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CPAP Equipment: CPAP Software

CPAP Software

CPAP Software

CPAP Software allows you to track your therapy progress and performance over time. Data capable machines will allow you to use CPAP software to spot issues and get hard data to measure the performance of therapy changes such as switching masks. By working with your physician, a read of your data reports can give you both a detailed look at your therapy.

CPAP Software FAQs

What are data capable machines?

Data capable machines track your therapy progress and performance over time. Therapy data can be used to spot issues and used to see how changes to your CPAP setup effects your overall treatment. You and your doctor can use the therapy information to make changes in your setup. Some changes might be altering the mask or fit or increasing or decreasing your pressure to see if your therapy performance improves to ensure you are getting effective treatment.

The data capable machines not only let you know how many hours the machine was used, like pure compliance tracking machines, but also tracks advanced information such as AHI, Leak Rate, and Average Pressure (if using an APAP).

Depending on the machine, the information can be reviewed or accessed

  • On Machine Screen Display. Machines that display advanced tracking using the on machine display allow for fast review of therapy metrics. Many people like to use the on screen display to check every morning. Information such as AHI and leak rate for the previous night are displayed allowing the user to make adjustments such as mask fit. The information provided on the on machine screen is usually average values over different time frames, such as 1 day (last night), 7 night, 30 nights, etc.
  • SmartCode. SmartCode is a code that is accessed through the machine's display. This code is then inputted into the machine's product page on CPAP.com and a summary report is generated. You can see a Sample Report here. An example of an on machine display with the SmartCode is shown below. The only machine with advanced data capable SmartCode is the IntelliPAP AutoAdjust. The SmartCode provides therapy data averages for the following time frames: 1 day (last night), 7 day, 30 day, 90 day, and cumulative. This is like the information provided from the on screen display, however the information is displayed in chart format instead of a single number at a time. SmartCode Display
  • Optional External Software. Some machines have external software that can be used to download the data from the machine for detailed analysis. External software, unlike the on machine display or the SmartCode, allows you and your doctor to look into any night of use. Further, the information for any given night can be broken down hour by hour. This allows you and your doctor to look for patterns in your data through the night; for instance, do you tend to have more apneas in the early morning? Or do you begin to breathe with your mouth open in the middle of the night? Some external software is available for sale to patients, other software is only sold by the manufacturer to sleep professionals. External software may require other components to be able to get the information from the machine onto you computer with the software installed.

What are compliance tracking machines?

Compliance tracking machines only track the numbers of hours the machine is used. These machines do not track any advanced information such as AHI or leak rate.

Compliance machines are basic machines which the manufacturers made to be able to track usage hours. Compliance tracking machines are a manufacturer response to Medicare requirements that mandate DME (Durable Medical Equipment) providers show the Medicare patient used the equipment for the required minimum number of hours set by Medicare. DME providers cannot continue to be paid by Medicare without this information.

There is one billing code for all CPAP and APAP machines. Therefore a DME will be paid the same from Medicare or insurance whether they provide a patient with a more expensive machine that is data capable with more comfort features or a basic compliance tracking machine. Therefore, compliance tracking machines are the most common type of machine that is provided to patients through local DMEs.

There is software created to show the compliance information from the machine, however CPAP.com does not recommend purchasing this software. This data will only tell you how many hours you actually used the machine. It will not tell you how effective your therapy is.

What data capable machines are available?

CPAP machines which record full data (such as AHI and leak info):


AUTOPAP ("Autotitrating CPAP" or "APAP") machines which record full data:


BILEVEL ("BiPAP") machines which record full data:


CPAP Machines that only record Compliance Data (Hours Used) are:

  • IntelliPAP Standard Travel CPAP Machine
  • PR System One REMstar DS150 CPAP Machine
  • PR System One REMstar Plus CPAP Machine with C-Flex
  • PR System One REMstar 60 Series Plus CPAP Machine with C-Flex
  • PR System One REMStar 60 Series SE CPAP Machine
  • S9 Escapeâ„¢ CPAP Machine with EPRâ„¢
  • SleepEasy II CPAP Machine with Built In Heated Humidifier and C-Flex
  • SleepStyle 234 CPAP Machine with Built In Heated Humidifier

    How do I interpret my data?

