14 cm. I think the machine controls better with a tighter range. In any case the tighter range is within your current use pattern.

Your Vib Sounds Avg are good, for the most part, but your daily high of 15.9, leads me to think at that time you may have been mouthleaking then or had other loss of presure.

Usually when my Snore rate goes up so does my pressure and even more leaks, that or I'm really congested, anyway it doesn't make for a good night.

Over all you are good, just a little fine tuning, and No Leaks Allowed. Jim

[Goofproof]

DO you use MyEncore, If so I pay attention to the time I spend in Apnea, and the number of Apnea events, as they are in direct relation to O2 shortages. AHI is a good indication of it too, it's just easier to see how long you were in trouble. Jim

[linda b]

No, I don't have MyEncore installed. We had so much trouble getting Encore Pro up and running on this old laptop that we decided to wait until I get my new laptop before trying to download that program.

In the meantime, does anyone out there have an idea as to why there are no pressure responses to the apneas and hypopneas I seem to be having during the first two hours?

[Goofproof]

You are under the target of AHI less than five, maybe you aren't asleep and they are being scored, the machine may not treat until it deturmines you are asleep. I would go ahead and install MyEncore, It is a small program, Use version 15b7 only.... Jim

[rested gal]

Hi Linda,

I don't use MyEncore. It's a nice program that a lot of people like. Derek gave very generously of his time to create it and make it available. I've found just Encore Pro to be sufficient for me to make good treatment decisions, so Encore Pro is all I use.

I agree with Goofproof that your numbers look good, and that raising the lower pressure a notch or two might be a useful experiment. I don't think it matters at all where you put the upper pressure at this point, since you can already see that the machine is not hitting where you have it now anyway. You might as well leave the top pressure as it is. I wouldn't drop that, although I would try increasing the lower pressure some.

All I'd try, since you're getting good numbers already, is increasing the lower pressure to 8, as Goofproof suggested; or even to 9. See if that cuts down on the few apneas/hypopneas you are seeing in the first couple of hours.

The Vibratory Snore index might mean nothing at all in your case, Linda. It seems to be a very iffy indicator for some people and is not worth worrying about, imho, if the AHI is good -- which yours is.

Looks like you're doing very well, indeed.

[linda b]

Thanks for your responses, Goofproof and Rested Gal. I'll dig out my copied copy of the clinician's manual and reset the low end to 8 for awhile and see if there is any change, then decide about going on up to 9.

Goofproof, I really don't think I'm still awake for two hours every night. I usually go to sleep within about 10 to 20 minutes of getting in bed. Rarely, I may have a night where it takes a good deal longer, but not every night! As a matter of fact, it is usually about 2 hours into the night that I make my first position change -- from my left side to my right side -- due to problems I have with sciatic nerve pain in my hips. And I feel quite groggy, as if being awaken from a pretty deep sleep when I make that turnover and go back to sleep immediately -- at least I THINK I do!!!

[danw2002]

hey all, just switched to a resp. auto w/cflex cpap and i love it , now i have all this great info( about 10days worth so far) and don't know what to make of it, is there a doc file somewhere that will tell me what the numbers show from myencore, and what is good and not so good? thanks gang.

[quote="Goofproof"]You are under the target of AHI less than five, maybe you aren't asleep and they are being scored, the machine may not treat until it deturmines you are asleep. I would go ahead and install MyEncore, It is a small program, Use version 15b7 only.... Jim

[rested gal]

One thing I have noticed in the “Sleep Therapy Daily Details” reports is that on ALL of them, 6 weeks worth, the pressure has not increased during the first two hours of sleep -- not once. And there have been several days showing tick marks during those two hours for obstructive apneas and many days with bunches of hypopnea tick marks. Any ideas on why this is happening and if it means something is wrong with the machine?

Linda, you haven't set the Ramp timer for 2:00, have you? When using the older ( non-M series ) REMstar Auto with C-flex in either of its "auto" modes (APAP or AFLE), ramp MUST be set for 0:00 or the machine will use "split night therapy" mode. That means the machine will operate only at your minimum pressure setting of 7 cm's for however many hours the Ramp timer is set for (2:00, 3:00, or 4:00 hours.) It will record events (apneas/hypopneas, etc.) but won't begin varying the pressure as needed until after the hours set for "Ramp" time have finished. You can't use a traditional "ramp" when using the non-M REMstar Auto in autopap mode. The newer M Auto can use a traditional ramp in its auto modes, but the older auto cannot.

You might want to go through your settings again and be sure the Ramp timer is set for 0:00. What you described in the quote above sure sounds like you might have inadvertently set Ramp for 2 hours of split-night therapy.

[Goofproof]

[quote="danw2002"]hey all, just switched to a resp. auto w/cflex cpap and i love it , now i have all this great info( about 10days worth so far) and don't know what to make of it, is there a doc file somewhere that will tell me what the numbers show from myencore, and what is good and not so good? thanks gang.

