vibe snore score ?

[shippy]

I think i understand how an AHI is calculated, number of OA's plus the number of H's divided by the hours slept. What i don't understand is the vibratory snore index, what is the importance of this data? others have said they don't pay much attention to it. How does my machine measure or calculate this number and how does it determine a snore? is a high number bad?

Cpap pressure 16cm
C-flex 3
Humidifier 3

My last 7 nights data
In descending order starting with last night as number 1

Night 1 - AHI 4.1 VS 95.8 Large Leak 59.5 mins. Avg. Leak 63.13
Night 2 - AHI 1.5 VS 150.1 Large Leak 31.5 mins. Avg. Leak 54.53
Night 3 - AHI 3.3 VS 75.7 Large Leak 0.0 mins. Avg. Leak 49.78
Night 4 - AHI 1.4 VS 48.0 Large Leak 3.5 mins. Avg. Leak 49.28
Night 5 - AHI 0.9 VS 21.8 Large Leak 8.0 mins. Avg. Leak 55.7
Night 6 - AHI 1.4 VS 10.8 Large Leak 5.0 mins. Avg. Leak 54.11
Night 7 - AHI 1.7 VS 19.8 Large Leak 0.0 mins. Avg. Leak 52.54

The reason i am curious is because in the afternoons i have been feeling really sleepy again, I am trying to figure out why this is happening, I did come down with a nasty cold last week, (around night 4 of my data) runny nose, stuffy sinuses etc. taking over the counter antihistamines for the sinus problem. I am pretty sure i have been mouth breathing since i got sick, dry mouth syndrome.
The last two nights have some pretty good leaks going on and yesterday afternoon was the worst as far as feeling sleepy. Does mouth breathing show up as a leak?

Dale

[Snoredog]

don't worry about the snores, machine will take care of those on its own.

Daytime fatigue is most likely from the antihistamines, even if it is Clartin, that is one of the main adverse side effects of a antihistamine, they make you tired.

[rested gal]

Does mouth breathing show up as a leak?

Dale

Yep. A leak is a leak is a leak...whether the culprit is the mask, the mouth; or even a leaky hose or a loose connection anywhere between machine and you.

The software (or M machine display window data) doesn't tell you what was causing the air leak. Just tells you what the leak rate was. You have to be your own detective to track down where air leaks come from.

[SleepySandy]

don't worry about the snores, machine will take care of those on its own.

Then why is it tracked? I have the same question about Variable Breathing. Both of those puzzle me.

The software (or M machine display window data) doesn't tell you what was causing the air leak.

Boy wouldn't it be nice if it did?

[shippy]

Snoredog wrote:
don't worry about the snores, machine will take care of those on its own.

Then why is it tracked? I have the same question about Variable Breathing. Both of those puzzle me.

sleepysandy

My thoughts exactly !!!!!!

I guess i should have titled this post as the Great Vibratory Snore Index Mystery. I guess we could e-mail or write a letter to Resperonics and ask why and what does it all mean etc. and see what explanation they give. My guess is if you look at the data i posted, the VS numbers are higher on the last two nights (night 1 & 2) when my large leaks were higher, probably due to mouth breathing because my nose was stuffy. My other guess is leaks and VSI are somehow connected together on the data report as it looks like more leaks = more snores. What i don't understand is how my machine arrives at and calculates these snores and the significance or importance of these numbers, and that would be a question for Resperonics to answer.

Dale

[Snoredog]

Snoredog wrote:
don't worry about the snores, machine will take care of those on its own.

Then why is it tracked? I have the same question about Variable Breathing. Both of those puzzle me.

sleepysandy

My thoughts exactly !!!!!!

I guess i should have titled this post as the Great Vibratory Snore Index Mystery. I guess we could e-mail or write a letter to Resperonics and ask why and what does it all mean etc. and see what explanation they give. My guess is if you look at the data i posted, the VS numbers are higher on the last two nights (night 1 & 2) when my large leaks were higher, probably due to mouth breathing because my nose was stuffy. My other guess is leaks and VSI are somehow connected together on the data report as it looks like more leaks = more snores. What i don't understand is how my machine arrives at and calculates these snores and the significance or importance of these numbers, and that would be a question for Resperonics to answer.

Dale

Because for:

1. It is automatically handled by the machine, on a Remstar if snore continues after 3 pressure increases it will stop responding to them anyway. So once that happens what are you going to do?

2. Remstars (in my opinion) are overly sensitive to snores to begin with, in fact dragging the hose across the bed can many times score a snore. You can see that difference using a different machine, on a Remstar you have a major snore problem, on another machine they may not even be significant enough to score. Another example; Resmed uses snore as one of its 3 main detection triggers in its algorithm, and if you snore with it, it will continue to increase pressure for as long as the snore exists, ignoring many other SDB events along the way I might add. But the machine doesn't track them at all nor does it report them, press them keys all you want. It only reports them if you have the optional Reslink SAO2 module, as a patient in the US you cannot even buy that module any longer.