    Software data can be interpreted by your physician or clinician. There are also many websites and search engines available to help you research the sleep apnea related terms which will provide you more knowledge in managing your own cpap therapy. CPAPtalk.com. our free Sleep Apnea forum is a great resource for CPAP users who want to understand their condition and take control over their health.

    How do I change the pressure setting of my machine?

    When a physician orders a pressure change, or a patient moves to an area with a very different altitude and does not have an altitude compensating machine, there are a number of ways to ensure you are receiving CPAP therapy at the correct pressure.

    Sleep laboratories and sleep disorder centers may be willing to make this pressure change. Just call a big local hospital or ask you physician for sleep lab phone numbers. Be sure to take your prescription.

    A second way is to do it yourself. We sell manometers that are very portable, accurate, and simple to use. All the machines we sell come with instructions on how to set pressure to physician orders. Most patients have little trouble doing this themselves. If you need help we can talk you through the procedure.

    Gauge Manometer (for pressure measurements)

    Fisher and Paykel Water Column CPAP Manometer with HC325 Chamber

    A third option is to ship the machine to us with the new prescription. We will set it and ship it back.

    It is the law and good common sense to run all sleep disorder devices at the prescribed pressure. If you think your prescribed pressure is wrong, talk to your physician.

    What is an APAP Machine?

    An APAP (Automatic Positive Airway Pressure) machine automatically adjusts on a breath by breath basis to blow the minimum pressure needed to keep your airway open during sleep. This allows your machine to provide you with your ideal pressure nightly.

    APAPs tend to be more advanced than CPAPs in that they normally offer more therapy tracking information and more comfort features. You can learn more about therapy tracking information in our Software section of the Learning Center.

    Every APAP machine can be placed in a CPAP mode to blow one straight pressure like a CPAP. However, no CPAP can automatically adjust pressure like an APAP. An example of an APAP machine is the DeVilbiss IntelliPAP AutoAdjust that comes with built in Smart Code therapy tracking software.
    IntelliPAP AutoAdjust CPAP Machine

    AHI (Apnea Hypopnea Index)

    Apnea Hypopnea Index is the number of apneas and hypopneas per hour. This index, as well as oxygen saturation levels (O2 Sat), is used to determine how severe a case of Sleep Apnea a patient has.

    To determine AHI add the total number of apnea events, plus hypopnea events and divide by the total number of minutes of actual sleep time, then multiply by 60.

    Example:

    Apnea + Hypopnea divided by actual sleep time, then multiply by 60

    200 Apneas, 200 Hypopnea (400 Total Events)

    420 Minutes Actual Sleep time (7 hours * 60)

    Divide 400 by 420 =.95 x 60 = 57 AHI (Severe OSA)

    The Severity of OSAHS as defined by the American Academy of Sleep Medicine Task Force (1999) is:

    AHI < 5 Normal
    5 =< AHI <15 Mild
    15 =< AHI <30 Moderate
    30 =< AHI Severe

    Hypopnea

    A hypopnea is a decrease in airflow by at least 50% for ten seconds or more, with a 3% desaturation of blood oxygen level.

    BR Arousal index

    BR Arousal index is the number of breathing related arousals (apnea, hypopnea, snoring & RERAs)multiplied by the # hours of sleep.

    What types of Software are available?

    There are two types of software available: Compliance software, and Advanced software.

    Compliance software provides data such as patient hours, total machine operating hours, your pressure setting, and pressure relief information. Advance software includes compliance data and provides more detail such as AHI (Apnea/Hypopnea Index), Leakage, most pressure used, and a detailed usage histogram.

    Compliance software is available with some standard CPAP machines. Advanced software is available with most top of the line CPAP machines, APAPs, and Bi-level machines as well.

What does CPAP software do?

CPAP software allows the downloading of information from certain CPAP machines. Information on breathing, pressure levels delivered, apneas, etc. is available to help determine the effectiveness of CPAP therapy. Software is not required to operate a CPAP machine. CPAP Software also provides more data than obtained through the on screen display or SmartCode. The CPAP Software also allows you and your doctor to drill into any night of data recorded and view the data on an hour by hour basis.

Some CPAP manufacturer maintains a proprietary software package that is only compatible with their machines.

