What's important to you in your CPAP report software?

[jedimark]

Hi,

I'm looking for ideas on what information should be presented in CPAP reports before I start developing the GUI & graphical side of things of my program.

What is most important to you when you read Encore/ResScan/etc reports? What don't you like about your software?

Also, to those of you who have used more than one brand of cpap software, which bits do you feel stand out as better presented? Is there something you miss having from another machine's software?

Program name suggestions anyone? Best I can come up with is SleepyHead

For now it just does PR S1 and Zeo, (but Zeo's reportings switched off until I get the CPAP stuff awesome) it will do others later (the framework is in place).

Right now, all I have to do is put my SD card in my notebook, and run my little program. It automatically imports any previously unread data into a database, and then produces the following text output:

*** Stats for Last 7 Days ***
2011-03-12 Sessions=1 6:17:08 Hours Pressure=6.6 AHI=4.6 CI=3.34 CSR=0.80
2011-03-11 Sessions=1 11:45:19 Hours Pressure=7.0 AHI=7.7 CI=6.89 CSR=1.96
2011-03-10 Sessions=5 5:49:49 Hours Pressure=6.7 AHI=7.9 CI=7.38 CSR=1.20
2011-03-09 Sessions=3 4:41:46 Hours Pressure=7.0 AHI=11.1 CI=11.07 CSR=2.13
2011-03-08 Sessions=3 11:50:16 Hours Pressure=7.0 AHI=4.9 CI=2.03 CSR=0.59
2011-03-07 Sessions=1 9:25:59 Hours Pressure=7.0 AHI=3.7 CI=0.64 CSR=0.11
Total Sleep Time 2 days, 1:50:17
Average Pressure=6.8
Average AHI=6.2
Average ClearAirway=4.6
Average CSR=1.1

*** Last Nights Stats ***
0 Vibratory Snore Events
2 Obstructive Apnea Events
27 Hypopnea Events
21 Clear Airway Events
3 RERA Events
5 Cheyne Stokes Respiration Periods
6:17:08 Hours Sleep

found 58 signifigant event records between 2011-03-12 13:00:00 and 2011-03-13 13:00:00
found 76 wave records between 2011-03-12 13:00:00 and 2011-03-13 13:00:00
2011-03-13 02:14:07 1 ClearAirway [51]
2011-03-13 02:14:42 1 ClearAirway [26]
2011-03-13 02:16:09 1 ClearAirway [18]
2011-03-13 02:16:30 1 ClearAirway [21]
2011-03-13 02:17:29 1 ClearAirway [41]
2011-03-13 02:18:22 1 ClearAirway [24]
2011-03-13 02:19:06 1 ClearAirway [27]
2011-03-13 02:20:21 1 ClearAirway [23]
2011-03-13 02:21:06 1 Hypopnea [23]
2011-03-13 02:23:06 1 Hypopnea [43]
2011-03-13 02:23:55 1 ClearAirway [21]
2011-03-13 02:24:18 1 ClearAirway [18]
2011-03-13 02:25:06 1 ClearAirway [16]
2011-03-13 02:25:07 1 Hypopnea [20]
2011-03-13 02:25:49 1 ClearAirway [22]
2011-03-13 02:26:09 1 Hypopnea [17]
2011-03-13 02:28:06 1 ClearAirway [33]
2011-03-13 02:28:22 1 Hypopnea [18]
2011-03-13 02:29:06 1 Hypopnea [27]
2011-03-13 02:29:31 1 Hypopnea [32]
2011-03-13 02:30:07 1 Hypopnea [19]
2011-03-13 02:30:31 1 Hypopnea [23]
2011-03-13 02:31:06 1 CheyneStokes [143, 183]
2011-03-13 02:33:06 1 Hypopnea [22]
2011-03-13 02:35:06 1 CheyneStokes [141, 180]
2011-03-13 02:36:45 1 CheyneStokes [101, 201]
2011-03-13 02:58:59 1 Obstructive [8]
2011-03-13 03:05:06 1 RERA [54]
2011-03-13 03:07:06 1 Hypopnea [12]
2011-03-13 03:07:25 1 RERA [8]
2011-03-13 03:25:06 1 Hypopnea [33]
2011-03-13 03:31:45 1 ClearAirway [10]
2011-03-13 03:33:06 1 Hypopnea [32]
2011-03-13 03:35:24 1 ClearAirway [11]
2011-03-13 03:48:54 1 ClearAirway [10]
2011-03-13 03:53:06 1 Hypopnea [23]
2011-03-13 04:07:06 1 Hypopnea [16]
2011-03-13 04:57:06 1 Hypopnea [42]
2011-03-13 05:13:06 1 Hypopnea [12]
2011-03-13 05:29:16 1 ClearAirway [15]
2011-03-13 05:29:25 1 Obstructive [8]
2011-03-13 05:31:06 1 Hypopnea [33]
2011-03-13 05:41:34 1 ClearAirway [12]
2011-03-13 05:47:06 1 RERA [43]
2011-03-13 05:49:06 1 Hypopnea [15]
2011-03-13 05:49:07 1 Hypopnea [26]
2011-03-13 05:53:48 1 CheyneStokes [146, 183]
2011-03-13 05:53:51 1 ClearAirway [12]
2011-03-13 06:51:44 1 Hypopnea [12]
2011-03-13 06:51:55 1 Hypopnea [15]
2011-03-13 07:17:24 1 Hypopnea [16]
2011-03-13 07:21:06 1 Hypopnea [12]
2011-03-13 07:22:20 1 ClearAirway [16]
2011-03-13 07:23:06 1 Hypopnea [32]
2011-03-13 07:23:35 1 ClearAirway [21]
2011-03-13 07:23:50 1 Hypopnea [20]
2011-03-13 07:25:06 1 CheyneStokes [60, 183]
2011-03-13 08:07:06 1 Hypopnea [28]

