Respironics APAP pressure test probes close up

[Pugsy]

Respironics machines use little test probes of increased pressure to test things to see if maybe something needs to be changed. ResMed machines don't do this. So to a ResMed machine user these test probes may look abnormal but in fact they are just an indication the machine is doing its job and if all we see are test probes then it just means the minimum pressure is doing its job for the most part.

I have screen shots here of 1 single night using Encore software and SleepyHead.
The test probes look more severe than they really are. I used the zoom in feature of SH to move in much closer so we can see that it isn't a sudden increase but instead it goes up rather slowly and back down rather slowly.
These saw tooth probes aren't responding to anything at all...instead it is something the machine does to try to determine if something needs to be responded to. These examples also show a small period of time where the machine did increase the pressure just a little...stayed there for a short period of time and then using the probes it decided that it could reduce the pressure.

Original Encore Report here


Same report with SleepyHead normal scale view


SH zoomed in on a smaller section


and finally SH zoomed in much closer so much smaller scale

[Sir NoddinOff]

Thanks for the info Pugsy. I don't use a ResMed machine but I like to hear about the different implementation of the technology.

[Pugsy]

I do also have and use a ResMed machine. So I can definitely see the difference in the reports.
I mentioned this for a couple of reasons. It is good education for newbies so that they can understand what they are seeing and also so that a ResMed user won't tell a Respironics user that the machine is trying to increase the pressure all night long in response to some sort of event and that they need to increase the minimum pressure. It is going to look odd compared to a Resmed report but odd doesn't mean that there is a problem with the minimum pressure.
While the little peaks would likely indicate something going on with a ResMed machine it is entirely normal when we see Respironics reports. As long as a machine is in APAP mode or in BiPap auto mode...those pressure probes and saw tooth pattern are going to be there and are entirely normal.

[rosacer]

Pugsy, this is a very interesting point.

I had the opportunity to check the Sleepyhead graph's from my former System One auto that my friend is using.

The pressure line was a straight line (at 9 cmH2O) for long periods of time. I was wondering how is it possible, it was as if the machine doesn't reacts a lot. The other thing I need to mention is his leak rate is very high for nasal pillows around the 50s and even 70s. That's the case even on days with an AHI of 2.5 I would expect the machine do more to control the pressure, the max pressure was set at 13 and the machine never arrived there even at 12 neither.

His mask was really not adjusted at all and the leaks were evident.

Do you think the machine was not reacting because of the constant high leak? I would have expected to have a high pressure response because of that not the opposite.

I adjusted his mask and told him to try the Swift FX which has Large pillows, I hope he will do what I told him dot do

[jweeks]

...and also so that a ResMed user won't tell a Respironics user that the machine is trying to increase the pressure all night long in response to some sort of event and that they need to increase the minimum pressure.

Hi,

Guilty as charged. I had never seen this before. It is amazing how quickly my two very new machines (in 2008 and 2010) are now already getting to be 2 generations old.

It is too bad that they don't make these things like iPhones where you can flash the ROM chip to get the new software and new features. Then again, if Apple made a CPAP machine, it would cost 3 times as much, and I'd need to get a new one every year.

-john-

[Pugsy]

Do you think the machine was not reacting because of the constant high leak? I would have expected to have a high pressure response because of that not the opposite.

May the leak is affecting the sensors and the machine doesn't know what to do. It takes a lot of large leak to have that happen though. I have never seen it myself but I have seen this happen on a couple of other PR S1 reports. One on a BiPap Auto and another on an APAP.
It does look like the machine is set to cpap or broken.
These new machines simply don't seem to have the run a away pressures like we used to see with leaks on the older machines.
They even say in their literature that when a large leak is detected that they back off on the pressure a bit in an effort to get things back in line instead of trying to fix it with increases.

Also it is possible that the machine just wanted to stay at 9 cm for a long time.
Let me see if I can find an example on mine. I don't spend a lot of time with the increased pressures due to mine mainly being REM related I think.
If there is an increase and the machine just wants to stay up there a little then we would assume that the sensors are sensing things that they think should warrant the pressure to stay where it is. Just because it can go done doesn't always mean it should drop back to the minimum.
Do you have one of your friend's report you could send me?

I had never seen this before. It is amazing how quickly my two very new machines (in 2008 and 2010) are now already getting to be 2 generations old.

No problem John, you aren't the first to misread something on a report that is foreign to you. I just thought it would be a good time to have a little software 101 type of stuff. Maybe help out the newbies while clearing up how the machines differ in what they do.
It's a challenge to keep up with which machine does what and reports how and why is this leak big on a ResMed machine and not on a Respironics machine? Then try to remember that the S8 machines report leaks differently than the S9 machines.

