PB 420E data question

[plr66]

How is the graph for "Cycle States" to be read and interpreted?

[plr66]

Not sure how to interpret the silence on this question.

[tangents]

If you look at the Cycle States graph, your ideal plot would be straight across, at the top of the graph. On the Pie Chart, that correlates to 100% "Normal" state. I think the other categories on the pie chart are "Intermediate" and "Flow Restricted", but I don't have one in front of me to verify. When the cycle state changes, you'll see marks in the "RUNS" graph as well. In my case, I can see a clear correlation between cycle states, runs, mask leak rate, acoustical vibrations, and apneas. For me, the key to it all is to control the leaks.

I'm sure other PB 420E users will chime in with their knowledge too.

Take Care,
Cathy

[plr66]

If you look at the Cycle States graph, your ideal plot would be straight across, at the top of the graph.......In my case, I can see a clear correlation between cycle states, runs, mask leak rate, acoustical vibrations, and apneas. For me, the key to it all is to control the leaks.

I'm sure other PB 420E users will chime in with their knowledge too.
Take Care,
Cathy

Thanks so much for your reply, Cathy. I have studied my reports in comparison to your printed data graph, and there seems to be no comparison. I am unable to figure out how to copy and print the Silverlining details graphs you show here from my own report. But my Cycle States graph line is all over the map, and seems to have no correlation at all to anything else on the data. My leak rate is low and steady, AHI is also really low. But the Cycle States line is all over the place. Anyone have suggestions? I'm stumped.

[ozij]

My cycle states graph is all over the place too - nothing like Cathy's. You can see how Cathy's cycle states graph dip way down when the machine identifies flow lmitation runs. In my case the machine misedntifies many of my breaths as flow limited - I have to turn IFL1 off - and my cycle states graph is all over the place: Neither hugging the top like Cathy's, nor dipping down as dramatically for longish periods. The mistaken identification of flow limitations - and therefore of cycle states - is what causes the uncontrolled rise in pressure that makes it necessary for some of us to turn IFL1 off. I have about 25-30% flow limited breaths - and a cycle states graph that is often jiggling in the middle.
How are you feeling, Peggy?
O.

[plr66]

My cycle states graph is all over the place too - nothing like Cathy's. How are you feeling, Peggy?
O.

Thanks for your response, ozij. Hard to respond to your question. I'm lots better than I was 5 months ago!! But in terms of the past few days with my 420E backup machine set on cpap (always now with the FL1 turned off since my first runaway experience)....I'm feeling pretty well. Nothing specific to report on that. No real differences in how I actually feel, that I can distinguish, from when I was using my Remstar set on Apap 10-15, but have been showing an AHI which is now lower to being consistently below 1.0.

Do you think that the Cycle States graph lends any value? And I am still curious that no one else but you and Cathy have chimed in about how to interpret the darned thing.

[Hawthorne]

You are wondering why not many people have responded here? Maybe not that many people use the PB 420E. That would be my guess for not many responses.

I looked at it but use a Respironics APAP and am familiar with Encore Viewer software data. I don't know how to interpret this. You use a Respironics APAP too I see. You have the advantage of knowing the 2 softwares.

[ozij]

My cycle states graph is all over the place too - nothing like Cathy's. How are you feeling, Peggy?
O.

Thanks for your response, ozij. Hard to respond to your question. I'm lots better than I was 5 months ago!! But in terms of the past few days with my 420E backup machine set on cpap (always now with the FL1 turned off since my first runaway experience)....I'm feeling pretty well. Nothing specific to report on that. No real differences in how I actually feel, that I can distinguish, from when I was using my Remstar set on Apap 10-15, but have been showing an AHI which is now lower to being consistently below 1.0.

I take it that you're at min=max=10 at this point, trying to find out why, every now and then the Remstart was registering apnea clusters and zoomin away.

Do you think that the Cycle States graph lends any value?

I have't cracked that one yet....

And I am still curious that no one else but you and Cathy have chimed in about how to interpret the darned thing.

As Hawthorne pointed out - we PB user are such a minority...

O.

[rested gal]

My 420E data always reported a lot of cycle state activity and many, many "runs." Probably for the same reason that ozij mentioned -- both of us seem to have breathing that the 420E interprets as "flow limited", causing us both to turn off IFL1 to prevent unnecessary pressure climbs.

So ... since I got very good treatment with IFL1 turned off, and felt fine each morning, from that point on I simply stopped looking at the cycle state and runs data from my 420E.

[mindy]

Thanks all - I had been wondering about those cycle states graphs too, and also had to turn off IFL. I get loads of "runs". Since my heart condition affects my breathing, too, I've been wondering if that contributes to the interpretation of "flow limited" breathing.

Mindy

[briank]

The question arises all over again in the Sandman series.

Cycle states don't seem to be quantized into three or four states (which ought to display as a stair-step function with discreet levels), it appears to be a continuously variable function.

Since it is unit-less on the graph, I'm wondering if it's something like % of peak flow, without associated interpretation as normal, intermediate, limited flow?

[mars]

Hi All

I tried to figure out cycle states and runs a few months ago. Eventually took Rested Gals advice and ignored them. Every now and then I try to make sense of them in relation to treatment, but cannot.

My AHi (obs and cnt combined) hovers around 2.4. So knowing how cycle states and runs can help not only remains a mystery, but does not appear to be that important.

One day we will find out, so until then..............................

cheers

Mars

[briank]

I'm not particularly worried about it, but between my RPSGT, my doctor, PB Tech Support, and a friend who works at Covidien, I'm determined to find out what the cycle states are.

I thought the flow limitation runs were basically hypop-wannabes (i.e. not meeting strict criteria), but I can inquire about that too.

[john5757]

My impression of cycle states looks very similar to ResMed "flatting" curve on my old ResMed S7 auto machine with the ResLink that shows flow limitations by distortion of the breathing wave form that is continuously variable like what we see here. I personally do not like quantized graphs in a stair-step display because our breathing is not stair-case like it would be confusing for me.

[briank]

I only mentioned discreet or quantized states because I've read some Silverlining reports here on the forum showing % of time spent in these four cycle states:

Flow limited cycle
Invalid cycle
Normal cycle
Intermediate cycle

I was therefore theorizing that since this graph appears to be continuous, that it was not a graph of the above four states (which I would expect to be stair-stepped to represent them), and that it was some sort of uncategorized function of flow such as % of peak or nominal, or something.

Am I making more sense now, or still as clear as mud?