Help interpreting AutoScan graph

carlossm · Post by **carlossm** » Sat Feb 03, 2007 4:38 pm

Can someone help me interpret this graph please?

Thanks

Slinky · Post by **Slinky** » Sat Feb 03, 2007 6:35 pm

Well, I'm a newbie to all this and graphs have never been my forte. So I've been guessing at what my graphs are supposed to be telling me by looking at all of that night's data, including the data and graphs from my recording oximeter.

Looking at the bottom graph first, the ones for the apnea and hypopnea events. It looks like you turned your PAP on right a midnight. That first tall red line shows that you had one apnea that lasted almost a full minute (about 55 seconds).

At the same time or darn close to it, just before or just after if not simultaneously you had a large leak (middle graph) of 1 l per second or more.

It looks like you were pretty steady at about 6 cms of pressure, then a sudden dip in pressure about the time of that first apnea event and a corresponding quick rise in pressure to about 9 cms to compensate for the apnea event (top graph).

It looks like you stopped using your PAP about 6:20 that morning, so about 6 1/2 hours of PAP therapy for the night.

I'm guessing the drop in pressure had to do w/the apnea event itself. It was NOT a matter of the PAP failing to provide pressure and letting you down.

Okay, now you pros jump in here and correct my mistakes and clarify things for us both, PLEASE! I need to learn to interpret these graphs too.

And, Carlos! I sure do wish I had results as good as these!!! Mine are so erratic.

dsm · Post by **dsm** » Sat Feb 03, 2007 7:13 pm

Good go Slinky,

I will add my 0.2c worth

Firstly I am assuming this is an Auto due to the fact that the pressure started at 5 & ended at 10.

Almost as soon as you went to sleep your breathing slowed, then at 30 mins in you had a mask leak but it corrected itself

then at approx 50 mins you had an obstruction that lasted approx 57 secs (quite a serious block - am sure your PO would show a desat on that one + your heartbeat will have gone up markedly).

My guess is that you then were aroused by the obstruction & the mask shifted & leaked noticably. This was corrected within a couple on mins & you settled down.

Then 90 mins into sleep you had a 15 sec obstruction. Again it seems you were aroused & shifted (PO data should sho a big jump in pulse) the mask leaked for about 30 mins and your breathing declined (3 hypops) then a big leak occurred but was sealed again at about 120 mins sleep.

At 3 hours of sleep you again had leaks & a small obstruction - by now you should be able to follow the pattern. Your PO data should show atleast 1 distinct desat (drop below 88% Spo2) perhaps 3.

Cheers

DSM

#2 - Snoredog has pointed out in his distinctive and 'kindly' manner, that you are not the one with the Pulse Oximeter - I had read Slinky's post and mistakenly put it as part of your post while I was reading. But despite this, if you were to have a PO (as Slinky clearly does) you would most likely see the things I was mentioning. Cheers Doug

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): auto

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): auto

Snoredog · Post by **Snoredog** » Sat Feb 03, 2007 7:23 pm

Reports are pretty lame aren't they... but if you look at your pressure report, you can "assume" from the pressure "peaks" those events are either:

-Flow limitation
-Snore
-Apnea

The above are the 3 events that the machine responds or triggers on, it responds to Flow Limitation NOT Hypopnea. It responds to snores but no snore data is given on the report, again why they are lame.

If you look at your bottom AHI report, you can assume (based upon their duration) that the vertical lines with a ball at the top are apnea. The horizontal graphs below that are either FL's or Hypopnea. The HI data displayed on the LCD and in the report is a calculated value.

You may be able to correlate the raw data to the graphs and make heads or tails from it. I see 4ea apnea from your bottom report.

It is like I said before, those reports really don't give you much of anything than you can obtain from the LCD display.

Snoredog · Post by **Snoredog** » Sat Feb 03, 2007 7:27 pm

[quote="dsm"]Good go Slinky,

I will add my 0.2c worth

Firstly I am assuming this is an Auto due to the fact that the pressure started at 5 & ended at 10.

