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Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
#1
Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
I have a longer thread from a couple weeks ago that I am still trying to sort out data from but I have a more specific question about trying to interperet the data between the two machines that I didn't want to update the thread that has fallen dead.  Basically I was switched from a Dreamstation Auto CPAP to a AirCurve 10 Vauto BiPap.  Looking over the old CPAP data on the dreamstation it reports RERA, Variable Breathing, and Pressure Pulse events.... but I have not seen the Resmed/AirCurve report any of these events in the several months since I've been switched over to the BiBap.  I can "eyeball" see identical breathing patterns .. but they are not marked in the same way across the two different machines.  Is this normal?  Is there any way to get richer reporting data using the Aircurve?

Is there a way to get graphical/summary data for inspiration/expiration data over time?  Since my PE in the fall of 2019 my average Expiration time has increased (from ~2.5 to ~5).. which I can tell by looking at the data, but while I see respiration rate and volume in the graphs/overview sections I don't see where I can pull time data?

For folks that were following the old thread -- the variable breathing events post PE seem to line up with my SPo2 drops/pain spikes when I switched back to the dreamstation CPAP (AHI / SPo2 dropouts seem no different with CPAP or BiPAP machines).  Still no real answers/solutions - but it's looking like BiPap isn't particularly helping either =(.
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#2
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
I could be way off base, but maybe these items aren't showing because they didn't happen. Admitted, I never have used a VAuto and without a proper machine for therapy, I'm not familiar with what info OSCAR would show for your machine.

It may be helpful to show a representative OSCAR screenshot for the VAuto. As with any machine, unless proven as acceptable, I don't think a setting of 4 at the minimum will offer acceptable therapy. Most will feel air starved and it may allow apnea events to occur.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
I'm not sure either... it does seem strange that, while I didn't show RERA/Variable Breathing events *every* night prior to switching to the bipap.. that I haven't seen any of them at all in 3 months.  I don't know if it is a dreamstation specific thing.. or if my machine is borked.

20190918_CPAPPrePE is CPAP data pre PE
20191114_CPAPPostPE is CPAP data post PE
20200249_BiPap - Shows some of the same breathing patterns that were flagged on the dreamstation, which I think should be flaggged (and also O2 drops corresponding with the breathing pattern changes)


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#4
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
(05-10-2020, 02:54 PM)Desiree Wrote: Is there a way to get graphical/summary data for inspiration/expiration data over time?  Since my PE in the fall of 2019 my average Expiration time has increased (from ~2.5 to ~5).. which I can tell by looking at the data, but while I see respiration rate and volume in the graphs/overview sections I don't see where I can pull time data?

I found how to show Expiration overtime on Overview graphs...

File -> Preferences -> Waveforms -   Check "Overview" next to the Expiratory Time


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#5
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
That's good for you. Wait on pressure and chart guys. I'm OK at my own chart reading, but when it comes to others' I mostly miss the dartboard.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
Now that I found the graphs I mentioned the Inspiration vs Expiration thing to my plumonologist via portal msg that SarcasticDave94 had mentioned in the other thread... and pulmonologist replied back either my machine is broken or the graph is broken because my median inhalation time can't be 1.18s...  

:Confusedcratches head::  

Is there something buggered with my data/machine how OSCAR is reading data from the Aircurve?


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#7
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
I don't know how you get these flow rate graphs. There cannot be inspiration without expiration yet your graphs show it 2 out of 3 closeups. Could be the machine, but it looks like you have found a way to get around your mask. I have no idea how you get such bizzare flow rates, and it was present in your previous Philips graphs as well. The SpO2 results make no sense n relation to flow rate which is unchanged through the segment you showed, but is far from normal because most of it is missing.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
(05-10-2020, 08:08 PM)Sleeprider Wrote: I don't know how you get these flow rate graphs.  There cannot be inspiration without expiration yet your graphs show it 2 out of 3 closeups.  Could be the machine, but it looks like you have found a way to get around your mask.  I have no idea how you get such bizzare flow rates, and it was present in your previous Philips graphs as well.  The SpO2 results make no sense n relation to flow rate which is unchanged through the segment you showed, but is far from normal because most of it is missing.