[robysue]

First an impression of what you've presented: I like your list of individual events with the time stamp of each event and the summary data of the actual number of events. I currently compute the number of events of each time by hand, but cannot easily determine either when each event happened or how long the event lasted. My guess is that the numbers in brackets after the each event in the long list the number of seconds the event lasted. That correct?

Now for the input you asked for: I've used both a Resmed S9 Autoset with ResScan 3.12 and a PR System One BiPAP Auto with both EncoreViewer and EncorePro. And you ask for feedback from folks who had used one or more software programs to analyze data. In my humble opinion, ResScan is a better software package than either Encore product in many ways, although it does have its flaws. And Encore does have a few strengths that are missing in ResScan.

ResScan
Strengths of ResScan:
* The detailed graphs give you a superb amount of control in how close you want to zoom in on the data. It's really nice to be able to change the time frame on the graph to zoom in on a suspescious area or an area that clearly has clusters of events that are covering each other up in the "overview" of the Events graph.

* The summary leak data is meaningful in that it gives median and 95% leak rates instead of just an "average" leak rate

* The times are labeled with local time.

* It is easy to tell how long each apnea lasted. But there's no indication of length of the hypopneas unless you stare at the flow data for a long time.

* It is easy to look at the Events graph and the Flow graph at the same time and zoomed in to the same amount. This makes it very easy to correlate the Events to the Flow.

* Summary graphs make it easy to see total AHI as well as AI and HI at a glance.

Flaws in ResScan:
* No useful information is given on what the y-scale in the Flow limitation and Snore Index actually mean.

* Bars used to represent the individual Events are so wide that when clusters happen, events get lost in a forest of flags until you zoom in.

* Somewhat awkward interface between user and software. It's not intuitively clear, for example, how to select which of the many graphs available under Detailed data to show and which to supress. Not intuitively clear how to save your preferences on which Detailed data to display.

EncoreViewer and EncorePro
Strengths of Encore:
* Respiratory Events chart provides a nice quick overview of the night, although if events are too close to each other, some of the tick marks get hidden or smushed togther. Having different events on different lines helps somewhat, but while easy enough to identify a cluster of events, it still can be tough to figure out how many events are in each cluster.