Here is a list of each manufacturer and the name of its related full data software:

  • Philips Respironics: EncorePro - sold for Sleep Professionals
  • Philips Respironics: EncoreViewer 1.0 - sold for Patient Use
  • Puritan Bennett (Legacy 420 Series): SilverLining 3.10 - sold for both
  • Covidien: Sandman Series Therapy Software 1.2 - sold for both
  • Resmed: ResScan 3.3 and ResScan 3.7 - sold for Sleep Professionals
  • DeVilbiss: SmartLink Therapy Management Software - sold for both
  • Fisher & Paykel: Performance Maximizer - sold for both

Here is a list of each manufacturer and the name of is related compliance software:

  • AEIOMed: DataRest Compliance Software Kit - sold for both
  • Fisher & Paykel: Compliance Maximizer - sold for both

What reports are shown when using SmartCode?

The IntelliPAP AutoAdjust generates advanced user data. The IntelliPAP Standard only generates basic compliance information. See the image below for a complete breakdown of the reports available for each type of IntelliPAP. See a Sample Report.

SmartCode Comparison

What are SmartCode Report Definitions?

This is a list of report topics generated when using SmartCode to track therapy effectiveness.

Usage Threshold: Determines the minimum amount of time that the patient must use the device to be logged as a compliant day. Device settings allow for 4 or 5 hours, with 4 hours being the default setting. This setting can be changed in the device clinical set-up menu.

Adherence Score: Shows the maximum adherence achieved for any period of thirty consecutive days of use within a ninety-day time frame. The score represents the percentage of days, within thirty consecutive days, where usage met or exceeded the 'Usage Threshold.' The Adherence Score reports the 'best' consecutive thirty days of usage. For example, if the 'best' 30 out of the last 90 days show 22 days used above the usage threshold and 8 days below the threshold, then the Adherence Score would show 73% (22/30). For this calculation, the usage must be continuous hours and longer than the Usage Threshold.

Days at Least X Hours: Shows the number of days in the timeframe where the total usage within each day is at least X hours. "X" represents the 'Usage Threshold' setting in the patient's device. For this calculation, all usage within a 24-hour period is recorded.

% Days at Least X Hours: Shows the percentage of days in the timeframe where the total usage within each day is at least X hours. "X" represents the 'Usage Threshold' setting in the patient's device. For this calculation, all usage within a 24-hour period is recorded.

Day Count: Shows a count of days for each timeframe. If, for example, the 90-day code is collected at day 45 of therapy, then the "Day Count" for this code will be 45 days. In most cases, however, the day count is equal to the days in the code's timeframe(s).

While Breathing Hours: While breathing hours are only available within the last-day timeframe and with the cumulative code. This measurement shows the total hours of use.

95th Percentile Pressure: AutoAdjust pressure was at or below this pressure 95-percent of the time it is in use.

90th Percentile Pressure: AutoAdjust pressure was at or below this pressure 90-percent of the time it is in use.

AHI: Apnea/Hypopnea Index (AHI) represents the average number of apneas and hypopneas per hour for the timeframe.

Pressure Plateau Time: Represents the percentage of time the AutoAdjust spent at the upper pressure setting. A value of 10% or more indicates a possible need to raise the upper pressure setting to allow higher pressures.

High Leak Flow Time: Shows the percentage of time where leak was above 95 liters per minute. A value of 10% or more indicates that the mask fit should be checked.

NRI: Non-Responding Event Index (NRI) represents the average number of non-responding events per hour. A non-responding event is a respiratory event that is detected but by design does not result in a pressure change during AutoAdjust therapy.

EPI: The Exhale Puff Index (EPI) is the number of exhale puff events detected per hour. Exhale puffing is caused by inhaling through the patient circuit and exhaling through the mouth.

PLM arousal index

PLM arousal index: The number of periodic limb movements that cause arousals multiplied by the number of hours of sleep.

RERAs

Respiratory event-related arousals. Episodes that are not apneas or hypopneas, often related to loud snoring, that generally do not cause a decrease in oxygen saturation.

RDI (Respiratory Disturbance Index)

Includes apneas and hypopneas, and may also include other respiratory disturbances such as snoring arousals, hypoventilation episodes, desaturation events, etc. They are often identical, but depending upon what is scored, the RDI may be larger than the AHI.

Spontaneous arousal index

Spontaneous arousal index: The number of spontaneous arousals (e.g. arousals not related to respiratory events, limb movements, snoring, etc) multiplied by the number of hours of sleep.

Total arousal index

Total arousal index: Total number of all arousals multiplied by the number of hours of sleep.

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