How accurate is Encore Pro compared to a human?

I talked to the person who computed my wife's titration at 6 today.

Making a long story short, I told him he saw her one night, while she was on a sleeping pill so she would sleep.

I have almost 3 months of Encore Pro that says she is up to 14+ on IPAP.
He said Encore Pro was way off.

He says his human is much more accurate and that my wife was in REM sleep with a 6 dialed in. I repeated that 90 days would seem to give a more accurate picture than one night.

We are taking her smart card up there Monday.

He was NOT happy that I had the software, said it belonged with professionals in the industry, NOT owners. I had some trouble keeping my mouth shut, but I will be talking with his boss about some of this guys comments.

I don't know how accurate Encore Pro is......GIGO I guess.

When I told him she had an auto bipap he asked where I got it and so on.
Must have been a bad week for him I guess.

What do YOU think? Encore Pro for almost 90 days vs a one night observation?

dllfo wrote:
What do YOU think? Encore Pro for almost 90 days vs a one night observation?

I think that the numbers from my own titration study were too low, as evidenced by the higher numbers that I saw after several nights of treatment. Whether that's true or not, I've assumed that it had to do with the very small amount of sleep I had during the study.

Fortunately for me, when I contacted my sleep doc and gave him my stats, he told me to adjust my pressure from seven to ten, which helped.

I think that some "trained professionals" feel threatened whenever anyone questions their conclusions. If Encore Pro is so far off, why do medical folks use it to monitor progress at all?

OCO

dllfo wrote:I talked to the person who computed my wife's titration at 6 today.

Making a long story short, I told him he saw her one night, while she was on a sleeping pill so she would sleep.

I have almost 3 months of Encore Pro that says she is up to 14+ on IPAP.
He said Encore Pro was way off.

He says his human is much more accurate and that my wife was in REM sleep with a 6 dialed in. I repeated that 90 days would seem to give a more accurate picture than one night.

Truth is, Dave, that neither method is infallible. The sleep study titration could be off, or the machine's titration could be off. There's a quick and painless way to find out well either is working though. Simply ask your doc or sleep lab to prescribe an oximeter for a few days and you'll be able to determine which way is working best (i.e., whichever way shows the fewest oxygen desaturations).

Personally, I suspect you're right about the sleep lab's titration being wrong, but I'm sure you also remember some of the heated discourse I prompted on one of your threads some months back when I stated that the Respironics algorithm is prone to runaway pressure at times. The good news is that you don't have to guess which is working better for your wife. The oximeter will resolve the matter unequivocally.

Good luck, Dave. Hope things are going well with you.

Regards,
Bill

GREAT ADVICE from Bill, Dave!!!

The essenced of all that we do here is to make sure that our cells are getting enough O2. A pulse/ox will tell ya how much is being carried in your blood.

Follow Bill's advice.

Chuck

That is good advice. I am also very interested in the outcome of your dilemma, I have had similar questions recently.

Recent events have been leading me to try and keep in mind that OSA is not the only obsical to a good nights sleep, just the most serious one I have. My issues also related to the validity of Encore data. I believe the data is correct and that my issue was just not captured by the data.

I had been using my bipap in auto mode and was getting great numbers in EncorPro. My total number of apneas was always zero with one croping up occasionally. My mask leak data was consistant and everything looked great. I felt awful though, I was getting more and more tired. I felt my mental sharpness being dulled, I woke up tired, basically all the symptoms of untreated OSA.

The thing is, my numbers were all pretty much as good as they could be. I remembered reading on the forum that some people do not tolerate auto mode well. I switched my bipap from auto mode into straight bipap mode. I started feeling better and am now back to feeling really good. My EncorePro numbers are STILL really good and everything is going much better for me.

The theory I have is that the pressure changes while the machine is in auto mode is enough to prevent apneas, but still causes me to become aroused and not get the full benifit of my sleep. I can't think of any other explination for my results so I am forced to pretty much assume that is the cause.

That ambiguity is frustrating. It did reinforce that my goal is not to treat apnea. My goal is to get a good nights sleep and recieve the benifits that a good night sleep provides. In this instance I don't think an oximeter would have indicated a problem. The apnea's were treated so the oxygen levels probably didn't drop. I don't know much about oximeters though so I could be wrong. I definately want one though because the data they provide sounds very useful in tracking apnea issues.

I suspect that what I would need to really verify my hypothisis is an ekg to monitor my brian waves. That can track what stage of sleep you are in. I would love to generate a timeline so I could look at when the auto changed the pressure and see if my brainwaves indicate that I was aroused from the deeper sleep stages at that time.

There are other outside infuences that can affect your sleep as well, noise, light, restless legs, comfortable bed, ect. Sleeping in an unfamiliar room, wired up, watched, and probably in a non-normal sleep position...that could definately lead to skewwed results. I don't know of a better way to diagnoise sleep issues, but after they determine you have apnea I can't help but feel like the only sane thing to do would be to have people re-titrate using an auto machine in thier normal sleeping environment.

