Auto Data Interpetation

RM-

In order to access and use ALL the data stored within the your S8, you'll need to purchase ResMed's AutoScan v5.7 software,and ResMed card reader, both of which are available on CPAP.com.

There's a thread under the FAQs button above about ResMed detailed data. In that thread, they point out that ResMed uses a SmartCard with an entirely different form factor than Respironics SmartCard, and so, the ResMed SmartCard will only work with a ResMed reader. Also, the drivers are all custom and the reader won't work without the proprietary drivers.

So, you're stuck having to shell out about $200 if you want to look at the detail data. You can take your SmartCard into your DME and they can download it for you, or maybe someone here has AutoScan 5.7 and the reader and you can send your card to them.

BTW, to download to the SmartCard all you have to do is to insert the SnartCard into the slot on the back. It'll do all the work, and tell you what its doing on the LCD screen. You don't have to do anything other than insert and remove the card when it tells ya to.

Chuck

I was able to download the data to the card successfully

Now, I just need to decide if that reader and software is worth it. For now, it doesn't seem necessary. What do you think?

I guess RM, the question is "How are ya sleeping and how do you feel???" If you're sleeping well, and feeling rested and zippy, then leave well enough alone. If you're not, then perhaps being able to monitor what is going on at night on a detailed basis would help you to make decisons about how your treatment should be managed.

For me, I've had frustrations, but I've made decisions based on the efficacy data that I get on the LCD and these decisions are beginning to pay-off. Besides, I'm a confirmed Macintosh fanatic, so the AutoScan software won't work on my TiBook. I AM very frustrated though that my sleepdoc ordered me a ResMed and then , it turns out, that HE doesn't have AutoScan, so HE can't view or use the detail data that the S8 will give him. I consider that to be close to malpractice and I intend to let him know that tomorrow during my first follow-up visit in 10 weeks of xPAP therapy.

I do consider the S8 to be a splendid, robust and very well designed APAP, and I have lots of faith in its algorithm, based on reviewing the literature. And, I AM feeling better; much less daytime drowsiness and much more energy. Besides, I'm the kind of person who would drive myself nuts if I had too much daily detail data to worry about. I'd constantly be wondering what the next tweak should be just to improve my data JUST A LITTLE BIT. So, I'm content without the software. I know that those here like Nighthawk, Snoozin' Bluez, Goofproof, Rested Gal, Wulfmann and several others appropriately feel that having the software and monitoring are a VITAL part of owning and taking control of your own treatment. I couldn't agree more, but I know myself well enough to know that it would drive me nuts, and sometimes limiting my own choices is a good thing for me to do.

Anyhow, whatever you do, I wish you the nest of luck RM, and from the frequency and flavor of your posts recently, it sounds like the S8 is working well for you!

Chuck

GoofyUT wrote:I AM very frustrated though that my sleepdoc ordered me a ResMed and then , it turns out, that HE doesn't have AutoScan, so HE can't view or use the detail data that the S8 will give him. I consider that to be close to malpractice and I intend to let him know that tomorrow during my first follow-up visit in 10 weeks of xPAP therapy.

In all seriousness, Chuck, I do understand how you might feel this way. You have certainly been a strong proponent for empowering physicians with maintaining control over monitoring and diagnosis.

When you think about it though, your sleep doc is just practicing his craft the way all physicians do. He looks at the patient's assessment (tired? family history, etc.), combines that with a snapshot of objective data if there is any (your sleep study, blood test, etc.), and then merely adds in his own assessment. How can he do any more than that? Don't be so hard on your physician. He's just a business man, Chuck. The only deity-like powers he has are those we mistakenly attribute to him. We have no right to expect him to have those powers, or to let him delusionally assume those powers.

Regards,
Bill

This IS getting interesting. My numbers today have me a bit puzzled. Press has decided to go up up up to the maximum level set today. But AHI is continuing to go down. AI is staying pretty low and HI is now starting to drop. Leaks have gotten even better.

17.0
Leak: 0.06 L/S
AHI: 7.5
AI: 0.7
HI: 6.8

Notice that I was on a CPAP with a 13 and now my pressure has gone up to the max of 8 to 17? I find this interesting. Yes, the number seem to reflect better results if I'm reading this right. But this leaves me wondering is it even using 8 other than the 10 start time. And would it go even higher with better results if it's ceiling was higher. Say 10 to 18 instead of 8 to 17. I don't know. Any thoughts? I do realize it's not at 17 all night, and that 17 is just what it took last night to totally take care of 95% of the apnea's.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, AHI

Thanks for your thoughts Bill. This has nothing to do with deification of my sleep doc. I see all physicians as technicians that I hire to do a job. I demand craftsman-like work from them. The EXCELLENT point that you bring up is that, though they might most often rely upon snap-shots of objective data, that in its own right is malpractice if they fail to avail themselves of EVERY bit of data available to them. As you know, decision making with the greatest risk is decision making with uncertainty, and making decisions without considering all AVAILABLE data is, by definition, making decisions with uncertainty.

