SleepyHead software development PROPOSAL

[Pugsy]

Use the term the brand uses. Don't go practicing medicine.
SleepyHead is supposed to report the data...and that's it...not evaluate the results and offer opinions.

ResMed is quite comfortable calling an open airway cessation of breathing a "central apnea". They pretty much have proven that what their machines call centrals are the same centrals that were named such in sleep lab studies. This has been well documented in the past.
They did extensive testing comparing what the machine flags as as whatever in conjunction with in lab studies flagging by a live human...and they were pretty much in agreement. The slight discrepancies were miniscule and actually well within the differences even between what the humans might call something.

Respironics isn't so comfortable using the term central...and instead they prefer the term clear airway. Did they just want to be different and call it something else or are they wanting to walk a fine like here??? Dunno why and it doesn't really matter.

It's a central apnea folks...the airway is open but there is no air flow because there is no effort.
Doesn't matter if we are asleep or not...there's still no air flow because of lack of effort.
Hold your breath for 10 seconds...that's a 10 second central apnea...no air flow because of no effort.
Yes we were awake and not asleep but it's still a central apnea by definition....airway is open but no air flow.

These machines just measure air flow...they can't measure sleep status. That's why we get SWJ flagging happening.
Awake breathing is irregular and it can and will confuse the machine...and from evaluating my own SWJ stuff...not just for centrals...I have seen SWJ OAs and hyponeas flagged. SWJ or post arousal flagging this is so obvious a blind man could see it. Not even iffy.

SleepyHead should report what the machine reports...nothing more and nothing less. It's going to be up to the person to figure out SWJ vs asleep breathing. SleepyHead shouldn't be offering opinions or making any comments on the results one way or the other.
I really hated seeing SH pop up and tell me I spent WAY too much time in large leak when the highest it went to was 26 L/min excess leak. Leave the evaluation up to the person.

And those are my thoughts on it. The machines don't offer a diagnostic opinion and neither should SleepyHead.
ResScan and Encore don't offer opinions...they just report the facts and the facts are the data points it gathers.
Evaluation of anything is left up to the individual or their medical care team.

A clear airway apnea event is a central apnea event by definition. Now whether it is real or not depends on sleep status and that's not the machine's job to make that evaluation. Maybe some day the machines can offer sleep status but it's not available at this time.

[prodigyplace]

Use the term the brand uses. Don't go practicing medicine.
SleepyHead is supposed to report the data...and that's it...not evaluate the results and offer opinions.

I am not sure what the added work would be to change that now. At first guess we would need to investigate what term each manufacturer uses.
I think that after we get a reasonable release, perhaps we can look at such things.

Remember Mark first wrote this software for his personal benefit and was generous enough to extend it and share with us.

I assume Arie concurs.

[Pugsy]

At first guess we would need to investigate what term each manufacturer uses.

Respironics is the only brand that uses something other than "central" and some brands don't even distinguish centrals vs OAs period.

Yes...I am well aware of why Mark went with Respironics terminology because that was the machine he was using.
I was around here when SleepyHead was just a sparkle in Mark's eye and he was bitching about having to use Encore.
He added other machine compatibility because it was requested.
I have been here through the times when we didn't have SleepyHead at all and then I went through all the various incarnations of SleepyHead and each time a new machine compatibility was offered.

Again...it's a central apnea folks...doesn't matter what the machine brand calls it. It's an open airway cessation of breathing or no air flow because the airway is open. By definition that's what a central apnea is.
If we can only use one name and not choose....let it be central because that's what all the other brands use if they even separate between central and OA.

Ideally people should be able to choose depending on the brand of machine...just like the red line statistic for large leak needs to involves a choice. I am really sick and tired of explaining what that 24 default red line is scaring the bejesus out of people for reason.
I wish that statistic had never been made available...that doesn't come from the machine...that's all Mark's creation.
He's using some Respironics stuff and some ResMed stuff...all mixed together. It's very confusing to the newbies.

[prodigyplace]

I hope we can deal with some of these "pain points" later.

We need to deconstruct & hopefully document the program flow to know what happens where. As far as I am aware, that is all in Mark's head, unavailable to us.

[A KLERK]

And I also said: "AFAIK there are some fine tuning by some manufacturers, like Resmed, but still I propose to keep with the term that is used in the official program.". Thus I totally agree with what Pugsy said earlier. We are not able to alter what a Manufacturer says, they've thought about what term to use...

But for the moment I'm OK with Central Apnea, as I foresee that it can and will be machine-dependent like other terms. I do not see RERA when I use a Resmed machine... So Central Apnea will be confusing to a Philips User.