Almost as soon as you went to sleep your breathing slowed, then at 30 mins in you had a mask leak but it corrected itself

then at approx 50 mins you had an obstruction that lasted approx 57 secs (quite a serious block - am sure your PO would show a desat on that one + your heartbeat will have gone up markedly).

My guess is that you then were aroused by the obstruction & the mask shifted & leaked noticably. This was corrected within a couple on mins & you settled down.

Then 90 mins into sleep you had a 15 sec obstruction. Again it seems you were aroused & shifted (PO data should sho a big jump in pulse) the mask leaked for about 30 mins and your breathing declined (3 hypops) then a big leak occurred but was sealed again at about 120 mins sleep.

At 3 hours of sleep you again had leaks & a small obstruction - by now you should be able to follow the pattern. Your PO data should show atleast 1 distinct desat (drop below 88% Spo2) perhaps 3.

Cheers

DSM

dsm · Post by **dsm** » Sat Feb 03, 2007 7:35 pm

Snoredog,

I believe this person has a PO ? - perhaps I read it wrong & it is slinky that has the PO - if so then naturally Allen won't have such PO data.

Also - 'lame reports' ?

You are off your meds again aren't you

Cheers

Doug

Snoredog · Post by **Snoredog** » Sat Feb 03, 2007 7:54 pm

dsm wrote:Snoredog,

I believe this person has a PO ? - perhaps I read it wrong & it is slinky that has the PO - if so then naturally Allen won't have such PO data.

Also - 'lame reports' ?

You are off your meds again aren't you

Cheers

Doug

I was thinking more along the lines you may be hitting the bottle again, because you are the one making things up from data that doesn't exist.

You can try and weasel your way out of it again, but it doesn't matter if he has a Pulse Oximeter or not, the above reports do NOT show ANY SP02 data, nothing even closely resembling 88% desat levels.

I think Resmed is doing the patient a favor by not letting them purchase that software because when they get it they realize they paid upwards of $150 for something that you have to assume what the data is.

The Leak data is good, the guy can probably figure out if he is mouth breathing or not.

What are we to assume from the bottom graph?

You can determine that an event lasted XX seconds, but from the horizontal plot graph below that, that is only AHI values shown, doesn't show you they were flow limitation, snores, apnea or what they are. SleepTalker told me the Red vertical linebar graphs with the ball at the top were apnea events. That is all you can get from that bottom graph. It tells you what your AHI does throughout the night.

You have to use the Pressure graph to determine any patterns seen and then have to "guess" at what the event was that drove the pressure up. You cannot look at the event right before therapy hour 1 and conclusively say that was an apnea. Then if you look at the other graphs to what corresponds with that pressure increase, leak is all the way to the top, so what is that?

mouth breathing? Large Leak?

And that is the point with that software you cannot identify anything conclusively with it. If I was having a lot of Hypopnea where I could see it on the report, I may be able to say well maybe I could increase the Min pressure and eliminate those, but with those reports you can't.

dsm · Post by **dsm** » Sat Feb 03, 2007 8:13 pm

Snoredog,

I don't really want to see your personal issues with me mess up Carlos's request for help.

Am more than happy to discuss / clarify any points via PM. I appologise for the meds remark.

Cheers & thanks

Doug

Slinky · Post by **Slinky** » Sat Feb 03, 2007 8:27 pm

Thanks, DSM.

SnoreDog, your comments would be much more appreciated if they were a tad more gentle or tactful, please.

Actually, since I evaluate my response to xPAP therapy by how RESTED I FEEL, the data, including graphs, are more a source of curiosity and interest than something to rely on. And that includes anything my sleep doc has to tell me. The proof is in the pudding as far as I'm concerned and that pudding is how I FEEL, how RESTED I FEEL. The rest is just interesting frosting on the cake.

pedroski · Post by **pedroski** » Sun Feb 04, 2007 12:46 am

Hi Carlos,

You're doing well based on that graph. The top graph is pressure and the peaks are when your flow generator increases pressure in response to an apnoea or pressure loss. Like Doug said, it started around 6 cms and before you got up was around 10 cms. That's the advantage of an apap. If you were on straight cpap and you had it set at 6 it wouldn't be able to respond to all those leaks.

