Post Reply 
RERAs and Sleep Quality
Author Message
holden4th Offline

Advisory Members

Posts: 239
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #1
RERAs and Sleep Quality
While my treatment has been going well I still feel as if it could be better. Now that I have my new Remstar PRS160 I get to see more data than my S9 loaner could give me.

Sleepyhead results show that RERAs are the biggest events of my nights sleep. Last night I had 23 of them, mostly in the first three hours of sleep. I didn't feel that good this morning and am wondering if these are indeed true arousals and how they are affecting my sleep.

One suggestion is that I slightly raise my minimum pressure level.

[Image: KmGn0l.png]
10-11-2016 04:15 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,399
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #2
RE: RERAs and Sleep Quality
Just a quick correction. You are using a PRS1 Remstar Auto model 560, not 160. You are doing very good on the therapy, with nearly no leaks and very few indicators of obstruction like flow limitation or snores. You seem to have the pressures dialed in and get good stable therapy without a lot of pressure fluctuation. Hypopnea seems to be the dominant event, but RERA can be very tiring.

RERA can be a symptom of upper airway resistance, and bilevel is generally easier to work with to deal with it. That was t he reason I got a bilevel originally, even though most don't consider this a therapy problem. With the auto cpap, you can try small pressure increases and see if it improves the volume reductions of hypopnea and reduces RERA. Trying increases in minimum pressure of 0.5 cm at a time and observing the results is really the best approach, and leaves you the option to return to current prescription if it becomes uncomfortable. You have not crossed the pressure thershold to where you're seeing CA, so this option is pretty open to you and is the only tool I see you have readily availalble.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
10-11-2016 08:28 AM
Find all posts by this user Post Reply Quote this message in a reply
holden4th Offline

Advisory Members

Posts: 239
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #3
RE: RERAs and Sleep Quality
(10-11-2016 08:28 AM)Sleeprider Wrote:  Just a quick correction. You are using a PRS1 Remstar Auto model 560, not 160. You are doing very good on the therapy, with nearly no leaks and very few indicators of obstruction like flow limitation or snores. You seem to have the pressures dialed in and get good stable therapy without a lot of pressure fluctuation. Hypopnea seems to be the dominant event, but RERA can be very tiring.

RERA can be a symptom of upper airway resistance, and bilevel is generally easier to work with to deal with it. That was t he reason I got a bilevel originally, even though most don't consider this a therapy problem. With the auto cpap, you can try small pressure increases and see if it improves the volume reductions of hypopnea and reduces RERA. Trying increases in minimum pressure of 0.5 cm at a time and observing the results is really the best approach, and leaves you the option to return to current prescription if it becomes uncomfortable. You have not crossed the pressure thershold to where you're seeing CA, so this option is pretty open to you and is the only tool I see you have readily availalble.

Thank you for your reply Sleeprider. I increased the min pressure to 11.5 last night and it resulted in lower RERAs but still too high for my liking.

I did some research today and Flow Limitation came up when I typed in RERA. I've looked at the graphs where the RERAs occur but can't see the typical 'seat' signature of flow limitation where I have RERAs. However, the wave form doesn't look that normal either.

Another suggestion that came up in my research was to lower the EPR (Aflex). It's currently set to 2 and maybe I'll try at at 1. I'll leave the min pressure at 11.5 for a few days to see what sort of pattern develops.

If I do have UARS, how do I determine that?
10-12-2016 03:25 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
pupcamper Online

Advisory Members

Posts: 406
Joined: Nov 2015

Machine: PR DreamStation CPAP Pro
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 Pillows; Quatro Air FFM
Humidifier: DreamStation Heated Humidifier
CPAP Pressure: 10.5 cmH2O; no ramp; no C-Flex
CPAP Software: SleepyHead EncorePro

Other Comments: Lung cancer survivor since 11/2004; CPAP since 11/2015

Sex: Male
Location: Van Buren, Arkansas, USA.

Post: #4
RE: RERAs and Sleep Quality
I ended up turning Flex off and raising my pressure (fixed) to get rid of my RERAs. They only appear in sleep/wake junk now.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
robysue's Beginner's Guide to SleepyHead
10-12-2016 04:15 AM
Find all posts by this user Post Reply Quote this message in a reply
Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,399
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #5
RE: RERAs and Sleep Quality
When I had PRS1 Auto CPAP, I also changed Aflex to 1 and it did help. Keep in mind Flex is different from EPR and is flow based. People with good tidal volumes and normal exhalation flow will probably find lower flex numbers to be comfortable, while those with low volume or flow during exhale may never even see the full pressure reduction of a higher flex setting. Sounds weird, but true, and contrast that to the bilevel implementation of EPR in Resmed which always drops EPAP pressure regardless of respiratory effort, and does not recover IPAP pressure until spontaneous inhalation is initiated.

Anyway, take the changes slowly or you risk over-shooting the mark. It may take 3-days or more for a setting to settle in.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
10-12-2016 08:29 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
OpalRose Offline

Monitors

Posts: 3,181
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: #6
RE: RERAs and Sleep Quality
The approach I took to lower RERAs and Flow Limitations was to raise pressure slowly and set AFlex to 1. It didn't take much of an increase in pressure to accomplish this. Raised it .5cm until those events were pretty much gone.
Overall, I ended up with 1cm higher in miimum pressure.

OpalRose
10-12-2016 08:35 AM
Find all posts by this user Post Reply Quote this message in a reply
holden4th Offline

Advisory Members

Posts: 239
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #7
RE: RERAs and Sleep Quality
Thanks folks, I'll implement that tonight.
10-13-2016 03:58 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Reras and Dreamstation v Airsense10 marcus10 9 119 Today 06:32 PM
Last Post: marcus10
Information Vitamin D & B's and Sleep Quality membus 13 1,947 10-28-2016 05:35 PM
Last Post: mcsheltie
  Overall quality of sleep SamStamport 13 749 08-03-2016 08:18 PM
Last Post: Sn00zeAlarm
  Rental Airsense 10 - RERAs, Purchased - None?? DruiD 12 655 07-23-2016 10:26 AM
Last Post: DruiD
  RERAs - first time poster JJ7801 6 679 06-16-2016 05:49 PM
Last Post: DariaVader
  Could these be RERAs? EuroGuy 10 941 02-06-2016 04:53 PM
Last Post: vsheline
  RERAs do you trust your machine ? dwd1249 9 1,009 12-20-2015 08:30 PM
Last Post: sonicboom

Forum Jump:

Who's Online (Complete List)