3. Snores are scored just like any other event, figure one per breath usually on inhale (cartoons are wrong). If you breathe at 12 BPM then you could have I guess a SI of 720hr. But snores generally don't result in a SA02 drop of any significance. They are thought to contribute to micro/arousals, but many times snores continue with increased pressure as in the case of palatal snores. Then they can be mask dependent.

In the sleep lab they will try and eliminate the snore if they can because they usually precede an apnea event, so eliminate the snore and you can many times prevent the following apnea. It is also why many of the autopap manufacturers use it in their algorithm schema.

But snores can many times not be eliminated, many times increasing the pressure to eliminate the snore you trigger a pressure induced central apnea, which wakes you up. If you are in a lab titration, they have to stop and back down pressure and basically your titration study is over because you are now awake. That is what is bad about central apnea, it wakes you up to a wake state vs. kicking you down to a lower stage of sleep. Many times they don't put down on the PSG report, attempted elimination of snores and triggered a central at xx pressure ending the test settling back down at xx pressure. All you see is persistent snoring noted. So if that happened to you in the lab, guess what happens when you be bop down and use an off the shelf Resmed Vantage set wide open? yep it blows a central trying to chase a down the snore. The result to you is you wake up wondering what the hell just happened. Machine doesn't track them, so you have no idea what caused it and just wonder around aimlessly in the dark. Come here and say I wake up during the night, most likely the answer is your pressure is not high enough so increase it

But if you are concerned about snores, you have no business being on a autopap, you might as well just go on cpap and set the pressure high enough to where it eliminates the snores, it should also eliminate everything else.

But that is not the reason many go on autopaps, they go on it because it results in lower pressure by only increasing when needed, the result is more comfort, more comfort equates to more use which results in better compliance.

Variable Breathing: You tell me what that means? None of the autopaps on the market report "Variable breathing". If you are seeing that you are seeing it from a non-manufacture supported report panel such as MyEncore or james Pro Analyzer.

That is because Derek added it in MyEncore, but you won't find it in any standard Respironics EncorePro report for your particular machine unless it is a Bipap machine.

The EncorePro database templates contain data for all Respironics machines, it is machine dependent if it uses and reports that data for your particular machine. Another example is Non-Responsive Apnea/Hypopnea it is not reported in the Pro machine Reports because the Pro machine doesn't respond to NR events, so it doesn't show up in the report. Using the same software, if you switch to the Auto machine then NR appears in your report, same for VB. But we have no idea if that data being presented in that report can be relied upon with any kind of accuracy.

Ask yourself why did Respironics leave the feature out of its own reports?

Like I said, we don't even know if that data is accurate, it was found in the database template so Derek added it in. If that data is so important, WHY did Respironics decide to leave it out of the EncorePro reports for your machine? If you want to know what it means, go here:

myencore.php

But if your fraction of VB goes high which is the cause? wakefulness? distress? or REM sleep? and what can you do about it?

Of course my suggestion would be reduce wakefulness and distress and get more REM sleep, but you already knew that right?

[SleepySandy]

Hey Snoredog

It's not so much that I worry about the snore score or the variable breathing. I just wonder about them. My machine gathers the information. I like to know what's so important about them.

1. It is automatically handled by the machine, on a Remstar if snore continues after 3 pressure increases it will stop responding to them anyway. So once that happens what are you going to do?

I don't have an Auto, so I don't think the snores are automatically handled by my machine. But, the snores are listed on my EncorePro report.

But if you are concerned about snores, you have no business being on a autopap, you might as well just go on cpap and set the pressure high enough to where it eliminates the snores, it should also eliminate everything else.

Nope. Not concerned. Just curious. I can tell you my CPAP pressure nearly eliminates snores. This is good information, though since I'm considering an Auto.

I'm not sure if Shippy is on an Auto. The machine Shippy has listed is the REMStar Plus M Series and that can't be right if AHI data is being reported.

Variable Breathing: You tell me what that means? None of the autopaps on the market report "Variable breathing". If you are seeing that you are seeing it from a non-manufacture supported report panel such as MyEncore or james Pro Analyzer.

Variable breathing is just something else I'm curious about. I did first see it in EPA but I also view my raw data for EncorePro.

EncorePro stores data on different tables depending on if the machine is an Auto or a Pro. For the Pro there are "Variable Breathing Events" and a total of "Variable Breathing Minutes" each night. Two nights ago I had 391 variable breathing events and 200 variable breathing minutes. Am I worried about this? Not at all. Am I curious about what qualifies as "variable breathing" and what it means to have variable breathing for 200 minutes? Sure I am.