I hope everything goes well for you and also hope you let us know how things turn out on monday. I am very interested to know if they are able to come up with any compelling arguments. I do think Bill is right on the money though, I think that would provide useful data for you situation.

WillCunningham wrote:
The theory I have is that the pressure changes while the machine is in auto mode is enough to prevent apneas, but still causes me to become aroused and not get the full benifit of my sleep. I can't think of any other explination for my results so I am forced to pretty much assume that is the cause.

I agree here.. however I wonder if eventually one could sleep through pressure changes like one would sleep through the tv being on throughout the night while their sleeping. Perhaps its something that you can train yourself to do.

WillCunningham wrote:
That ambiguity is frustrating. It did reinforce that my goal is not to treat apnea. My goal is to get a good nights sleep and recieve the benifits that a good night sleep provides. In this instance I don't think an oximeter would have indicated a problem. The apnea's were treated so the oxygen levels probably didn't drop. I don't know much about oximeters though so I could be wrong. I definately want one though because the data they provide sounds very useful in tracking apnea issues.

I suspect that what I would need to really verify my hypothisis is an ekg to monitor my brian waves. That can track what stage of sleep you are in. I would love to generate a timeline so I could look at when the auto changed the pressure and see if my brainwaves indicate that I was aroused from the deeper sleep stages at that time.

Oxy levels are only one factor, I think your right with the EEG idea... I purposed this a couple days ago. viewtopic.php?t=12570&highlight=eeg

Heightened daytime blood pressure seems to be connected with arousals and not so much with oxy levels. I remember reading an article on a study a while back about this.

My good friend ric [rolls eyes] seemed to be the only one really interested in this EEG idea. I found a do it yourself project online, but if anyone else knows of anything else out there, let me know.

WillCunningham wrote: There are other outside infuences that can affect your sleep as well, noise, light, restless legs, comfortable bed, ect. Sleeping in an unfamiliar room, wired up, watched, and probably in a non-normal sleep position...that could definately lead to skewwed results. I don't know of a better way to diagnoise sleep issues, but after they determine you have apnea I can't help but feel like the only sane thing to do would be to have people re-titrate using an auto machine in thier normal sleeping environment.

I agree again... compare and contrast the differnt data and the results that people get.

stryker5777

oops... logged me out. The above is me. Weird how it does that....

Stryker5777

dllfo wrote:I talked to the person who computed my wife's titration at 6 today. ....

We are taking her smart card up there Monday.

First, I agree that 90 days of data is more reliable than one night in an unfamiliar environments.

I am curious why you are talking to this guy? He does not seem very approachable or helpful. Do you need anything further from him?

For me, I found the most helpful and reasonable medical professional (my primary care doc), and I use him for the prescriptions I need.

Moogy

dllfo wrote:He was NOT happy that I had the software, said it belonged with professionals in the industry, NOT owners.

When I told him she had an auto bipap he asked where I got it and so on.

Moogy wrote:I am curious why you are talking to this guy? He does not seem very approachable or helpful. Do you need anything further from him?

That's a good question, Moogy. First this guy says the software is only for professionals like himself, then he says the software isn't accurate, then he wants to know how the equipment and software was obtained. Sounds like this guy is threatened by a patient knowing more than he does. They just hate it when that happens.

Yep! I agree with "Guest".....software is "way off", but it "belonged with professionals in the industry, NOT owners".....sounds like he's talking out of both sides of mouth or is an idiot (and threatened). The professionals are using software that is way off??? Interesting......

Den

Encore Pro, doesn't spend most of the night, getting coffee, talking to people on the phone , watching t.v., and sleeping at his desk. I'd have to go with Encore Pro even if it was half right! Jim

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CPAPopedia Keywords Contained In This Post (Click For Definition): Encore Pro

How accurate is Encore Pro compared to a human?

Depends on what color hair the person has. Of course.

Cheers!

Chuck

Moogy...I was speaking to him because he told our family doctor, who is VERY user friendly...been our doctor for about ten years...but our dr. used the "6" for titration. Apria called me, saying a titration of 6 would not support the Respironics Auto BiPAP my doctor oredered for her. the tech sent the "6" to our doctor, but if the tech would change it, based on 3 months data, we might be able to get the auto bipap. Otherwise, I am not sure the insurance will agree.

I sent Apria the info that his score was way off. Encore Pro showed her at 14+ on the 90% IPAP numbers....on several nights. I did not check all the nights, but of those I checked, her EPAP was as low as a 6 a few times, but the IPAP was double that. the auto bipap she is using now has her AHI scores at around 2-3. Wish I could get mine under 20 again. That is another story.

This guy asked if we would mail him the SmartCard. I told him we would bring it in, as they as about a mile from us. I will leave the card with him if he wants to give me a card. He might turn out to be a big help, but his ego needs to take a back seat to my wife's health.

