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Could these be RERAs?
#1
Hi all,

I'd be grateful for your thoughts on my SleepyHead data.

I've been on CPAP for about 6 weeks now. My AHI is always below 1.0, with negligible leaks, but I don't feel any less tired at all.

My Resmed machine doesn't report RERAs, but from my amateur research efforts, I'm starting to suspect that I am getting a lot of RERAs during the night, which is the cause of my symptoms remaining.

I have lots of brief sleep arousals (100+ per night). I suddenly wake up feeling startled, then fall back to sleep again within seconds.

Do the attached screenshots look like possible RERA waveforms to you? I get these all through the night, sometimes as close as 30 seconds apart. My Resmed isn't flagging them as anything at all.


Attached Files Thumbnail(s)
           
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#2
I can't tell when the A10 you have was manufactured but I have an A10 and it reports RERAs which I can see in both ResScan and Sleepyhead. I'm no expert in graph interpretation but it is certainly possible these could be RERAs.

I also recommend you activate UF 1 and UF2 readings in sleepyhead. These are defined as episodes that are less than 10 seconds so don't officially qualify as apneas but nonetheless could interrupt your sleep. Look under the preferences tab. Once set refresh your data and you can look back and see what you find from last nights for these graphs.
Coffee
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#3
yes, try clicking on "events" just to the right of "details" in the upper left. Here is a shot of mine showing RERAs logged by my machine. Note that where the RERA is flagged in the flow graph, it does not look all that unusual. I have been wondering what the machine is looking for to define a RERA.

You asked if your data looked like RERAs were happening and I am saying it seems unclear what constitutes a RERA in the data other than the machine saying there was one.


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#4
Thanks for your messages.

rhodesengr, is there a flow limitation associated with that RERA event (if your machine shows that)?
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#5
well the event id flagged right on the flow graph and I don't see any particular flow limitation. It right on a peak that looks like the others. I think I read somewhere that the machines detect a RERA buy the breathing frequency. In my graph, the breathing rate near the REAR is faster than a bit later. You can see that in my plot.
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#6
Quote:I have been wondering what the machine is looking for to define a RERA.

I was reading an excerpt from the book Atlas of Polysomnography, and it says that Flow Limitation Arousals (FLA) correspond very closely with the RERA index. So in the absense of esophageal monitoring, monitoring flow limitation can be used as a substitute.

"Such events are characterized by flow limitation (flattening) over several breaths, followed by an arousal and sudden, but often temporary, restoration of a normal-round airflow profile."

When we look at your Flow Rate, at 00:28:45 the peaks have flatter tops until just after the yellow RE flag.
It would be interesting to see if that pattern of flattening corresponds with your other RERAs

00:29:45 could be you moving position. This is generally what the waveform looks like if someone moves position:
osahelp.com/rollover.jpg
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#7
I am pretty sure that the detection of RERA's does not happen on Resmed machines, but does on the PR machines.
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#8
(02-05-2016, 01:38 PM)EuroGuy Wrote: When we look at your Flow Rate, at 00:28:45 the peaks have flatter tops until just after the yellow RE flag.
It would be interesting to see if that pattern of flattening corresponds with your other RERAs

I see the flattening. When i get home from work, I can look at the other events and expand the scale to look for the flattening.

I guess what I still don't understand is how the machine detects an arousal. How does it know if you are awake or asleep? maybe from the breathing rate?

Sure it is possible I changed position. No way to know for sure though.

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#9
(02-05-2016, 02:00 PM)PoolQ Wrote: I am pretty sure that the detection of RERA's does not happen on Resmed machines, but does on the PR machines.

The most recent versions of the "Resmed Airsense 19 Autoset" machines *do* report RERAs. So does the "Resmed Airsense 19 Autoset for Her"
Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#10
The machine can't tell whether your asleep or awake.
Coffee
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