BTW, AFAIK Philips is withdrawing the Respironics brandname in Europe for CPAPs. Also in the US?

[palerider]

Be careful! A Central Apnea can only be concluded when brain activity is measured. Most brands of cpap can detect an open airway apnea quite well. Nothing more than that! AFAIK there are some fine tunings by some manufacturers, like Resmed, but still I propose to keep with the term that is used in the official program. And a pop-up balloon that explains what the term really means, according to the official manual..
Just my 2 Euros.


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No, a "central apnea" is any time you don't *TRY* to breathe.

You're talking about a "centrals *SLEEP* apnea", which indeed, the machines can't determine if you're asleep or awake.

The machine manufacturers (except Respironics) call them "central apnea", to call them something else besides what the machine itself calls them is unnecessarily CONFUSING.

[palerider]

Be careful! A Central Apnea can only be concluded when brain activity is measured. Most brands of cpap can detect an open airway apnea quite well. Nothing more than that! AFAIK there are some fine tunings by some manufacturers, like Resmed, but still I propose to keep with the term that is used in the official program. And a pop-up balloon that explains what the term really means, according to the official manual..
Just my 2 Euros.

Sleepyhead isn't concluding anything, it's reporting what the device has flagged as a central. Sleepyhead should be reporting what the device has flagged.

Your argument for not using the term Central, could also be applied to Hypopneas. Hypopneas are defined as a 30% or greater decrease in flow lasting at least 10 seconds and associated with a 4% or greater oxyhemoglobin desataturation.

Most machines can detect the decrease in breathing quite well, but not the oxy. desat, but we would never consider renaming hyponeas to another H-word.

Heck, it could also be applied to the term "apnea", since in a sleep study, with EEG and chest bands, simply closing one's airway while not awake *would not count*.... The logic above would result in obstructives being called 'closed airways" instead of 'apneas'.

[palerider]

Use the term the brand uses. Don't go practicing medicine.
SleepyHead is supposed to report the data...and that's it...not evaluate the results and offer opinions.

I am not sure what the added work would be to change that now. At first guess we would need to investigate what term each manufacturer uses.
I think that after we get a reasonable release, perhaps we can look at such things.

Looking at such things should be part of "a reasonable release'.

They're not a big deal, he changed some other 'machine specific' things with just a few minutes of coding....

all that's needed is setting a flag while doing import, and then using that flag for display. It's not rocket surgery.

[palerider]

And I also said: "AFAIK there are some fine tuning by some manufacturers, like Resmed, but still I propose to keep with the term that is used in the official program.". Thus I totally agree with what Pugsy said earlier. We are not able to alter what a Manufacturer says, they've thought about what term to use...

Oh, you mean "official program" as "manufacturers software" like "resscan'... I misinterpreted you to mean "Official program" as "what sleepyhead is now".

My bad. I apologize for misunderstanding.

[A KLERK]

[prodigyplace]

Looking at such things should be part of "a reasonable release'.

They're not a big deal, he changed some other 'machine specific' things with just a few minutes of coding....

all that's needed is setting a flag while doing import, and then using that flag for display. It's not rocket surgery.

You are welcome to come over to Discord and make those changes.

They're not a big deal so you can show us how it is done.

This thread was to attract community volunteers to make this release happen.
Feature requests may come later.

[prodigyplace]

I have been using my own compiled version of a slightly later version than 1.1 that fixes the screen shotting F12

Is that fix in Mark's GitLab repo?

[palerider]

Looking at such things should be part of "a reasonable release'.

They're not a big deal, he changed some other 'machine specific' things with just a few minutes of coding....

all that's needed is setting a flag while doing import, and then using that flag for display. It's not rocket surgery.

You are welcome to come over to Discord and make those changes.

They're not a big deal so you can show us how it is done.

This thread was to attract community volunteers to make this release happen.
Feature requests may come later.

If I were a competent C++ programmer, I would have forked the code base *years* ago and fixed up all the little annoying bugs.

I base my comment that it's not difficult on the fact that it took Mark about 20 minutes to make similar "set a default based on the kind of machine the data belongs to" in the past.

[Jas_williams]

I have been using my own compiled version of a slightly later version than 1.1 that fixes the screen shotting F12

Is that fix in Mark's GitLab repo?

Yes 1.1.0 beta 2

[prodigyplace]

I have been using my own compiled version of a slightly later version than 1.1 that fixes the screen shotting F12

Is that fix in Mark's GitLab repo?

Yes 1.1.0 beta 2

Good.
His latest is marked 1.1.0 unstable 2 I assume that is what you mean.