* One page summary of detailed data for each night is nice.

* Humidifier settings are part of the data shown.

* Wave form data is presented in hour-long pages. Each line corresponds to about a five minute period. So it's easy to get a feel for the overall look of the wave form data by visually scanning through the pages.

Weaknesses of Encore:
* No EASY way to determine the length of each event. In Encore Viewer there is *no* way at all of telling how long any individual event lasted. In Encore Pro, the only way seems to be to visually guesstimate the length by looking at the flow wave. But even there, the x-axis scale is only divided into minutes. It would be nice if the scale had ticks at 10 second intervals since events have to last 10 seconds by definition.

* Wave form data only available in Encore Pro.

* In Encore Pro, wave form data is "static" in sense that you can not zoom in on a troublesome spot. While the "five minutes on each line" scale is fine for an overview, it really allow one to see accurately the shape of the wave form much of the time (or at least that's what I find).

* The fact that the total time (in hours:minutes) for each night's data does not explicitly appear on the Detailed Data page drives me nuts. To get that info, you have to go to the "Patterns of Usage" page. To get the time the machine was turned on for the first time in the noon-to-noon recording period, you have to go to the Detailed Data page.

* The fact that the time scale on the Respiratory Flags chart is only labeled with 1, 2, 3, 4, etc. instead of the actual local time is source of constant irritation to me. Also wish there were tick marks indicating 5 or 10 minute periods.

* The large leak data is meaningless. But at least you do get to see the real leak data and not a massaged version of it (like in ResScan)

* On the summary graphs on the Long Term Trend data, it is visually impossible to establish the AHI for each day since the AI and HI are on different charts AND the charts have different y-axis scales as well.
--------------------

Best of luck on your software product. It looks like something I'd find useful as an augmentation of EncoreViewer and EncorePro. It would certainly give me an additional tool to use to decide whether I really wanted or needed to look at a particular night's data in Pro (which is a pain in the you-know-where to use for me).

[Bodhi]

.

[gasp]

Skinner's Encore Analyzer Pro has all the features I find useful over the last few years.

[AMUW]

... 2011-03-12 Sessions=1 6:17:08 Hours Pressure=6.6 AHI=4.6 CI=3.34 CSR=0.80
...Average CSR=1.1
... 5 Cheyne Stokes Respiration Periods
... 2011-03-13 02:31:06 1 CheyneStokes [143, 183]

Having gone through 2 PSGs using REMbrand, and also looking into the ResScan Manual: nowhere do I see any mention of Cheyne-Stokes symptom tracking.
I first see it in ResMed's ApneaLink output.

Strengths of ResScan: ... Flaws in ResScan:
Strengths of Encore: ... Weaknesses of Encore:

Having used mainly ResMed S9 Autoset + ResScan 3.10, and just seen other people's Encore plots, here are a few contributions to the comparison chart:
- ResScan: it bothers me that the climate control options used (temp, humidity] or mask used don't make it into the records; these are parameters that I've been varying over my search for an optimum, so I have to rely on a separate spreadsheet to keep the total picture in sight.
- those ResScan flow curves look nice and detailed ... but the measurements are taken quite a distance away from one's upper airway, in the box; hence this dynamics engineer wonders about the effect of signal dissipation in time and space... say compared to using nasal cannulae
- interactive resetting of the vertical scales could be more user friendly

[TooGroggy]

Most of my experience has been with ResScan. There are a couple of things that I've found myself wishing for:

1) Highest AHI in any 60 minute period. Having an AHI of 2.0 for an 8 hour period is one thing, knowing that 10 of those events happened within a single 60 minute period is something else entirely. The only way to determine this with ResScan and Encore (from the little I've done with it) is to look for clusters in the graph.

2) Mouth-breathing occurrences. The only way I've figured to find these is to painstakingly look for absences of flow not correlated to events. There ought to be a better way.

3) Other occurrences: I also like to look for uneven or unusual breathing episodes. Once again, the only way to detect these in ResScan is through visual inspection of the graphs.

[OKCCowboy]

A Mac version would be nice