Ask yourself why did Respironics leave the feature out of its own reports?

I think Respironics has not done a great job of reporting data their machines gather. A great example is total time in apnea. My machine is a Pro and the total time in apnea is collected but it's not displayed on any of the EncorePro reports. So, I don't assume that Respironics had good reasons to leave certain data out of its own reports. They gather too much important information they choose not to report.

If that data is so important, WHY did Respironics decide to leave it out of the EncorePro reports for your machine?

I would ask the question the other way - if the data isn't important, why is my machine gathering it?

If you want to know what it means, go here:

I read that a long time ago. It doesn't help a whole lot in terms of what would be a good value to see.

But if your fraction of VB goes high which is the cause?

Yes, but what is "high"?

Of course my suggestion would be reduce wakefulness and distress and get more REM sleep, but you already knew that right?

Sure did. I would love to get more REM sleep. Got any ideas?

[Snoredog]

Got any ideas?

Nooooope you seem to have all the answers.

[shippy]

Thanks for the info

I may have had the wrong machine in my profile, I have the REMstarPRO M Series machine w/cflex which is a straight cpap machine not an auto.

Dale

[jeanc]

I know you all are saying the snore index doesn't mean anything...

I'm new to cpap - I've been on it 13 nights now. My husband (FJC) just printed my report for me and my snore index has ranged from 8.6 to 60.3 over the last five or six days, until last night where it was 143.2. I was very tired all day today. My hypopneas index was also 4.8 last night, where previously it was between .1 and .7. I have mild sleep apnea with pretty much no stage 3 and 4 sleep during my studies (but lots of REM - I can always fall asleep) and 4% O2 desat.

I have been noticing that I am waking up in a better mood every day with cpap (I have never been a morning person). I have varying levels of tiredness and sleepyness, but maybe it is getting better. I have a Remstar Pro M series CPAP with humidifier and and optilife mask.

So, I'm thinking there's something to that snore index... Any ideas?

[Wulfman]

I know you all are saying the snore index doesn't mean anything...

I'm new to cpap - I've been on it 13 nights now. My husband (FJC) just printed my report for me and my snore index has ranged from 8.6 to 60.3 over the last five or six days, until last night where it was 143.2. I was very tired all day today. My hypopneas index was also 4.8 last night, where previously it was between .1 and .7. I have mild sleep apnea with pretty much no stage 3 and 4 sleep during my studies (but lots of REM - I can always fall asleep) and 4% O2 desat.

I have been noticing that I am waking up in a better mood every day with cpap (I have never been a morning person). I have varying levels of tiredness and sleepyness, but maybe it is getting better. I have a Remstar Pro M series CPAP with humidifier and and optilife mask.

So, I'm thinking there's something to that snore index... Any ideas?

A couple.
Could be you're leaking therapy air out of your mouth and/or a mask leak.
Or.....maybe you needed a little more pressure. (assuming there was no leaking)

Since you have the software, what did it indicate in the leak figures?

Den

[jeanc]

O.K., I'm not sure I know how to read this. If I look at each day individually, my average leaks ranged from 23.13 - 26.44, and they weren't significantly different on the snore night. If I look at the trend graphs on the report, they list the leak grid with average max leak 79.7, average 90% leak 27.9, average leak 24.9, average large leak 0 mins. I guess I need help interpreting this data.

[JeffH]

I use nasal pillows and tape my mouth. I also use a home made strap around my mouth to help with the blowfish effect. I know I don't snore.

My reports in the morning always show snoring, and I think it is probably just the hose dragging across the headboard when I turn in my sleep.

[Wulfman]

O.K., I'm not sure I know how to read this. If I look at each day individually, my average leaks ranged from 23.13 - 26.44, and they weren't significantly different on the snore night. If I look at the trend graphs on the report, they list the leak grid with average max leak 79.7, average 90% leak 27.9, average leak 24.9, average large leak 0 mins. I guess I need help interpreting this data.

In Encore Pro, your leak chart will be below your chart that shows apneas, hypopneas and snores (in the Daily Details Report). In that leak chart may be some "peaks and valleys" (at least I doubt that it'll be a perfectly straight line). Where the lines go up (indicating a higher leak rate), are there any events (apneas/hypopneas/snores) in that chart?

Actually, your average leak rates don't sound like they're "high". Your "average max leak" number indicates that you probably had some higher leak rates at some point during the night. A "Large Leak" would be indicated by a black bar on the chart.....but you didn't have any.

Den

[shippy]

In that leak chart may be some "peaks and valleys" (at least I doubt that it'll be a perfectly straight line).

Den

I wish i could get a straight line on my reports, probably impossible though ha! ha!

Dale