Encore Pro V. MyEncore Variable Breathing

A thought just occurred to me reading a couple of posts about data. My Encore shows variable breathing and I cannot find variable breathing on any Encore Pro reports. Variable breathing comes from the Encore Pro database. Does this seem strange? Why can't I find variable breathing? Help!!!!

WHY? Because Respironics chose not to put it in their Encore Pro reports. They probably figured that the RTs and DMEs and Docs wouldn't know what it is, either.
BUT.....Derek found that it was being recorded (in some manner) in the data that's being stored and made it available......so everyone who used it would come to the forum asking "What's Variable Breathing?"

Best wishes,

Den

By the way, my VB averages in the upper 20's....near 30. (Whatever THAT means)

Derek says:
"Variable Breathing is defined as the situation when a person is not undergoing the quiet steady breathing of several states of sleep. In particular, according to the Respironics patent 'it happens during wakefulness, distress, and REM sleep.' ...Since REM sleep is a desirable state, some variable breathing is obviously a good thing."

Sooooooooo when I see I had 60% Variable Breathing last night, I don't know if I was in distress or REM sleep. I am not sure how to define "Wakefulness" at this moment, so I shall ignore it.

I searched our database and found this recent thread without an answer. How Derek found this is amazing...I now understand why he no longer communicates with this board...we are just mere mortals. If I were as smart as he is, I would not talk to you either. javascript:emoticon('')
Wink

curtcurt46 wrote:Variable breathing comes from the Encore Pro database.

Yes, depending on machine type, its stored in either the SleepTrendEventLog or SleepTrendEventLog2 database tables.

Cheers, -james

I think Derek mentioned that he became extremely overloaded with work, and then also happened to become ill enough to require an extended stay in the hospital. I also recall Derek saying that MyEncore was never intended to be his "life work". I think he only intended it as a casual and short-lived effort from the very start. I'm sure he's extremely surprised at the dedicated following that MyEncore managed to garner. I am extremely glad that James (jskinner) is willing to carry on Derek's excellent idea!

As to the variable breathing statistic that is embedded in Encore Pro's data structures. Some of those variable breathing conditions are clearly desirable, while others are not. In my way of analyzing, that makes the variable breathing statistic too confusing to patients and clinicians to be of any use as a stand-alone metric in Encore Pro.

So why, then, is variable breathing in the Encore Pro data structures in the first place? If I were an AutoPAP designer I would want it in that data structure for one very simple reason. If I were trying to gauge why some patients were not achieving suitable efficacy with my AutoPAP design, I would want some means of determining how easy or difficult it might be for my algorithm to baseline those challenging patients throughout the night. A patient with a significantly higher percentage of variable breathing should theoretically be more difficult to accurately baseline throughout an entire night than a patient with a much lower variable breathing percentage.

Under that premise alone, the variable breathing statistic would be useful to the manufacturers, yet potentially cryptic if not downright confusing to everyone else. At least that is my best guess regarding what that variable breathing statistic is all about and why it is not displayed by Encore Pro.

In digging through patents and algorithms, it appears that variable breathing (VB)(gotta have an acronym) is actually a mode in the Respironics APAP (at least the Auto BiPAP, anyway). When the AutoBiPAP senses breathing that may be too erratic, it suspends auto-titration and makes adjustments only using IPAP (or it will change EPAP only as necessary to maintain PS criteria).

James, in the database that you refer to, can you tell when the machine is seeing VB, or is it just a % of night?
SAG

Exactly as SAG mentioned. This detected breathing condition sends the algorithm into the "variable breathing controller" where one of several unique variable-breathing-controller pressure responses follow. And the amount of time spent in that portion of the algorithm can conceivably impact overall efficacy or suitability for AutoPAP.

Not to lose SAG's previous question for James:

SAG wrote:James, in the database that you refer to, can you tell when the machine is seeing VB, or is it just a % of night?

Ooh, here's the APAP VB algorithm. Looks like increase/decrease at 0.5 cmH2O/min up to 2.0 cmH2O, or maintain pressure. Laundry list of decision criteria.
SAG

SWS...what is baseline here? Baseline for what?

I was over 60% in Variable breathing a few night back. I was over 50% 3 more nights out of 7. It is VERY interesting to think the algorithm kicked in another
"circuit" to ....uh....correct the VB?

Moving a step further, if the algorithm "forces" an IPAP "rate" on our body to stabilize our breathing, is their anyway to determine what rate was used?

I have the Auto BiPAP. And with my breathing disorders, I can imagine the machine wondering what is going on. Fascinating...please continue