OXIMETRY - Interfacing the CMS50 with your CPAP Therapy

[quietmorning]

Interesting...

I know that we are all a little different, but it looks like your pulse rate is a little elevated.

You should sit down in a comfortable chair with a good book and do a pulse oximeter recording of your resting heart rate for 15 - 20 minutes.

If your awake pulse rate is around 90 beats per minute, your sleep rate should fall lower than that. For example my resting pulse rate is around 55 beats per minute and when I am sleeping it drops to around 45 beats per minute. It starts off a little higher than that, then drops as I sleep. Usually my lowest rate is just before I wake up.

The spikes in pulse rate on your chart don't seem to correspond to substantial drops in O2 saturation. If you have similar spikes while resting and awake it may be something to discuss with your doctor. You may have some heart rhythm issues that are beginning to show up.

I believe the "normal" pulse rate is something in the 60 - 100 beats per minute range, so you are in the high "normal" range.

My initial response to seeing your report is that you aren't making it into "restful" sleep. If you are feeling rested when you wake up, ignore my rambling...

Hosecrusher, who are you directing this too?

[HoseCrusher]

You. I believe your report was shown.

[4betterO2]

Received these valuable instructions in another thread.
I'm just quoting them in real-time here, will interlace them later in the original post for this thread, (which in time I hope to make a reference-type post)
These instructions for the "Pulse" brand are valid also for Contec-branded oximeters, and other models of the CMS50 line than those listed below,including, the CMS50D+.
Thanks Papit

Inserting CMS-50 Pulse-Oximetry Graphs into SleepyHead
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Here's the operating procedure I use. I hope it helps new and regular CMS-50E/F Pulse-Oximeter users experience consistent ease of use and convenient access to their pulse-ox graphs both in the provided SpO2 Review software and in SleepyHead.
...

CMS-50E/F Pulse Oximeter operating procedure
A. Record your Pulse-Ox data over night
1. Turn ON your Pulse-Oximeter after masking up at night.
2. Turn Record to ON.
3. Insert a finger into the sensor and sleep with it all night.
4. Turn Record OFF when you awaken in the morning.

B. 'Import’ your Xpap data to Sleepyhead
1. If you use SleepyHead software, remove the SD memory card from your xpap machine and insert it into the SD card reader on your computer.
2. Open SleepyHead and click ‘Import’ to upload the sleep session data from your SD card.
3. Click ‘My Computer’ on your desktop screen, right click on the drive containing the SD card, click ‘Eject’ and remove the card.
4. Return the SD card to your xpap machine and reinstall it.


C. Upload and view your Pulse-Ox data
1. Use the provided USB cable to connect the Pulse-Oximeter to your computer.
2. Open SpO2 Review software.
3. Click ‘Not Active’ button to open a New Session.
(Click ‘Cancel’ and repeat this Step if ‘New Session’ button on top line is not shown selected.)
4. Enter a file name (e.g., today’s date) and click OK. A message, "Device Connected: waiting for data…," should be displayed.
(If you see a message, "Can’t open COM 6", click OK, disconnect the USB cable from the Pulse-Ox, then reconnect it and go back to Step 3.)
5. If Record is ON, turn Record OFF on the Pulse-Ox.
6. Turn Upload ON on the Pulse-Ox.
7. Wait (up to a minute) while ‘Receiving data, Please wait….’is displayed.
8. View the Pulse-Ox graphs. Click ‘M’ on bottom line and set the Time scale by changing 'HH: 1’ to the number of whole hours you slept last night rounded up by one. Click OK.

D. View the Pulse-Ox Reports and Graphs in the SpO2 Review CMS-50 software
9. Click the Print Settings button in the lower far right, select a report (e.g.,'OxiMetry Report'), and click ‘Preview’. Print it for your file and/or for your doctor, or just view it. For easier viewing change ‘ % ‘ to 100% or higher (right-most button at top of screen).
10. Press and hold Power off to turn OFF the Pulse-Ox (“Bye Bye!”).
11. Recharge Pulse-Oximeter.

D. View the Pulse Oximetry Reports and Graphs Time-aligned in SleepyHead software
1. Open SleepyHead and click the 'Oximetry' tab at the top. Click the ‘Open .spo/R File’ button in the lower right. Select the sleep file you want to view and click ‘Open’. You should see your red pulse and blue oximetry charts vs. clock time.
2. Click the Save button just left of ‘Open .spo/R File’ button and confirm ‘Yes’ that you want to save the data. (Disregard the ‘No Oximetry Data’ screen.)
3. Click ‘Data’ on the top main menu line, then click ‘Rebuild Oximetry Indices’.
4. Exit out, then restart SleepyHead and click the 'Daily' tab to view the graphs, now including pulse and oximetry, all aligned to the same time scale.
5. Click the 'Daily' button in the SleepyHead Navigation bar on the right. The dates that appear in red on the calendar will display time aligned pulse-oximetry data and graphs. Click on a red date to see the pulse-ox charts for your sleep on that date along with the standard SleepyHead graphs.