[quote="Goofproof"]You are under the target of AHI less than five, maybe you aren't asleep and they are being scored, the machine may not treat until it deturmines you are asleep. I would go ahead and install MyEncore, It is a small program, Use version 15b7 only.... Jim

[Snoredog]

linda b wrote:

One thing I have noticed in the “Sleep Therapy Daily Details” reports is that on ALL of them, 6 weeks worth, the pressure has not increased during the first two hours of sleep -- not once. And there have been several days showing tick marks during those two hours for obstructive apneas and many days with bunches of hypopnea tick marks. Any ideas on why this is happening and if it means something is wrong with the machine?

1. Sounds like your Remstar has a "split-night" timer programmed. Depending on the model you have any timer should be set to 00:00. You should enter Setup mode and check this. Your pressure settings are fine and your results are good but if the machine is not responding in the first 2hrs then it could be a timer is set for 120.

2. You would have to refer to your last PSG for Latency to REM seen. If your REM latency is 120 minutes that could explain why your not seeing any pressure increases for the first 2 hrs.

Your pressure range seems fine, I wouldn't change it. But I would check your machine for the Split-Night timer (value is Ramp in cpap modes, depends on the model you have).

I would check machine, make sure it is set to:

Mode=AFLE
Min=7.0cm
Max=15cm
CFLEX=2 (or what ever you have it set to now)
Timer=00:00 (MUST be 00:00 for auto modes)
Alert=0/1
LED=0/1

[danw2002]

thanks for the answer Jim, yep i have done that, but i need more info on what a high or low number means, what is good, what is bad, etc. i am self insured and have to do this all on my own. i am being careful but am trying to get a handle on the numbers.
Dan
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Jim said....
You can go to cpap.com, Encore Pro software purchace area and it shows the MyEncore software, that explains a lot. Also the FAQ has lots of answers at the top of board. Jim

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, Encore Pro, CPAP, AHI, auto[/quote]

[Goofproof]

danw2002, The main thing is to get the AHI under 5, shoot for the lowest you can get. Use the treatment every time you sleep all the time, compliance is 4 hours, but progress requires all the time.

You want the numbers as low as possible. leaks cause poor treatment, and promote Snores. In MyEncore, I pay attenton to time spent in Apnea, and length of Apnea event, this means the times you didn't breath, pretty important.

You can't do much about the numbers, to keep them low, except to find your best pressure and stop those excess leaks. Mouth breathing is a big problem for some and it has to be whipped. Figuring out the numbers isn't hard, and it;s a game of avg, the number change nightly, so to make judgements , you need 5 days to get the avg, if you change something just change one thing at a time. Jim

[danw2002]

thanks Jim, just to clear up things a bit, i have been on normal cpap(a LX that is now for back up) for about 3 years now and doing well(pressure was set at 11.5), just got the auto about 2 weeks ago, that is what this is all about. how do i get the adv numbers from myencore, it just gives the dailys and the charts. how do i get this info in numbers form, i seem to remember encorepro did that, but i can not get it to do it, then i could post some numbers for you all to see what i am doing...thanks again. like this from above....

Averages for 6 weeks:

90@ 9.1
Avg. pressure 7.7
NR A/H 0.0
Flow Limit. 0.6
Obs. Apnea 0.7
Hypopnea 2.7
Vib. Sounds 1.5
Avg AHI 3.3
Highest overnight pressure avg: 10.3

Highest daily during 6 week period:

90% 11.3
Avg. pressure 8.5
NR A/H 0.0
Flow Limit. 1.4
Obs. Apnea 2.2
Hypopnea 5.7
Vib. Sounds 15.9
Avg. AHI 7.9
Highest overnight pressure: 14.0


[quote="Goofproof"]danw2002, The main thing is to get the AHI under 5, shoot for the lowest you can get. Use the treatment every time you sleep all the time, compliance is 4 hours, but progress requires all the time.

You want the numbers as low as possible. leaks cause poor treatment, and promote Snores. In MyEncore, I pay attenton to time spent in Apnea, and length of Apnea event, this means the times you didn't breath, pretty important.

You can't do much about the numbers, to keep them low, except to find your best pressure and stop those excess leaks. Mouth breathing is a big problem for some and it has to be whipped. Figuring out the numbers isn't hard, and it;s a game of avg, the number change nightly, so to make judgements , you need 5 days to get the avg, if you change something just change one thing at a time. Jim

[linda b]

Just a note to say Thank You for all your posts to my 2 hour problem and to let you know that Rested Gal and Snoredog were right again -- the RT who set up my machine had put a 2 hour ramp time in there!!!! Who needs a 2 hour ramp time? Wow. I also raised the lower range number to 8 and in just one night, even calculating in those 2 undertreated hours, my AHI went down to 1.4.

As they say, "You guys ROCK."