High RERA Numbers

[SideSleeper]

Do high RERA numbers push up your AHI or do they just disrupt your sleep? For those that don't have Sleephead, RERA stands for "Respiratory Event Arousal...a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea."

I see my DME tomorrow afternoon and would like to try APAP. I'm doing very well on CPAP (on11 since strting on Sept. 11) and my 7 day AHI is 1.2, 30 day 1.5 a of today. I know he will say "why change a good thing" and say I'm doing great. I have a heart problem and am worried about Cheyne-Stokes Respiration and CA's. They both had high readings at first, but are going down now. I don't want to risk pushing CA's up with higher pressure. How can I get the RERA's down--they range from 50 to a low of about 15 per night. I had a AHI once this week of .3--it consisted of 1 CSR, 0 CA, 1 hypopnea, 1 OA and 35 RERA. I did turn off my ramp--set a 5--after a week or so because I couldn't breathe. I haven't changed settings on my own--want to get by my 3 month doctor's appointment before I do that! Have 100% all night compliance and 100% no Large Leaks. Thanks to all who try to help--great forum!

[kaiasgram]

RERAs are not part of the AHI.

The approach to reducing them would be more pressure.

[SideSleeper]

Thanks--didn't think they were. Now need to know just how they affect the overall sleep experience.

[kaiasgram]

Thanks--didn't think they were. Now need to know just how they affect the overall sleep experience.

They can cause fragmented sleep and daytime symptoms because of the arousals.

[SideSleeper]

That may be the reason for my never-ending yawns most of the day. I haven't fallen asleep in the late afternoon or evening like I used to and haven't taken a nap since I started the CPAP routine. My energy level hasn't improved much either. I usually only wake up once during the night--at least that I remember. I don't move around much--pain sometime interferes. I've had two rotator cuff surgeries in the past year--was just able to sleep on my side again when I got the CPAP--I'd been sleeping on my back for a long time. My right knee will be replaced in February and it causes sleep problems.

[JudgeMental]

As mentioned, RERA is an arousal statistic. With your mentioned health issues , it is certainly no wonder that you have a lot of RERA's.
RERA's can be caused by daily psychological issues, stress, pain, anxiety, spicy foods, too many issues to mention.
The arousals certainly interfere with the quality of sleep.
If a cpap were placed on most of the population (those not with sleep apnea) I feel sure that nearly all would record many events.

[SideSleeper]

Thanks you for your information, JudgeMental!

[Sleeprider]

I used a PRS1 Auto and had higher RERA than after I switched to BiPAP. In auto, I got good treatment at a pressure of 11 cm, but with BiPAP I use a minimum pressure of 12.5/8.5 (IPAP/EPAP), and pressures 13.5*8.75. So with the comfortable reduction of pressure for exhale, and slightly higher IPAP pressure, it works to keep RERA lower. I do trade off a small amount of CA, but my sleep feels better. RERA index is currently .2 to .6 and varies up to to 1.0 rarely. The RERA index on Auto was around 3.5.

I can't say bilevel is your answer, but a number of members here have similar experience with bilevel and RERA reduction.

[kaiasgram]

As mentioned, RERA is an arousal statistic. With your mentioned health issues , it is certainly no wonder that you have a lot of RERA's.
RERA's can be caused by daily psychological issues, stress, pain, anxiety, spicy foods, too many issues to mention.
The arousals certainly interfere with the quality of sleep.
If a cpap were placed on most of the population (those not with sleep apnea) I feel sure that nearly all would record many events.

Just a point of clarification: Arousals can be due to a number of issues like those mentioned above, but RERAs are respiratory effort related arousals that are due to flow-limited breathing. A RERA is a very specific type of arousal with a specific cause.

[SideSleeper]

I appreciate the information--anyone else with opinions, suggestions, etc?