The middle graph is leaks and not too bad considering you're just starting out. You'll get that graph looking better as you get used to your mask and the machine.

The bottom graph is the most important as it tells you how many apnoeas and hypopneas you had during the night. In spite of all those leaks, you still only had 4 apnoeas, only one of which was really serious, and your hypopneas are very low. Based on that graph I wouldn't change anything, the Vantage is doing its job, as long as you're feeling good, the figures are excellent.

You'll need to fool around a bit with your mask to lower the leaks but you'll get the hang of that.

One thing you might like to do is check out Doug's excellent website which has a number of Autoscan screenshots. Study the different graphs and compare them to each other and you'll get a better handle on what's happening with yours. That's what I did.

http://www.internetage.com/cpapinfo/index.html

Good luck

Peter

carlossm · Post by **carlossm** » Sun Feb 04, 2007 10:28 am

I think the leaks are because of my mask.I've has it for about 4 years. I just ordered a new Mirage Activa. What is a Reslink?

Thanks for the help.

Slinky · Post by **Slinky** » Sun Feb 04, 2007 11:57 am

You can buy just parts for your masks. They really do recommend that you replace at least your cushion every 6 months and our US Medicare whose guideline most US insurances follow allows for replacement of the cushion once a month. So w/4 years on that poor mask cushion I'd say it deserves a decent retirement and burial.

I don't think that the cushion needs to be replaced every month but certainly every 6 months maximum it should be replaced. Medicare allows replacement of headgear every 6 months but heck, if the headgear still gives you a good fit why go to the expense or bother?

So don't toss that faithful 4 year old mask just yet. Maybe purchase just a cushion for it and keep it as a backup in case the new mask doesn't work out too well for you.

dsm · Post by **dsm** » Sun Feb 04, 2007 2:16 pm

Carlos,

The reslink module is a unit with a Pulse Oximeter built in & it attaches to the S7 S8 & VPAP III machines.

I never actually seen one, just photos, but the data is very useful. I have my own seperate PO and always its an effort to match the PO data to the xpap graphs

DSM

Slinky · Post by **Slinky** » Sun Feb 04, 2007 2:42 pm

THANK YOU for that info about the ResLink module, DSM!!! I've wondered about just what it was and does. Is it really available for the S8 Elite??? Or did you mean just w/the VPAP III whether S7 or S8??

I have COPD which is why I purchased the SPO 7500 recording pulse oximeter and frankly, so far, my sats stats "ain't" so hot and I don't think my sleep pulmo is gonna be any too happy. I "know" my regular pulmo is NOT going to be happy when he sees my oximeter printouts.

My sleep pulmo did say last month that he was going to script an Auto and I got the script and was going to self-purchase a RemStar Auto w/C-Flex. (I didn't want to give up my easy to access Resmed LED screen data and already had the software and reader for it). In fact, I almost made the RemStar purchase when the sale of something I had going fell thru until the people's income tax refund comes thru.

Does the Reslink module work w/the the AutoScan 5.7 and Smart Card reader or is a different software and reader cable necessary? Gads, if not I sure hope my sleep pulmo doesn't decide to go w/that ResLink module and mess up my getting access to my data!! I would NOT be a happy camper at all. Besides, isn't the VPAP III a bi-level machine? He wouldn't do this to me, would he?

pedroski · Post by **pedroski** » Sun Feb 04, 2007 2:42 pm

Hi Carlos,

This is a quote from a similar question I asked Doug:

The reslink units used to be for clinical use only and very expensive but I phoned Resmed last week to get pricing of them & they had no qualms about selling me one & the price was (for the S8 attachment) about $AUD850.

Peter

Help interpreting AutoScan graph

Help interpreting AutoScan graph

Data