[rosacer]

Pugsy

I'm not proud of myself I saw him on a meeting and it didn't pass by my mind to take his SD card and put it on my computer, what a shame .

I will call him and tell him to bring his SD card and computer in two weeks when he is coming to my area. I will remember him to try the Swift FX, he is so stubborn the Headrest has Large pillows but that is not as large as the Swift FX Large, the Headrest pillows goes literally inside his nostrils OMG he preferes to use that than to try the Swift FX . I understand why his wife told me she was unable to sleep because of the noise the leaks produced

But, he is doing well and now he understood the machine makes something good to his health, he is getting more rested and energetic. If he could reduce his AHI under 2 in a constant way it would be great. My patience is needed

Thanks Pugsy, he was heading to the thumb; even the Dr told him ''I thought for now you was already dead''.

rosie

[Pugsy]

I saw him on a meeting and it didn't pass by my mind to take his SD card and put it on my computer

Are you saying that he is a little bit stubborn? A man being stubborn? How can that be?
No problem. Unless his leaks are well over 90 L/min and prolonged it is unlikely that they are causing the machine to not be able to respond properly. Most likely the lack of a lot of those test probes just means the machine wants to stay up where it is. I would need the see the report first. I don't have one myself that would show what I thinking is happening with him. I accidentally erased several months of PRS1 APAP data and every bit of my M series data. So I don't have anything in SH that would be a good example. I just don't have prolonged periods of time at any higher pressures since mine are almost totally related to REM and REM is intermittent.
If I have time I will go see what I might have in the old reports of Encore but that is such a PITA to get to the old reports 7 nights at a time and then not find a good example. I went through about 2 months and didn't find one.
Here is one of mine when I happened to have much higher pressures and thus a higher 90% number and I had minimal test probes. This isn't something that see often but I do see occasionally.
Also is a good example that higher pressures don't always come from leaks...this is an Encore report with the software set to show only unintentional or excess leak...hence the zero baseline. The pressure increases and the little clusters of stuff...I frequently see this stuff (though maybe not this number) at about the same time every night. Right when I would likely be hitting REM stage sleep.

[rosacer]

Pugsy,

If you copy a Respironics SD card (all the files inside) are you able to read the data with Sleepyhead or do you need to copy the files into a new SD card to be able to read the information with Sleepyhead?

Rosie

[Pugsy]

If you copy a Respironics SD card (all the files inside) are you able to read the data with Sleepyhead or do you need to copy the files into a new SD card to be able to read the information with Sleepyhead?

I can create a new user profile and I am pretty sure I do what you are asking.
Problem may be in sending the files. Depends on how large the files are. If they are too big then email systems won't let them be sent unless they are zipped down to a size below their sending limits.

If you can get your friend to copy the SD card and you can get the contents to me...I am pretty sure I can make it work. You have my email address.

One would have to copy the SD card contents to a folder and then zip the folder to get it sent as one unit.
I can then unzip it in its own folder and point SH to that folder. I have some old data saved that way and have imported it to SH. I did this when the Beta SH version was released. I had old data that wasn't on a SD card and I still was able to include that data in my profile.

[rosacer]

Pugsy

Have you tried Dropbox dot com ? It is a in the clouds storage, there is a free option big enough. When you register you can do a couple of things that allow you to increase the free storage capacity. It is very handy in case you need to partake big files with somebody, pictures whatever you want.

I sent you an invitation, it will allow you to join and to start increasing your storage space at the same time.

Rosie

[Pugsy]

I have not tried Dropbox but I have used hotfile and yousendit for online storage of a large file (software ) that I needed to get to someone. I don't need to do it very often though. I will check out the invite and see if it is less work than hotfile. I found yousendit to be a bit of work unless I bought upgraded thing and I didn't want to do that.
It may be a few days. I am planning on starting work on the SleepyHead tutorial this week. I have put it off way too long.

[robysue]

Pugsy

Have you tried Dropbox dot com ? It is a in the clouds storage, there is a free option big enough. When you register you can do a couple of things that allow you to increase the free storage capacity. It is very handy in case you need to partake big files with somebody, pictures whatever you want.

I sent you an invitation, it will allow you to join and to start increasing your storage space at the same time.

Rosie

I have tried Dropbox. And SH has no trouble downloading data from the SD if it has been written to a Dropbox folder. But Encore (Pro, Viewer, and Basic) will only doenload directly from an SD card.

[rosacer]

Thank you Robysue, it is good to know. SH is the champion

Rosie

[ywp]

Does this inflate the 90% and max. pressure it reports ?

And, how does this relates to the little red dots on the flow chart on sleepy head. I thought the red dots were the test pulse?

I have been mis reading these saw teeth.

Thanks for the help