Announcing Onkor: free,open alternative to Encore Pro/Viewer

Yeah, RDI would be perfect (CA+OA+H+RE/Hrs).

Yeah, I'd love to see the breathing rate back. Would it be possible to see how the breathing rate varies at different times during the night?

Good

Josh816 wrote:Yeah, I'd love to see the breathing rate back. Would it be possible to see how the breathing rate varies at different times during the night?

Yes, it is, I think. As far as I can remember from my math courses (and I'd be glad for someone to correct me if they know better) a Fourier transform of the breathing waveform should result in the breathing rate. But a discrete fourier transform requires some block length (perhaps 1 minute) and it will give the average breathing rate for that duration.

So in other words, I can show a graph of a bunch of x-second breathrate averages. But choosing that number x is the trick, I guess. I'll tinker.

RDI calculations have been added. Good news and bad news about breathing rate. good: i got it work on my dev laptop an it seems to be somewhat helpful in indicating problem areas. Bad news: the server I'm using isn't powerful enough to perform the calculations in a reasonable time.

I'm going to shop around for a new server, which will hopefully speed everything up..

Sorry if this is the wrong thread in which to post...

I am absolutely new to all of this and still very low on the learning curve. I have searched this forum as well as the wiki but still haven't found a definitive answer.

What do all the abbreviations on the chart below the waveform mean (plain English please for a dumb newbie)? I see

PB
RA
OA
CA
H
VS
FL
CSR
PP
LL

They main be painfully obvious to everyone (and some are to me - such as OA) but most are not.

Also - how does one post the page and/or charts to the forum?

BTW - thanks for this software! I know it must take a great deal of time and effort.

For bakermo....I forgot to quote the request.



Full definitions available in clinical manual if you have one. If you don't have one you can request one here.
http://www.apneaboard.com/CPAP%20Adjustment.htm

I will see if I can find something to copy/paste that shows definitions.

to post image of reports this is how I do it


Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key
I think windows 7 has the snipping tool.
Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

Edit to add

bakermo wrote:What do all the abbreviations on the chart below the waveform mean (plain English please for a dumb newbie)? I see

PB
RA
OA
CA
H
VS
FL
CSR
PP
LL

CSR Cheyenne Stokes Respiration
PP Pressure Pulse ... probes by the machine used to determine airway patency and thus event class
Glossary
A-Flex

An algorithm for adjusting CPAP pressure during the later stage of inspiration and during exhalation to improve patient comfort based on a user-defined gain setting.

AHI

Apnea/Hypopnea Index. A count of apnea and hypopnea events per hour. When the AHI is greater than 15, the patient is likely to complain of excessive daytime sleepiness. When the AHI is greater than 30, the patient is at increased risk for cardiovascular complications.

Apnea

An apnea is indicated if there is an 80% reduction in airflow for 10 seconds compared to the average airflow over an extended period of several minutes or if there is no airflow detected for 10 seconds.

ASV

Automatic Servo-Ventilation. Pertains to a low-pressure, electrically driven ventilator system with electronic pressure control. The device’s pressure controls are adjusted to deliver pressure support for patient ventilatory assistance. The device augments patient breathing by supplying pressurized air through a patient circuit. It senses the patient’s breathing effort by monitoring airflow in the patient circuit and adjusts its output to assist in inhalation and exhalation.

Auto-CPAP

Continuous Positive Airway Pressure (CPAP) that automatically titrates the pressure up and down based on the varying requirements of the patient.

AVAPS

Average Volume Assured Pressure Support therapy mode

Average AHI

The average AHI (Apnea/Hypopnea Index) is the total number of apneas and hypopneas that occurred during sleep divided by the number of therapy hours.

Average FOSQ Score

The total of all FOSQ scores divided by the number of questionnaires completed.

Average Hours of Use

The total number of hours the patient received therapy divided by the total days of use.

Average Time in Apnea Per Day

Total hours the patient spent in Apnea divided by the total days with device usage.

Average Time in Large Leak Per Day

Displays the average amount of time the patient spent with excessive air leakage that will compromise therapy. This could be the result of poor mask fitting.

Bi-Flex

A small amount of pressure relief (levels of 1, 2, or 3) applied during the latter stages of inspiration and during active exhalation (the beginning part of exhalation).

Bi-Level

Two different positive pressure levels (IPAP/EPAP). The dual pressure levels provide a more natural means of delivering pressure support therapy to the patient resulting in improved patient comfort. The pressure toggles between an inspiratory and an expiratory pressure during spontaneous breathing.

