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I Need Some Educaation on RERA's Please!
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SideSleeper Offline

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Posts: 211
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Machine: PR DS560HS REMstar Auto-A Flex+ +
Mask Type: Nasal mask
Mask Make & Model: Respironics Wisp
Humidifier: Respironics System One
CPAP Pressure: APAP 12-12
CPAP Software: SleepyHead

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Sex: Female
Location: Western Oregon

Post: #1
I Need Some Educaation on RERA's Please!
I know RERA stands for Respiratory Event Related Arousals--and that is about all I know. How much do they effect sleep quality? I don't have Restless Leg Syndrome but sometimes move around a lot--especially now after knee replacement surgery trying to get comfortable. I always have RERAs--probably average 20-25/night since I started CPAP in September 2015. In the last 3 out of 4 days I've had 61, 69, and 62. I appreciate any information, advice, guesses, etc., that might be forthcoming! Thinking-about

03-05-2016 02:23 PM
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OpalRose Offline


Posts: 3,027
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: I Need Some Educaation on RERA's Please!
I used to experience a lot more RERA's that I currently do. They have really dropped over the last few months, and I can only assume its from tweaking my lower pressure upwards until I could see a difference in the RERA's. But what I also noticed was while getting results with lower RERA's, Flow Limations and snoring came way down too.

A RERA is a Hypopnea that hasn't grown up..."a Baby Hypopnea".

A Hypopnea is scored when the airway is collapsing, but there is still an effort to breathe, and lasting at least 10 sec.
A RERA is scored when the airway just starts to collapse, with an effort to breathe, usually resulting in arousal. A RERA doesn't last long enough to be flagged (Baby Hypopnea.), but as far as I can tell, it still affects your sleep.

Basically, you are arousing yourself before the RERA has a change to be flagged as a Hypopnea.

I don't see much written about it, and some machines don't record RERA's.

I'm sure that others on this forum are more knowledgeable than I am on this subject.

03-05-2016 04:17 PM
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vsheline Offline

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Posts: 1,905
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #3
RE: I Need Some Educaation on RERA's Please!
Hi SideSleeper

RERA stands for Respiratory *Effort* Related Arousal.

These are arousals caused by needing to exert excessive effort during inhalation because of partial obstruction in the airway.

All arousals kick us out of a deeper stage of sleep into either a more shallow stage of sleep or an awakening, and tend to prevent us from reaching deep restorative sleep and/or REM sleep, both of which we need.

RERAs are not counted in the AHI. AHI is the average per hour of the total Apneas plus Hypopneas.

The Respiratory Disturbance Index (RDI) is the average number of RERA per hour plus the AHI.

RERA is an obstructive event. Like all obstructive events, higher pressure tends to prevent RERA. Also, I think an A-Flex or C-Flex setting of 1 is best for avoiding RERA, because settings of 2 and 3 cause the pressure to drop earlier, while we are trying to finish the last bit of our inhalation.

If one is using ResMed EPR, I think higher pressure with an EPR setting of 3 is best for helping to avoid RERA.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 03-06-2016 03:25 AM by vsheline.)
03-06-2016 03:17 AM
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zonk Offline

Advisory Members

Posts: 7,907
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: I Need Some Educaation on RERA's Please!
From PRS1 Auto manual
Event definitions: RERA (Respiratory effort-related arousal) is defined as an arousal from sleep that follows a 10 second or longer sequence of breaths that are characterized by increasing respiratory effort, but which does not meet criteria for an apnea or hypopnea. Snoring, though usually associated with this condition need not be present. The RERA algorithm monitors for a sequence of breaths that exhibit both a subtle reduction in airflow and progressive flow limitation. If this breath sequence is terminated by a sudden increase in airflow along with the absence of flow limitation, and the event does not meet the conditions for an apnea or hypopnea, a RERA is indicated.
03-06-2016 03:37 AM
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