I will take my laptop to my dr. and show him Chris's readings. Then I am hoping he will realize the tech took the data on one night. In a strange environment and when she was on sleeping meds. I was very surprised to hear him "bad mouth" encore pro. But he might be the best tech in the world and can prove encore pro is wrong. All I want is the best treatment possible.

And..I highly resent his attitude about the machines. If my doctor is willing to prescribe the Auto BiPAP, why is it any of this techs business???? I will be speaking to his boss about this. In fact, I will probably ask his boss to sit in on our meeting.

Bill...Oxygen levels? I got a good buy on a almost new SPO 5500 and I have been using it on me. During the day and early evening I run in the high 80s. I spike into the 90s. The dr. took a test of it all about two weeks ago and said I was fine....around 94. One company had a unit that you wear on your wrist while it records your oxygen levels. It sells for $495 new and they offered it to me at $425. I think it may have been the SPO 7500.
But we can ask our dr. to do it if you think it will help.

If I put my SPO 5500 on my finger when I went to bed, then tested it a half hour later, are you saying it should read in the mid 90s if I am well oxygenated? I can try that. Heck, I can lay down in the middle of the day, put it on my finger and put the mask on....see what I get.

STRYKER5777...I have leg spasms caused by the morphine I am on. My legs will "jump" around. Even my hands a fingers will do it. The bad side is my right foot. Before I take my morphine I drive around locally on errands.
For the first time in my life I have to pull my right foot back from the gas pedal and I monitor my car's position very carefully. I stay an extra car length back and so on. My fingers spasm...I will click on the mouse when I did not want to. Most of the time my leg spasms do not wake me up. But it is a real odd feeling for my body to be moving and I am not telling it to.

I saw my cardiologist last week, the new EKG or is it a EEG? Anyway, the lady put the cordless sticky "transmitters' all over, then within a couple of seconds, not minutes but seconds she said the ekg was done. So I am not sure how you would use that kind of reading. Unless you had a machine do a continuous readout.
Chuck...Bill...I agree that the professionals can feel threatened by the electronic programs. EXCELLENT point Bill....if encore pro is so far off , why DO they use it to monitor us?

OCO, isn't it interesting so many of us think our original numbers were too low??? Mine was really different...4/25 originally if I remember right and the machine was on full auto. What a wonderful feeling to sleep all night again.
If I do not interupt my sleep with an alarm clock or severe pain, I will sleep 8-10 hours a day now. I never used to sleep that much, but I guess my body is tired from fighting my ailments. Getting a morphine pump might turn out to be a blessing in disguise. It would give me a steady dosage 24/7 and let my body get used to one level of medication. That might go a long way to stopping the spasms too. 26 pills a day. 5 years ago I had 2 or 3 a day. No doubt in my mind some of these meds could effect my sleep.

I am trying to copy my page two...auto bi-level statistics. Not having any good luck. When I post it here it is a jumble of words and numbers. No luck.

thanks for the help....Dave

dllfo wrote:Bill...Oxygen levels? I got a good buy on a almost new SPO 5500 and I have been using it on me. During the day and early evening I run in the high 80s. I spike into the 90s. The dr. took a test of it all about two weeks ago and said I was fine....around 94. One company had a unit that you wear on your wrist while it records your oxygen levels. It sells for $495 new and they offered it to me at $425. I think it may have been the SPO 7500.
But we can ask our dr. to do it if you think it will help.

I do think you should get the doc involved with the oximeter, Dave. If you can record data overnight with your unit then that may be all it takes, otherwise you'll probably want to have your doc prescribe an oximeter for a few days. If you make two overnight oximetry recordings on your wife, one with her titrated pressure of 6 cm (yes, the BiPAP-auto can run in CPAP mode at that pressure) and one with the machine in automatic mode, that should tell you how effective her titrated pressure vs the higher "auto" pressures. If the data shows significant desaturations at the titrated pressure, but none in "auto" mode, then, obviously, the BiPAP-auto is treating your wife effectively in auto mode and the titration was just plain wrong. Assuming you get this result, then it will be difficult for the tech or doc to argue against your wife keeping the BiPAP-auto. On the other hand, if the data shows that your wife does just fine at 6 cm pressure for several nights in a row, then she doesn't really need the BiPAP-auto, and the high pressures it's been using on your wife might be the result of the machine's algorithm not matching your wife's needs very well (although I personally doubt that will be the outcome).

Good luck, Dave. Sounds like you're on the right track with your wife's treatment. Ya just have to work through the issues though, until you get it right.

Regards,
Bill

I will call our dr. Monday am.

They mailed us my wife's report....what data would enable our group to guess at the titration? Do we know enough to even make an educated guess?

Final page did say a 6, but said it could go higher. On page 2 of 3 it mentioned 14+ scores. I have not read it all the way thru.

I will try to read it tonight.

I have been reading my info on MyEncore. I LOVE IT. I am a numbers nut anyway, so trying to understand this is fun.....

I am still trying to transfer all the sleep data from our laptop to the desktop.

Oh well, it keeps me off the streets.