(06-30-2020, 06:54 AM)vrapche031 Wrote: Hi,
this was already asked a million times here and I went through some of the topics, also did a lot of googling. But I am having a bad day, feeling exhausted and I cant get my brain to understand what I am reading - so I am reaching out to some help.
I did my sleep test in Germany so the results are also in German and I think its missing some of the information that is needed for UARS diagnosis. So I think certain things were maybe not even checked. I will post both the original and the German version below, in case we maybe have someone who is from Germany to correct my translation .
Results :
Number of apneas: obstructive 7; mixed 0; central 3; hypopneas 145
Oxygen saturation: continuous (average value) 97.0%; minimum during sleep 94.0%; ODI 4.9%; PLMS index 6.3 /h ;
Anzahl der Apnoen: obstruktive 7; gemischte 0; zentrale 3; Hypopnoen 145
Sauerstoffsättigung: kontinuierlich ( Mittelwert ) 97,0% ; minimal im Schlaf 94,0%; Entättigungsindex (ODI) 4,9% ; PLMS-Index 6,3 /h ;
I can not post Oscar results because my machine does not support it, I only get information about my AHI, pressure and leakage results. In the last 3 months I had one night where I had 6/h central apneas, on other nights its going from 0/h to max 4/h ( on most nights its 1/h or 0/h ).
Does the fact that I have 145 hypopneas mean that its not UARS ? Since the AHI is above 5 ? I dont see any info about RERA events and I cant figure out if the oxygen levels are good or not.
I am currently on APAP with 7-14 pressure, usually the machine shows that I am somewhere around 8 to 12. But I still wake up feeling like crap so I am trying to fully understand whats happening. Any help is appreciated.
Hello...
Healthcare in Germany and Austria sticks to the AHI definition and negates the existance of UARS as I myself have witnessed it, RERAs are not scored.
Here is a nice interview of a man who defined the AHI and also defined the UARS:
https://doctorstevenpark.com/guilleminaultencore
My case is much less sever than yours. I have around 8 hypopneas per hour and they mentioned nothing about RERAs. I did have around 64 arousals per hour and no one even cared to question what that was. I still don't understand it very well.
Some of the arousals from the EEG are contributed to the hypopneas (namely 8 of them per hour) and the rest? I had around 1 periodic limb movements per hour so 1 arousal goes for that. What about the other 55?
Here I found a study that says for people my age it is normal to have 10 arousals per hour:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564772/
So I deduct that as well. So what about the remaining 45?
I have 45 arousals left I do not know what to attribute it to. So I guess I can assume they are RERAs or at least half of them.
To answer your question from what I was able to understand so far (I am myself a newbie)
HYPOPNEA AND RERA are the same sh*t.
airflow reduction that causes EEG arousal and interupts your sleep.
Hypopnea however has higher airflow reduction and oxygen desaturates more or equal to 3%.
Now that is not the case with RERA.
In RERA you are able to compensate that flow reduction by breathing stronger and deeper with more effort. That is why it is Respiratory EFFORT related AROUSAL.
So... obviously your brain knows you can not breath properly, how else would it get aroused and how else would you startd breathing with more effort? It is non sense to say it does not exist.
So.. before you develop these Hypopneas most likely you do have RERAs. Considering you had so littel obstructives, I guess, some logic tells me you most likely do have RERAs.
So, yes you officially do not have UARS because you have enough of hypopneas and have just touched the 3 % desaturation with each. But, forget about it... Drawing line between this is so stupid.
You can have someone who has RERAs all the time and yet still has 2 obstructives and 3 hypopneas per hour and then what? He has AHI of 5 and maybe 30 RERAs, then what? So had he shown AHI of 4 in that sleep study, you would consider it UARS but if he had 1 more hypopnea, then it is over and he does not count as UARS?
The goal is ideal breathing and just get a better machine, mandibular advacement device.
Whether they are RERAs or Hypopneas or Apneas, they all deserve to be ZERO and gone.
Drawing a line of AHI 5 was just a thing of procedure,
The answer is I do not know if you have UARS or dont because your AHI is high already, at the same time so you may have it and maybe not.
IF you stick to the definition, then no, you do not have it because definition requires AHI to be low. HAHA but definition is stupid.
One could have typical UARS with only RERAs for 4 hours and then turn on his back and get obstructives in REM sleep for 1 hour and end up having what then? High AHI while his sleep was constantly full of RERAs and thus breathing was UARS type of breathing most of the night.
As you can see, biology does not follow the number and line drawned by an insurance company.
What we do not for sure:
Air CAN NOT flow good and is limited> It MUST flow good with therapy.
Period.
The goal is always the same, have good inspiration and expiration curves, and as less arousals as possible.
TIPS:
For proper sleep study with manometry and nasal cannula contact this guy:
Hofklinik Prof. Dr. Med ARto Nirkko,
For diagnostics of anatomy of your airways CT scan, MRI scan, sleep endoscopy and MRI while sleeping contact: PD Dr.med. Dr.med.dent. - CHRISTINE JACOBSEN
Keep in mind everything I said might be wrong because I am a noob. If others say soemthing else then listen to them.