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AHI or RDI
#1
AHI or RDI
I changed the data in SH from AHI to RDI last night. My AHI was 0.26 and my RDI was 1.76. The RDI figures were basically made up of RERAs which were 1.53. While both sets of readings are good, is the RDI a better way of determining sleep disturbance? While my RERAs have dropped on BiPAP I'm still looking to get them lower or is 1.53 OK?
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#2
RE: AHI or RDI
I know I'm repeating what others have said here before. It's not just about numbers.

How do you feel?

Are you sleeping well at night?

When your numbers get down to where you have them you can start adjusting for comfort.
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#3
RE: AHI or RDI
If it helps you work with it to improve your sleep, by all means, do so. Getting RDI under control further improves AHI.
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#4
RE: AHI or RDI
Your question got me to reading up on RERA's. In a sleep study they use EEG's to detect RERA's. I'm not so sure the Machines are all that accurate when it comes to RERA's. It's probably why API is used on the machines instead of RDA.
Of course I have no idea. Just a total guess on my part.
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Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#5
RE: AHI or RDI
Walla Walla has a very good point there! The same way the machines can not really detect a central apnea (left alone central hypopneas) they cannot really detect RERAs - the important part beeing the A. With the RER-Part they are as good (or bad) as with all other events.

RERAs are a diminishing flow, which ends in strong breaths (similar but not the same as the "recovery breaths").

Guess what happens, if you turn around in your bed? Noone can change position without changing the breathing pattern. (If your bed is very soft, this increases - but that does not mean that on hard beds you are able to change position without changing your breathing pattern.)

So, if you see the occasional RERA once in a while - most likely it is just that! - Let's call it an artefact.
If you see on the other hand a lot of flowlimitations and maybe even hypopnoes before the RERA - chances are good, that it is a "real" RERA.
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#6
RE: AHI or RDI
Wanted to add this for thought.

From RobySue’s  Beginner's Guide to SleepyHead:

    "Because the RERA algorithm is proprietary and is based on just flow rate data rather than (flow rate + belts + EEG), it's important to

understand that RERA flagging by the Philips Respironics machines should be considered an "extra" that is probably not always accurate. The RERA

algorithm probably flags things that aren't real RERAs and it probably misses some real RERAs as well."
 


So all things considered I'd ignore the RDA number and be happy with the API number.


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#7
RE: AHI or RDI
respironics are (by long) not the only ones that flag RERAs - ResMed does too (in the Airsense 10 - with the european firmware only in the For Her model!) - Weinmann / Heinen + Loewenstein tracks RERAs as well (although highly aggressive - but they do score artefacts as well!)

in the current clinical guide from resmed (at least in the german one) is a pretty good explanation about what gets scored as a RERA - although ResMed does not score a length for them.

RERAs are real!

The events scored by the machine are never meant to be end-user-informations! - they have to be put into perspective! Not every central or clear airway apnea is a central apnea - as is not every obstructive apnea - or UA!
The machines try to do the best they can with the very limited informations they can gather - nothing more - nothing less - some are in some cases better than others - some are in some cases worse. Depends on the machine, the problem (disease) and the circumstances (and the patient)!

however - if you have plain OSA, RERAs are not the primary concern - but that does not hold (by long) for every xpap-patient!
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#8
RE: AHI or RDI
TBNx, Never said RERA's weren't real. I just meant in this case with a RDA below to 2 and a API below 1 it's not worth trying to get the RDA any lower. Of course the RERA can be important. I agree with you.
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#9
RE: AHI or RDI
I meant no offense - I was just putting the not that up2date quote into perspective!

Data - meaning screenshots - from the distribution of these RERAs would help a lot - as well as some closer looks on the flow!
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#10
RE: AHI or RDI
I'm pleased that this has opened up discussion on RERAs. For me they are usually the major RDI indicator, outscoring all other forms of apnoea. My feeling is, that if I can reduce these then I will feel even better than I already do. Walla Walla, I am sleeping well at night and feel OK in the morning though I have felt better on PAP therapy in the past. At this point of my therapy I'm having trouble distinguishing between fatigue caused by OSA and general fatigue. If I don't use my machine then I certainly feel very crappy. I am tired at parts of the day but I work hard. I no longer am in the situation where I just spontaneously nod off.

I see the therapy as an ongoing journey to dial in that sweet spot that has me jumping out of bed in the morning.

TBMx, a very interesting point about the true nature of RERAs

Walla Walla has a very good point there! The same way the machines can not really detect a central apnea (left alone central hypopneas) they cannot really detect RERAs - the important part beeing the A. With the RER-Part they are as good (or bad) as with all other events.

RERAs are a diminishing flow, which ends in strong breaths (similar but not the same as the "recovery breaths").

Guess what happens, if you turn around in your bed? Noone can change position without changing the breathing pattern. (If your bed is very soft, this increases - but that does not mean that on hard beds you are able to change position without changing your breathing pattern.)

So, if you see the occasional RERA once in a while - most likely it is just that! - Let's call it an artefact.
If you see on the other hand a lot of flowlimitations and maybe even hypopnoes before the RERA - chances are good, that it is a "real" RERA.



BTW, last nights AHI was 0.72 with
3 OA
3 H
3 FL
6 RERA

The RDI was 1.45
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