(All the steps above need to have previously been performed to see a date's pulse-ox graphs and data in SleepyHead. If the clock time setting on the Pulse-Ox and on your xpap machine do not match closely enough, you will see a notice that the pulse-ox data cannot be linked with SleepyHead. Re-sychronize the current time on the Pulse-Ox so its time setting and that on the xpap machine are the same or very close. Note that fractured sleep sessions are listed in the lower left and each can be toggled ON and OFF.)
__________________

[Papit]

[quote="4betterO2"]
Received these valuable instructions in another thread.
I'm just quoting them in real-time here, will interlace them later in the original post for this thread, (which in time I hope to make a reference-type post)
These instructions for the "Pulse" brand are valid also for Contec-branded oximeters, and other models of the CMS50 line than those listed below,including, the CMS50D+.
[quote]
Re. Inserting CMS-50 Pulse-Oximetry Graphs into SleepyHead
___________________________________________

Sure thing. Have at it, 4betterO2.
--papit

[growing]

Make sure you check the results from various fingers. Most of the time there will be no difference but sometimes a little finger will read a little differently then a middle or index finger. You can check this while you are awake and not active. Just put the unit on your various fingers and compare the readings.

You can also use your toes, but I find that more uncomfortable than my fingers...

Toe, yes. I will also experiment on toe, tonight. This idea had not occurred to me. Thanks.

[4betterO2]

...
Re. Inserting CMS-50 Pulse-Oximetry Graphs into SleepyHead

Thanks Papit for your post!
I must say I'm far behind in practice, in my own efforts to integrate oximeter data with PAP data: I was so interested in the subject that I asked questions, but the great, detailed replies came to be far ahead of me. I'm sure they have helped other users already, who are ahead of me on PAP graphs; as for myself, I'm still struggling with understanding the technicalities of the PAP graphs themselves, before putting theory into my own practice, regarding oximeter integration.

If you can please help answer my questions on PAP graphs, in this thread:
♪,¸¸,¤º°`°º GRAPHS º°`°º¤,¸¸,♪ Meaning ?
viewtopic/t87417/-GRAPHS---Meaning-.html

I'm struggling especially with understanding the timing scale on graphs, which is essential for synchronizing oximeter and PAP data. Thanks!

[Papit]

I'm using ResMed's machine right now with both ResScan and SleepyHead software. You should find a copy of the user guides for your software to get the answers to your specific questions on their graphs and/or read up on SleepyHead. (Go to Help, etc. You'll find the content you need and the exploring for it will help familiarize you with the navigation.)

You can also find links to the learning resources you need by looking at the bottom ('signature line') of any recent post put up by the dozen or more sleep angels here who have years of experience and a lot more technical knowledge imo than many sleep doctors.

In my experience, the horizontal time scale is what it looks like, clock time -- horizontal hour and minute scale for the data recorded and plotted on the vertical axes.

Re. Inserting CMS-50 Pulse-Oximetry Graphs into SleepyHead, just follow the steps in the procedure below. If you do, trust me, it works very smoothly and you wind up with pulse and oximetery graphs perfectly aligned on the time scale with all the standard SleepyHead graphs. Then you can quickly visually correlate which apnea events, if any, are associated with sharp reduction in blood oxygen. You can then ask questions here and also take any really troubling graphs to your doc.

[4betterO2]

Thanks Papit for the advice on help links. I've been away, and not yet really back into the forum yet.

In my experience, the horizontal time scale is what it looks like, clock time -- horizontal hour and minute scale for the data recorded and plotted on the vertical axes.

I think you mean in SleepyHead, right? In SpO2Review, the time lime is showing duration, not clock time. It always starts at zero.
In SleepyHead, I find the time is not always realistic, but I don't know whether the problem is with my machine or with the software, and whether the software reads the time from the machine, or, translates the time from 'duration data' from the machine, into 'clock' time. (That would be a question for Jedimark?) It seems clock time should be set on the machine, but I don't remember anywhere on the manuals of 2 different machines, where it said how to set the time...

[Pugsy]

It seems clock time should be set on the machine, but I don't remember anywhere on the manuals of 2 different machines, where it said how to set the time...

There is no way to set the clock on the Respironics machine. It has in internal clock/calendar set to GMT time and powered by a little battery inside the machine. Only way for it to be reset is at the factory level.

Now ResMed machines do have a clock that the patient can reset.

[Papit]

In my experience, the horizontal time scale is what it looks like, clock time -- horizontal hour and minute scale for the data recorded and plotted on the vertical axes.

I think you mean in SleepyHead, right? In SpO2Review, the time lime is showing duration, not clock time. It always starts at zero. ...

That's correct. I was referring to the horizontal time axis of the SleepyHead graphs.