In my case, the data IS AVAILABLE. My sleepdoc made the really bad decision of first ordering an APAP for me for which he lacks the capacity to view all the AVAILABLE data that it is capable of providing, and then, making decisions about my care without the benefit of ALL the available data, which is therefore, decision making under uncertainty and risky. I am grateful for the decision to order a ResMed because I am confident in tis capacities after reading the available literature myself, but I sure as hell wouldn't undertake treating a patient with a ResMed unless I could access the critical data that it provides.

I'm afraid that you misunderstand the nature of my previous posts. I don't suggest that any of us should deify our physicians. I see them merely as technicians. I do believe that we should be self-respecting enough to demand able, state-of-the-art care from these hired technicians as we would from any hired-hand. I think that you and I disagree only in that, you believe that most docs won't offer that able state of the art care for a variety of reasons, and recognizing this, we should abandon hope and do it ourselves. I, on the other hand, believe that those that don't offer able state-of-the-art care should be fired and cashiered, and that we should settle for nothing less from those we hire to provide us with a critical service that we pay for.

Chuck

GoofyUT, the alternative would've been a Respironics product, which also would've been good. But the new M series wasn't out when you got your machine. So, you would've had a nice Remstar Auto w/ C-flex instead. What I would do is first decide if you would've been ok with EITHER machine. Then decide which machine you would've preferred. If you would've preferred the S8, then yes your sleep doc should've had or should get software to help read his patients machines. Why else carry that brand? Not all sleep doc's have DME's in their office or so I am told. Mine did. The funny thing is I have no idea if my sleep doc can read this card or not. I know they're pushing Remstar Plus M Series with C-flex, which don't require software readers. That much I know. I know they said they don't usually carry Respironics. Are they the new kids on the block? Who's oldest, who's newest?

I don't see this as a huge problem. Can't the doc just get what he needs to read your card? I'm sure he has more than one patient who needs this. If he can't manage this, get a new sleep doc. Simple. I take the path of least resistance though and that might not be your goal here. You might want to "educate" him on the benefits of being able to read the machines he prescribes. LOL! What is this world coming to?

[Off subject sidenote: The new Donald Fagen album "Morph The Cat" is excellent. I'm listening to it now.]

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, C-FLEX, DME, auto

Yup, I LOVE Donald Fagen and I like Morph the Cat a lot. I have it on my iPod, and its my usual work-out music.

Re: the Respironics M series....Sorry, but you still need the reader/software for it to. Its just that the enw Pro2 isn't out yet (or just came out). That's the one with the data.

Chuck

Yeah, the respironics products seem to be in an inbetween phase with several new products coming out. Somehow I think the M series is just more compact, perhaps a new feature or two as well.

I was able to turn on the autostart feature easily last night and it works great!

Would you be concerned if your press number gets up to your maximum pressure number? Does that happen to you?

GoofyUT wrote:In my case, the data IS AVAILABLE. My sleepdoc made the really bad decision of first ordering an APAP for me for which he lacks the capacity to view all the AVAILABLE data that it is capable of providing . . .

I guess I forgot that you don't have the software to monitor your own therapy, Chuck. I can see why you might be a tad upset if you were expecting your sleep doc to do that for you.

GoofyUT wrote:I think that you and I disagree only in that, you believe that most docs won't offer that able state of the art care for a variety of reasons, and recognizing this, we should abandon hope and do it ourselves.

In the case of sleep docs, based on evidence seen here, they don't seem able to offer nearly the same state-of-the-art care we can provide for ourselves. Should they? I guess I'd let the market sort that out, Chuck. Problem is, that market forces aren't in play currently, and the forces which do drive medical practitioners do not drive them toward either efficiency or effective therapy. That fact is amply demonstrated by the exorbitant cost of sleep studies and the mere 50% compliance rate for xPAP therapy.

Rather than abandoning hope though, I simply look at reality and choose the most effective option currently available. One can wish things were different. One can say things should be different. Politicians do that all the time, for example, but hardly ever accomplish meaningful improvements. We could wait a really long time waiting for physicians to improve their practices. What's required is a radical change in problem solving. That simply can not happen overnight, or even in a small number of years. As a practical matter, I don't think I'm likely to live long enough for that to happen, not even if I live into my 90's as most of my ancestors have.

