Respiratory Event Related Arousals (RERA)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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cathyf
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Re: Respiratory Event Related Arousals (RERA)

Post by cathyf » Sat Jan 24, 2015 5:52 pm

palerider wrote:
enriquezx5 wrote: He really didn't want to look at only wanted to look at my monthly average AHI.
that's gross incompetence/ignorance.

and far too typical.
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enriquezx5
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Re: Respiratory Event Related Arousals (RERA)

Post by enriquezx5 » Mon Jan 26, 2015 8:43 am

Not sure what's going on now. Seems the higher the pressure and the more weight I lose, the higher my AHI goes. I bumped up from 8.0 to 8.5 last night and was woken up twice and this morning my AHI was well over 5. I will post screen shots from SleepyHead tonight.

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Re: Respiratory Event Related Arousals (RERA)

Post by Sleeprider » Mon Jan 26, 2015 9:05 am

enriquezx5 wrote:Not sure what's going on now. Seems the higher the pressure and the more weight I lose, the higher my AHI goes. I bumped up from 8.0 to 8.5 last night and was woken up twice and this morning my AHI was well over 5. I will post screen shots from SleepyHead tonight.
If AHI is increasing, it probably makes sense to back-off on pressure to your previous optimum level and consider your apnea may not be obstructive, but central. Hypopnea can accompany either obstructive or central apnea and RERA are often part of central apnea. During the night, do you find yourself not breathing? Do you just hang at the end of exhalation and not take the next breath until you are aroused and consciously initiate the next breath? It would help to zoom in on these events to see what is in the wave form data.

If you do have central apnea, that may need to be looked at by your specialist so that a more appropriate machines can be prescribed. As I noted in the second post of this thread, "if your centrals and periodic breathing mean anything, you may be on the wrong machine". You have been compliant on CPAP for over a year according to your first post, and yet your AHI remains unacceptable. From all appearances, increases in pressure to a level that minimally treats most OA, actually made things worse. The solution to your persistently high AHI and RERA may require some professional help.

When you wake up from apnea events at night, it helps to mark that on your data so you can go back and have a closer look the next day. I will allow the mask to momentarily to create a leak spike that is easy to find in the data.

This link goes to a tutorial on how to post data, put together by a member Krelvin. https://sleep.tnet.com/reference/tips/imgur

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enriquezx5
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Re: Respiratory Event Related Arousals (RERA)

Post by enriquezx5 » Mon Jan 26, 2015 9:18 pm

Prior to losing weight, I generally slept through the night. Recently though I have been waking myself up. For example last night during the spike shown in the attached I woke up.

I uploaded an overview and will add a close up of one of the events now. Tonight, I think I am going to ratchet the pressure back down to the 6.0 I was prescribed and see how things turn out.

Please let me know what everybody thinks of the data.

http://s1381.photobucket.com/user/chris ... 3813839831

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Re: Respiratory Event Related Arousals (RERA)

Post by enriquezx5 » Tue Jan 27, 2015 7:33 am

Further data from last night, 26 Jan 2015, continues to confuse my simple mind. I backed the pressure down to 6.0 and my AHI was down to 2.6. I'll upload data tonight.

Under what circumstances, would a person's AHI decrease with a lower pressure?

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Re: Respiratory Event Related Arousals (RERA)

Post by surf_rower » Tue Jan 27, 2015 7:39 am

palerider wrote:
enriquezx5 wrote: He really didn't want to look at only wanted to look at my monthly average AHI.
that's gross incompetence/ignorance.

and far too typical.
Right, my doctor's like that. Actually he just wants to know if I've been compliant. Not sure he even looks at the AHI. That's why this forum is a lifesaver.
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palerider
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Re: Respiratory Event Related Arousals (RERA)

Post by palerider » Tue Jan 27, 2015 8:54 am

enriquezx5 wrote:Under what circumstances, would a person's AHI decrease with a lower pressure?
there's no detail in ahi, you need to break out the data.

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Re: Respiratory Event Related Arousals (RERA)

Post by palerider » Tue Jan 27, 2015 8:56 am

surf_rower wrote:
palerider wrote:
enriquezx5 wrote: He really didn't want to look at only wanted to look at my monthly average AHI.
that's gross incompetence/ignorance.

and far too typical.
Right, my doctor's like that. Actually he just wants to know if I've been compliant. Not sure he even looks at the AHI. That's why this forum is a lifesaver.
which begs the question, "why do you go to him?"

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Re: Respiratory Event Related Arousals (RERA)

Post by enriquezx5 » Tue Jan 27, 2015 9:11 am

which begs the question, "why do you go to him?"
As sad as it sounds it because I know any new Dr. I go to will want to order a new sleep study. As everybody knows those are very costly.

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palerider
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Re: Respiratory Event Related Arousals (RERA)

Post by palerider » Tue Jan 27, 2015 9:25 am

enriquezx5 wrote:
which begs the question, "why do you go to him?"
As sad as it sounds it because I know any new Dr. I go to will want to order a new sleep study. As everybody knows those are very costly.
what are you getting from this alleged "doctor" that you need? it's certainly not useful information and help.

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Jay Aitchsee
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Re: Respiratory Event Related Arousals (RERA)

Post by Jay Aitchsee » Tue Jan 27, 2015 10:10 am

enriquezx5 wrote:Further data from last night, 26 Jan 2015, continues to confuse my simple mind. I backed the pressure down to 6.0 and my AHI was down to 2.6. I'll upload data tonight.

Under what circumstances, would a person's AHI decrease with a lower pressure?
Here's one instance, but I have not looked at your data, so it may not apply.
First, note that CA's are part of AHI, further, the machines have no way to know whether you are awake or asleep when these happen, only that you have stopped breathing and your airway is still open. If you are awake they wouldn't count in a lab (in a lab they use EEG to determine awake or asleep). If you rouse and roll over or move, you could hold your breath while doing so and this could be scored as a CA, but it's not a real Central Apnea because of the arousal - still it counts in the AHI scored by your machine .
Now, let's assume that you find higher pressure disturbing because of increased leaks, uncomfortableness, or whatever, and you are roused and hold your breath several time during the night creating (false) CA's. But when you lower the pressure, your sleep is less disturbed, CA's go down, and so does your AHI.
A small increase or decrease in AHI is not necessarily directly related to an increase or decrease in quality of sleep.

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Last edited by Jay Aitchsee on Tue Jan 27, 2015 10:22 am, edited 2 times in total.

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Re: Respiratory Event Related Arousals (RERA)

Post by Sleeprider » Tue Jan 27, 2015 10:11 am

enriquezx5 wrote:
which begs the question, "why do you go to him?"
As sad as it sounds it because I know any new Dr. I go to will want to order a new sleep study. As everybody knows those are very costly.
Get a copy of your sleep study for your records. That study is good for whatever doctor you use in the future. The whole sleep apnea problem needs to be dealt with as a component of your overall health. Once you're diagnosed, you're unlikely to spontaneously go into apnea remission. Your own doctor should be able to use information he gets from you to support your prescription needs in perpetuity. If you have problems you can't solve between the two of you, that is the time to resume a relationship with a specialist.

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