BPM

Breaths per Minute

C-Flex

A small amount of pressure relief applied during active exhalation (the beginning part of exhalation).

Checksum

A computed value which depends on the contents of a block of data and which is transmitted or stored along with the data in order to detect corruption of the data. The receiving system recomputes the checksum based upon the received data and compares this value with the one sent with the data. If the two values are the same, the receiver has some confidence that the data was received correctly.

cm H2O

Measurement unit of pressure; centimeters of water.

Compliance

The consistency and accuracy with which a patient follows the regimen prescribed by a physician or other health professional.

Compliance Graph

Provides a view of the patient's therapy usage and the patient's compliance.

CPAP

Continuous Positive Airway Pressure

Cross-patient Report

Cross-patient reports display a summary of the patients associated with your company and offices.

Daily Events Per Hour

Number of events per hour for one night of therapy.

Date Range

Period of time included in a compliance download or on a report.

Desaturation

An indication that the patient's measured SpO2 is reduced by 3% or more.

Diagnostic RDI

Diagnostic Respiratory Disturbance Index. The total number of breathing events divided by the total sleep time without therapy.

DME

Distributor of Durable Medical Equipment

EPAP

Expiratory Positive Airway Pressure

ESS

Epworth Sleepiness Scale. A test used worldwide by sleep professionals to measure sleep deprivation and daytime sleepiness.

Exhaled Tidal Volume

The amount of air passing out of the lungs for each breath.

FL

Flow Limitation is a partial obstruction of the airway as detected by a change in the shape of the flow signal.

Flow Limitation Index

Changes in flow limitation are recorded as events. The Flow Limitation Index is calculated by the total number of flow limitation events per night divided by the hours of use. Note: The average is calculated by taking the total number of events divided by the number of therapy days. This can be used to indicate if there has been a significant degradation in the flow signal, resulting in a pressure increase.

FOSQ

Functional Outcomes of Sleep Questionnaire. A "Quality of Life" measurement designed specifically for people with sleep disorders. The results allow health care professionals to evaluate how effective therapy is in improving the patient's ability to accomplish every day tasks. The FOSQ consists of 30 questions and normally takes approximately 15 minutes to complete.

GMT

Greenwich Mean Time (time zone)

HIPAA

Health Insurance Portability and Accountability Act of 1996 (August 21), Public Law 104-191, which amends the Internal Revenue Service Code of 1986. Also known as the Kennedy-Kassebaum Act. Title II includes a section, known as "Administrative Simplification," that requires: 1. Improved efficiency in healthcare delivery by standardizing electronic data interchange, and 2. Protection of confidentiality and security of health data through setting and enforcing standards.

Hours of Usage

Shows patterns of use displayed by date.

Hypopnea

An hypopnea is indicated if there is approximately 40% reduction in airflow for a duration of between 10 and 60 seconds, compared to the average airflow over an extended period of several minutes. Following a reduction in airflow, the therapy device must see two recovery breaths in order to label the event as a potential hypopnea.

Hypopnea Index

The Hypopnea Index is calculated by the total number of hypopnea events per night divided by the hours of use.

Interactions

Activities performed to record patient data. The interactions in EncorePro include Download Data, Input FOSQ Test, and Create Prescription. The Create Prescription interactions enable you to record information related to the following: device prescription, filter replacement, humidifier prescription, mask prescription, tubing replacement, other accessory replacement.

IPAP

Inspiratory Positive Airway Pressure

JPEG

Joint Photographic Experts Group. A standard algorithm for the compression of digital images.

Leak

The amount of air leakage in the patient circuit.

LL

Large Leak

LPM

Liters per Minute

MaP

Minutes at Pressure

Mean Pressure

Average device pressure multiplied by the time at pressure divided by the total time in the device.

Minimum O2 Saturation

Lowest arterial saturation recorded during a sleep study.

Minimum Therapy Time

The minimum number of hours of usage per day to be compliant.

Minute Vent

The average minute ventilation (tidal volume x rate) measured per hour of use.

Modem

An electronic device that makes possible the transmission of data to or from a computer via telephone or other communication lines.

MPAP

Micro Positive Airway Pressure (can also be Mean Pulmonary Artery Pressure).