I thought that might be the case as well, but I really don't think it is.  So what possibilities does that leave?  The machine being wrong - but since all three machines report similar breathing patterns  (S9 - my original machine, the dreamstation, and the aircurve) is that likely?  I don't know how to get data off the AirMini to see I have an issue there?  The AirCurve is the worst of the other three esp with recording little to no inhalation time .... I know the dreamstation and resmed use different algorithms... but I thought that was in how it reacted to the patients breathing not in what it recorded? 

Could this be a bug instead with how OSCAR is reading/recording the data?  Some of my pressure data seems also wonky (even before I imported the old CPAP data and before I upgraded to the latest release of OSCAR). 

Stuff I've tried since the other thread:
  • I switched off of the hybrid & nasal style masks and am currently wearing the F20 strapped down nice and snug...  
  • Gotten the oximeter that works with Oscar & I've synced the watch and the machine to a time server.. and I am "starting" recording at the same time as I start my therapy at night.
  • Wearing a separate oximeter in alarm only mode on the opposite arm as the one that is recording CPAP data.  Set it to alarm at 80% at night, when it wakes me.  1) verify readings on both devices are reporting the same data.  2) focus on breathing to get my SPo2 back up.  I figure there is something wrong if my O2 is dropping below 80% on 5L O2 on BiPap.
  • I have even set up a video record to see if I was taking off stuff in the middle of the night... and I'm not.
What I do see in the video.. is the same thing that happens when I am awake when my O2 drops.. is the "pained" look/flinch / breath-hold / reserved / very shallow breathing until the pain passes.   I've tried wearing mask/oximeter while awake to record episodes and see identical readings during SPo2 drops awake or alseep.  Which to me says this isn't just a sleep apnea issue.  I asked the plumonlogist about "awake" apneas and he pretty much brushed me off... along the lines of I must have dozed off been mistaken etc. 

I am trying to pick apart this puzzle myself, but am at a loss for where to go next.  It's like I unravel one piece of the puzzle and only to get on another stuck... my breathing patterns shouldn't look like *this*.. but they do... so now what?  I'm trying to eliminate variables.. logging/noting anything from body temperature to bp to mask/settings to anything else I can think of... dual oximeters.. video recordings.. so fustrating =(


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#9
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
I'm pretty sure it's not the machine or OSCAR, especially with the same pattern showing up on multiple machines. Your respiration is at 12 BPM and that means each cycle is 5-seconds. During the inspiration with no expiration episodes the pattern looks like a quick snif of inspiration followed by expiration that escapes detection in the mask. The SD and PC events are independent of the PAP therapy, but seem to be flagged appropriately, and there are a lot of them. The only way I know to get to the bottom of it would be an observed sleep study, but the people that do sleep studies have no imagination, so they won't look for this or pick it up. I am yet to find a member of this forum that can get a specially designed study. I suppose you could eliminate the possiblity of oral expiration around the mask by taping. At this point I'm stuck with saying it is what it is, and we don't know why.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Dreamstation CPAP vs Aircurve BiPap data? Data over time for Insp/Exp?
If it was escaping detection wouldn't the mask pressure look different for the flow rates for the ones with missed expirations?  

In the zoom attached the Video recording shows odd breathing pattern, the pain spike, SPo2 monitor/display dropping down to 88% (the one not attached the OSCAR recording at 06:09 ish), pain passing, normal breathing pattern resuming.   Not quite sure how to describe the odd breathing pattern.. but it bloody hurts to breathe so while I am exhaling its "soft" / extremely guarded... I can see potentially why machine might not be picking it up Post PE.. prior to the PE, not a freaking clue why it wasn't being picked up.    

The part of the original inquiry is still in my mind... Resmed doesn't seem to be picking up / flagging any of the RERA/PB/variable breathing events that the dreamstation did.  Do BiPaps or Resmeds not detect these events? If I switch the mode on the AirCurve to CPAP might it pick up those flags? Is it something proprietary to dreamstation CPAP machine?

On sort of good news I was able to insurance to agree to an appointment with an alternative pulmonologist for a second opinion who also happens to be board certified in sleep apnea for next week.   Exceedingly annoying that won't let me see him directly for sleep apnea, but crossing my fingers that knowledge in both specialties might prove useful in untangling this mess.


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