. . . In SleepyHead, I find the time is not always realistic, but I don't know whether the problem is with my machine or with the software, and whether the software reads the time from the machine, or . . .

Make sure you set the current time on the Pulse-Oximeter to match the current time of your Respironics machine. You may need to translate the machine's current GMT time (see Pugsy's note below) to am/pm time so you can set that (same) time on the Pulse-Oximeter.

That should help. Don't worry, all these initial setup issues are one-time new-equipment matters. Once accomplished and you have the routine down, it will be smooth going. (I have a new computer and am having similar difficulties with getting my computer to recognize the Pulse-Ox. In my case, looks like I need to download a UHB driver. Keeps us all on our toes. )

[4betterO2]

my settings on the CMS50D+ do not include clock date/time, only "Alarm" which is an event-driven alert, not clock-time dependent, and "Record". Does your model have clock time functionality?

I have a new computer and am having similar difficulties with getting my computer to recognize the Pulse-Ox. In my case, looks like I need to download a UHB driver.

What is a UHB driver?
Do you use SpO2Review software with the Pulse-Ox? If so, wouldn't installing the software also install the driver automatically? Does Pulse-Ox use a UART cable instead of a USB cable, like some CMS50 models do?
Do you know what model in the CMS50 brand/category, your Pulse-Ox is equivalent to?

[Papit]

my settings on the CMS50D+ do not include clock date/time, only "Alarm" which is an event-driven alert, not clock-time dependent, and "Record".

You may well need to get yourself a CMS50E or F (or equiv.) if the model you have (??CMS50D+) does not allow you to synchronize it's current time setting to the clock time of your xpap machine; that is if you want to be able to see your pulse and oxygen graphs in SleepyHead with all the graphs time-aligned with each other.

Does your model have clock time functionality?

Yes, it does.

I have a new computer and am having similar difficulties with getting my computer to recognize the Pulse-Ox. In my case, looks like I need to download a UHB driver.

What is a UHB driver?

It my case it turned out to be a piece of software that is needed for the computer to properly recognize the CMS50F Pulse-Ox when connected to any of the available UHB ports (e.g., the driver for a usb to uart bridge com4).

Do you use SpO2Review software with the Pulse-Ox?

I do, yes. It was provided by the manufacturer with the Pulse-Ox. It came on a small CD or you can download it.

If so, wouldn't installing the software also install the driver automatically?

It did on my wife's computer this morning. It didn't on mine, which was the difficulty I had. I did a driver scan to find out which driver I needed and the name of the mfr (Silicon Labs cp210x), went to their site and then downloaded and installed it. Then it recognized the pulse-ox and I was good to go. : )

Does Pulse-Ox use a UART cable instead of a USB cable, like some CMS50 models do?

I think all the Contec CMS50's use the same cable, but I only have the CMS50F. It's how you connect these pulse-ox units to your computer's USB port.

Do you know what model in the CMS50 brand/category, your Pulse-Ox is equivalent to?

I'm using the Contec CMS50F. Here's what it looks like. I got it from a site in China like others here have done. I actually received it a week after I ordered it online. Impressive. Others have had the same experience. It works very nicely. Some of us have done a little "surgery" by making a small slit in the rubber finger holder (for comfort) so it grips the finger more comfortably. You'll see what I mean after you sleep all night with it a few times, but cut just a tiny bit at a time so you don't overdo it. Hope this helps.

[Papit]

4betterO2, it looks like you're in luck after all re. inserting your CMS-50D+ pulse-oximeter data and graphs into SleepyHead. Check out the updated instruction set in my signature which now includes a pointer to Burkebang's successful solution for the 50D+. I hope it will work for you.

my settings on the CMS50D+ do not include clock date/time, only "Alarm" which is an event-driven alert, not clock-time dependent, and "Record".

You may well need to get yourself a CMS50E or F (or equiv.) if the model you have (??CMS50D+) does not allow you to synchronize it's current time setting to the clock time of your xpap machine; that is if you want to be able to see your pulse and oxygen graphs in SleepyHead with all the graphs time-aligned with each other.

[Hivoltfl]

This is a great thread and I see I need more equipment, a little off topic and I apologize, I keep seeing these stages of sleep graphs, I have SH on my computer and see a graph named such but I cannot view it, am I doing something wrong, leaving something out?

[quietmorning]

This is a great thread and I see I need more equipment, a little off topic and I apologize, I keep seeing these stages of sleep graphs, I have SH on my computer and see a graph named such but I cannot view it, am I doing something wrong, leaving something out?

Named such as in the Oximetry? If this is what you are talking about - the oximetry page, you have to have a specific oximeter brand to use it. CMS50. It's a little persnickety - but once you get the hang of uploading your oximetry file or loading it from the oximeter, it's pretty straight forward. Let me know if this is what you are talking about, and we can go from there.