NRAH Index

Non-Responsive Apnea/Hypopnea Index. A non-responsive apnea/hypopnea flag is generated when a patient has apneas and or hypopneas that do not respond to increased pressure from a pressure therapy device. It is detected when the patient has at least 2 apneas and/or hypopneas, the pressure level of the therapy device increases at least 3 cm H2O, and the patient continues to have apneas and/or hypopneas. Total Events / Total Session Hours = Index.

Obstructive Apnea

Obstructive Apnea (OA) is a temporary cessation of airflow without an accompanying cessation of respiratory effort.

Obstructive Apnea Index

The Obstructive Apnea Index is calculated by the total number of Obstructive Apnea events per night divided by the hours of use.

OSA

Obstructive Sleep Apnea

Oximetry

Oximetry is a procedure for measuring the concentration of oxygen in the blood.

Patient Interaction Reports

Interaction reports display details of every interaction listed in a patient’s record.

Patient Summary Reports

Patient summary reports display a summary of each patient’s therapy.

Patient-Triggered Breaths

Breaths initiated by the patient.

Patterns of Use

Displays the total daily usage time of the therapy device.

PC

Pressure Control therapy mode

PCMCIA

A type of connector (port). Short for Personal Computer Memory Card International Association, and pronounced as separate letters. On many laptop computers, there will be a PCMCIA slot where a PCMCIA device (e.g., SmartCard reader/writer) can be connected.

PCP

Primary Care Physician

Peak Average Pressure

The largest average CPAP Pressure in the date range.

Percent Compliance

The percentage of days that the patient received therapy for more than the minimum therapy hours setting.

Percent Compliance Graph

Shows the percent of compliance for each mode of therapy.

Phoned-In Compliance

Refers to basic compliance statistics displayed on the device that the patient reports to the home care provider or DME via the telephone. Generally, low-end devices that do not have SmartCard or SD Card support use phone-in compliance as a means to report patient compliance for reimbursement.

Pressure

Pressure settings and average delivered pressures are indicated as colored lines on reports.

Ramp

During ramp time, a patient starts therapy at a pressure lower than the prescription. The pressure is incrementally increased over time while the patient is falling asleep.

Ramp Time

The time over which the pressure increases from the initial low-value, to the prescription value.

RERA

Respiratory Event Related Arousal

RDI

Respiratory Disturbance Index

REMstar Auto Flags

Measurements recorded in 30 second intervals for the following measures: NR = Non-Responsive Apnea/Hypopnea event OA = Obstructive Apnea event H = Hypopnea event FL = Flow Limitation event S = Snoring event AHI = Apnea/Hypopnea Index (the sum of the Apneas and Hypopneas during the night divided by the number of therapy hours).

S/T

Spontaneous/Timed therapy mode

SD Card

A SD Card (Secure Digital Card) is an integrated circuit which is housed in a compact, rugged plastic enclosure. SD Cards are designed to store data and to enable the transfer of data between devices equipped with SD Card slots.

Session

A length of time in which therapy has been delivered with breaks lasting no more than one hour.

Sigh

A breath that is delivered every 100 mandatory or assisted breaths at 150% of the normal volume.

Sleep Therapy Flags

Measurements recorded in 30 second intervals for the following measures: OA = Obstructive Apnea event H = Hypopnea event S = Snoring event AHI = Apnea/Hypopnea Index (the sum of the Apneas and Hypopneas during the night divided by the number of therapy hours).

SmartCard

A type of memory card inserted in some therapy devices that records the patient's device usage information. The SmartCard can be removed for easy download of the data into EncorePro.

SmartCard Reader/Writer

The SmartCard reader/writer is used to download compliance data from a SmartCard.

Snore

A loud upper airway breathing sound during sleep, without episodes of apnea.

Software Update

Refers to a new version of the EncorePro software that does not require a change to the database structure. Updates are less severe than upgrades and require less coordination.

Software Upgrade

Refers to a new version of the EncorePro software that requires a change to the database structure. Installation of an upgrade must be coordinated with an upgrade to the database server.

Split Night

A mode that enables the auto CPAP algorithm to be delayed by a pre-selectable time interval.

Therapy Exception

An indication when any of the Additional Reasons to Call (determined during the modem setup) occurred.

Tidal Volume

The amount of air passing in and out of the lungs for each breath.

Total AHI

The sum of the Apneas and Hypopneas divided by the number of therapy hours.

USB

Universal Serial Bus

USB Connector

A type of connector (port). Short for Universal Serial Bus. This type of connector can be used to connect peripheral devices (e.g., mice, keyboards, SmartCard reader/writer).

VAPS

Volume Assured Pressure Support, breath by breath correction towards a target tidal volume.

