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+--- Thread: Lots of RERA (/Thread-Lots-of-RERA)
Lots of RERA - Greg Schultz - 07-04-2019
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Aloha From Hawaii.
I'm a long time CPAP user so I thought I knew something about it. Hah! To the point: I've attached an Oscar image that shows many RERA incidents. All my other measurements seem within reasonable boundaries, but the RERA was kind of a shock. I think I'm getting enough pressure, but the constant mini-disruptions (which I probably sleep through?) must be harmful to my deep sleep.
Could changing pressure or other machine variables possibly help?
I use a PR System 1 (Series 60) RemStar Auto with A-Flex. I noticed a mention of an Auto-Trial mode that lets the machine auto-titrate the user. I have the practitioner's
manual but it has nothing about activating or evaluating Auto-Trial. Ideas welcomed.
RE: Lots of RERA - Gideon - 07-05-2019
What is a RERA. A RERA is a series of flow limitations followed by an Arousal. These are best treated by Increasing pressure support or the difference between exhale and inhale pressures.
On your machine we can only raise pressure. Recommendations would be min pressure 11 max pressure 16.
Alternatively I would suggest an experiment. Your RERAs are clustered. With OSA this strongly implies a positional cause, the chin tucking. Assuming your flow limitations are based on restriction a soft cervical collar loose fitting which has been extremely effective for OSA,
RE: Lots of RERA - Sleeprider - 07-05-2019
Greg, the Respironics machines are a poor performer with flow limitations, and this is a case where a Resmed machine would be much better. I agree with the advise by Fred to increase minimum and maximum pressure. You can see the settings you are using now are maxed out at 12 cm. I'm certain if you look at a zoomed view of these sections, you will see flattened inspiratory flow, interspersed with some larger recovery breaths or arousals. The flow limitations may be related to positional apnea. Read the Optimizing Therapy wiki in my signature for some good details.
RE: Lots of RERA - Greg Schultz - 07-05-2019
Thank you Fred. With a weak vendor and somewhat disinterested physician, your responses are very valuable.
Sleeprider, thank you for the valuable input. I'll work with it.