Regards,
Bill

GoofyUT wrote:I think that you and I disagree only in that, you believe that most docs won't offer that able state of the art care for a variety of reasons, and recognizing this, we should abandon hope and do it ourselves.

Which you are about to find out is the case with you as well, when your doctor won't order the Autoscan software and you will have to do it yourself.

Oh, the irony.

GoofyUT wrote:I've made decisions based on the efficacy data that I get on the LCD and these decisions are beginning to pay-off.

---snipped---

I know that those here like Nighthawk, Snoozin' Bluez, Goofproof, Rested Gal, Wulfmann and several others appropriately feel that having the software and monitoring are a VITAL part of owning and taking control of your own treatment.

GoofyUT, although I use a different machine (PB 420E auto) from the one you use (ResMed S8 Vantage auto), I believe the efficacy data you can see in the Vantage's window is ALL that a person really needs, in most cases, to give plenty of information for tweaking purposes. That and, as you said...how you feel. No need for software at all. Especially not the Autoscan software.

So, while I like having software if I'm using a Puritan Bennett machine or a Respironics machine, I don't think software is necessary at all with a ResMed machine. ResMed was very smart, imho, to design their machines to let the User see the most important info from the night before -- mainly, the AHI, leak, and 95th percentile pressure that was used. That's really all I'm interested in seeing from any machine I use. Unfortunately, it means having the software to get to see those simple facts from PB and Respironics machines. ResMed rocks, in that regard, for sure!! And they are top of the line machines anyway...again, imho.

Rastaman, I'm a big believer now in looking at other possible health issues if an autopap frequently has to use whatever maximum pressure a person sets for the top AND the AHI is not coming down below 5. I'd be looking for possible untreated or undertreated acid reflux disease. If throat tissue and/or vocal cords are being bathed in acid during the night, there will be swelling and rigidity of tissue that air pressure can't push aside. That might not be the case for you at all, but it's something to consider.

The following threads are about a person (loonlvr) using a REMstar Auto, but would apply to any autopap if GERD is an issue:

viewtopic.php?t=1800
Mar 10, 2005 subject: What is the REMStar Auto really doing?

viewtopic.php?t=1914
Mar 18, 2005 subject: What's REMStar Auto Really Doing? - new thread

viewtopic.php?t=5551
Nov 05, 2005 subject: SUCCESS AT LAST-GERD,420E, PRILOSEC AND BENADRYL

Rastaman wrote:I was able to download the data to the card successfully

Now, I just need to decide if that reader and software is worth it. For now, it doesn't seem necessary. What do you think?

Nope, I don't think the Autoscan software is something that would add enough to what you already can see in the Efficacy data on your ResMed machine to be worth buying that software.

Just find someone (perhaps on the message board) who can read and printout the card's data for you, if your doctor or DME can't. One printout of several days worth of data from the card will let you see the only thing of interest (imho) that you can't already see through the machine's window....how much time the machine is spending up at your maximum pressure setting...in the pressure graph.

Other than that, you're getting all the juicy info you need, in the Efficacy data displayed on the machine itself.

RG-
I by and large agree wholeheartedly with you, though as a clinician myself, I am curious about what goes on during various times during the night. And unfortunately, I require access to AutoScan to be able to view the detail data. The efficacy data is useful in terms of trending, and I know that I'm on the right track with the decisions I'm making based on using the efficacy data. But in terms of understanding the direct effect of various pressures on various events, it would take the detail data in the time domain to reveal that. Or, am I wrong about this? I am curious as well about my sleep architecture, though I know that the S8 won't be able to tell me that.

Chuck

Bill-
You make another really thought-provoking point. Market forces SHOULD be in play, and it is within our grasp to make that happen. We need to NOT ACCCEPT anything less than able, state-of-the-art care from our sleepdocs and our DMEs. We should demand it ourselves, and settle for NOTHING less. In that fashion, maybe we shift the focus from the medical establishment to the end -user as the customer that needs service for commerce to occur, and maybe WE bring the competitive forces into the market place rather than defeatedly hoping that our sleepdocs/DMEs will do it for us, and rebelling against them when the inevitably fail us.

To borrow the GREAT line from the GREAT movie, "Network":

I'M MAD AS HELL AND I'M NOT GONNA TAKE IT ANYMORE!!!

Call me a dreamer.

Chuck