Vibratory Snore (VS) Index

The Vibratory Snore Index is the total number of vibratory snoring events per night divided by the hours of use.

Wow, that's some good information.

I like the new stats on Onkor. I love the site and it's very helpful in tracking my progress.

Anyone have any suggestions.....
*My pressure is at 16 (titrated in a sleep study about 6 weeks ago). I've tinkered with the pressure and tried Auto (6-20), and it was in the 6-8 range all the time. I have tried the various flex settings and find no flex most comfortable.

*A few months back, I had surgery to repair a deviated septum, reduce my turbinates, and clear out my sinuses. For the first time in my life, my nose works well

*I use an oral appliance + CPAP, so it opens my mouth even if I don't want to.

*I'm currently using a ResMed Quattro FX. It's not comfortable, but beats the other dozen or so masks I've tried.

So long story short, my numbers are great (AHI averages 1.5. Of these, machine shows 0.4 OA, 0.4 OA, 0.8 H. Plus 0.7 RE) and I average about 7 hours a night. BUT I have no relief. I'm exhausted all the time, and can barely stand it.

Anyone have any thoughts or suggestions?

Pugsy typically goes to a lot of trouble to be helpful, but that post merits a special citation.

Thanks.

Decided to copy/paste the glossary from Pro so that Onkor users would have it all. That long, long post took 5 sec..
Now the other with screen shot a wee bit more work but not huge amount except one handed typing sucks..

Pugsy wrote:Decided to copy/paste the glossary from Pro so that Onkor users would have it all. That long, long post took 5 sec..
Now the other with screen shot a wee bit more work but not huge amount except one handed typing sucks..

Never the less - it is GREATLY appreciated. I learned more with this one post than about an hours worth of searching.

Thank you - you are the best!

Thanks again Pugsy.

By the way, another way to get images for the plots is to click the little blue plus icon in the bottom left of the plots.

Here:

If you click on the little Save Image icon after that, a window will pop up with the plot image, which you can right click and save. You can do this as many times as you want for the main airflow plot if you want to get multiple images of different sections.

This look like a great project! Congratulations to the developers!!

I am not sure which machines/models are covered by this software. Does this work with Respironics M1 Auto? I do not think it uses any 'sdcard' ??

Since this is open source, where does one find the source code?

The data card of M1 has all the detailed patient information, name, address, physician, and sometimes even medical/insurance account numbers depending on how the physician's office initially setting up the machine. So regarding privacy in the previous posts, I may be missing why such info posted at a public site may not be a legitimate concern. I think I must be missing something here.

Do the developers have similar plans for other machines such as ones from Resmed for example?

Cordially,
Feeling_better

I have read only a few msgs of this very long thread. I read that this works in chrome browser. But I have not been able to create an account under chrome 12 (latest) on winxp, nor on chome13 of chromeos of google netbook cr-48. I have a guess that the Captcha embedded is not quite compatible with the chrome, and may not be returning the user input correctly. Anybody else seeing this problem?

Feeling_better

feeling_better wrote:This look like a great project! Congratulations to the developers!!

Thanks!

I am not sure which machines/models are covered by this software.

Currently only PR System One CPAP is tested.

Since this is open source, where does one find the source code?

It's hosted on sourceforge here: http://sourceforge.net/projects/onkor/ Directions on getting the source code are under the "code" menu.

The data card of M1 has all the detailed patient information, name, address, physician, and sometimes even medical/insurance account numbers depending on how the physician's office initially setting up the machine. So regarding privacy in the previous posts, I may be missing why such info posted at a public site may not be a legitimate concern. I think I must be missing something here

.

Onkor accepts only 001/002/005 files from the PR System One. No information like you describe has ever been identified on these files. The only identifying information that I or any community member has been able to identify on these files is the machine serial number.

Do the developers have similar plans for other machines such as ones from Resmed for example?

[/quote]
Lots of plans, no time. Next feasible machine is PR BiPAP, as the file formats are similar. Moving on to different manufacturers probably won't be done by me alone any time soon. If you know any developers...

This is a great project! However, I've uploaded a bunch of data from the card on my machine, and the reports that Onkor gives are very different than the ones given by the Encore Pro 2.4 software. The length of times are different -- for example one night Onkor says that I used the machine for 56 minutes, and Encore Pro said that I used it for 5 1/2 hours. The number of OA, CA and H are also very different. Also Onkor reported two large leaks and Encore Pro reported none.