What is a definition of RERA?

[Yousuf]

So looking through OSCAR data, it mentions a type of obstruction called a RERA. I'm getting extremely good AHI numbers, which my machine's own Dreammapper software keeps track of, but OSCAR tracks even more stuff. AHI seems to be the culmination of Apneas, Hypopneas, and Central Apneas. Which sounds like the worst major issues. RERA seems to be something more minor than even a Hypopnea, but I get a lot of these per night, but they aren't counted for the AHI numbers. I was told that an Apnea is a blockage in the airway of 70% or more. A Hypopnea is a blockage between 40% and 70%. So what percentage of a blockage is a RERA?

[Pugsy]

So what percentage of a blockage is a RERA?

There is no % of blockage for RERA. It is not a category of apnea event.

http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

[Yousuf]

So what percentage of a blockage is a RERA?

There is no % of blockage for RERA. It is not a category of apnea event.

http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

Okay, so according to this definition:

"Respiratory Event Related Arousal... a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea.”

There should be an arousal from sleep. That indicates to me that you should be waking up. But the number of RERA's indicated doesn't correspond to the actual number of wake ups I've ever seen. I think at most I may have woken up 5 times a night, and it's usually around 2 or 3 times. They are talking of RERA's of up to 20 or more per night, I'm definitely not waking up that much a night.

[zonker]

So what percentage of a blockage is a RERA?

There is no % of blockage for RERA. It is not a category of apnea event.

http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

Okay, so according to this definition:

"Respiratory Event Related Arousal... a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea.”

There should be an arousal from sleep. That indicates to me that you should be waking up. But the number of RERA's indicated doesn't correspond to the actual number of wake ups I've ever seen. I think at most I may have woken up 5 times a night, and it's usually around 2 or 3 times. They are talking of RERA's of up to 20 or more per night, I'm definitely not waking up that much a night.

you are. you just don't remember it.

and i don't mean YOU specifically. we all wake multiple times per night and don't consciously remember it.

[Pugsy]

I'm definitely not waking up that much a night.

Ahhhh....you are assuming that you remember all arousals/awakenings which is an incorrect assumption.
We only remember awakenings when we are awake long enough to form a memory.
Arousals/awakenings that are brief....we don't remember them.
Just because we don't remember them doesn't mean they didn't happen.

[Dog Slobber]

Adding to Pugsy's explanation; our machine's don't know absolutely that we have woken up.

It is flagging a breathing pattern consistent with an arousal, but without EEG, it doesn't know for sure.

[Yousuf]

Ahhhh....you are assuming that you remember all arousals/awakenings which is an incorrect assumption.
We only remember awakenings when we are awake long enough to form a memory.
Arousals/awakenings that are brief....we don't remember them.
Just because we don't remember them doesn't mean they didn't happen.

The reason I say that I'm reasonably sure that I'm not waking up is because often when I do actually awake is because of having to go pee. Typically on a normal night, I usually have to go every 2 to 4 hours, due to a diabetic medicine that I take. But when I take a sleeping pill, I go into a deeper longer sleep, and I may not wake up until 6 to 8 hours have passed. I know I've produced the same amount per hour, as when I wake up after 6 or 8 hours, my bladder is almost in pain, due to how full it is. If I do wake up other times than these, I would normally just go to the bathroom, this drug makes me produce quite frequently, during the day I often have to go once per hour.

[Yousuf]

Adding to Pugsy's explanation; our machine's don't know absolutely that we have woken up.

It is flagging a breathing pattern consistent with an arousal, but without EEG, it doesn't know for sure.

That makes some sense. That may be why Philips doesn't bother counting it in its standard stats, as it may not be that sure about it?

[Pugsy]

Believe what you want to believe but the evidence of arousals/awakening is easily seen on the flow rate graph by examining the breaths.
You just have to be willing to do the work to learn about it and do the detective work.
You have to do the work though. I am not going to do it for you.
http://freecpapadvice.com/sleepyhead-free-software

I would bet my last dollar that I have on earth that you don't remember all your arousals/awakenings. 100% sure of that fact.
Everyone has arousals so brief they don't remember them.

Have a nice day. I am done here....anyone else wants to chime in go ahead. I have other stuff I need to do.

Oh...Phillips does flag RERAs if you have them....RE on the events graph.
Same definition though. It thinks your breathing LOOKS LIKE the breathing seen on a lab sleep study where it is easy to spot for asleep vs awake status. Best educated guess is what both brands do since neither can tell for sure if we are asleep or not.

[palerider]

So what percentage of a blockage is a RERA?

There is no % of blockage for RERA. It is not a category of apnea event.

http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

Okay, so according to this definition:

"Respiratory Event Related Arousal... a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea.”

There should be an arousal from sleep. That indicates to me that you should be waking up. But the number of RERA's indicated doesn't correspond to the actual number of wake ups I've ever seen. I think at most I may have woken up 5 times a night, and it's usually around 2 or 3 times. They are talking of RERA's of up to 20 or more per night, I'm definitely not waking up that much a night.

Unless you have wires strapped to your head, you have no way of knowing how many times you've waked up, because of how the brain works, and doesn't form memories while sleeping.

[palerider]

Ahhhh....you are assuming that you remember all arousals/awakenings which is an incorrect assumption.
We only remember awakenings when we are awake long enough to form a memory.
Arousals/awakenings that are brief....we don't remember them.
Just because we don't remember them doesn't mean they didn't happen.

The reason I say that I'm reasonably sure that I'm not waking up

I'm starting to be reasonably sure you're just being an argumentative annoyance.

[ILoveFlowers]

Does an arousal mean that you woke up enough to resume breathing? Can a RERA be bumping you out of REM sleep but not to a state of consciousness?

[Pugsy]

Does an arousal mean that you woke up enough to resume breathing? Can a RERA be bumping you out of REM sleep but not to a state of consciousness?

Yes and yes...with clarification.
People can have arousals/awakenings and not necessarily be experiencing some sort of airway event. We can have arousals from lots of things not related to the airway at all so all it means is you woke up...as to why that is often unknown.

Any awakening/arousal can mess will all the sleep stages and potentially make us have to start all over with the sleep stages.
My OSA is 5 times worse in REM (roughly one event per minute in REM) and I simply wasn't getting much REM. Would get kicked out of REM very often.

As with anything though there are always exceptions and it's not a given that everyone will have the sleep stages totally messed up with apnea events or even RERAs or spontaneous arousals. Some people can and do go back to sleep in pretty much the stage they woke up in....but most of the time we get kicked out.

The only absolute rule with this stuff is "there are no absolute rules"....lots of YMMV stickers here.

I have a lot of arousals showing up in my flow rate but not many (very rare) RERAs because most of my arousals are related to other medical issues that I have. About the only time I might see an arousal related to some sort of airway event is when I see the arousal breathing AFTER a flagged OA or hyponea which means the apnea event caused the arousal and occasionally I might see RERA flagged at the same time. It's very rare though...90% of my arousals are totally unrelated to the airway itself and instead all related to other issues. On a bad sleep quality night I might have evidence of 50 plus arousals and still have AHI less than 1.0 and I never have flow limitations worth talking about and I might only remember actually waking up maybe a dozen time but my flow rate tells me I slept like crap and it usually corresponds with my feeling like crap as well. Not all sleep problems are airway related. I wish they were because they would be a lot easier to fix than the other medical issues that I have that mess with my sleep.

[ILoveFlowers]

Yes and yes...with clarification.
People can have arousals/awakenings and not necessarily be experiencing some sort of airway event. We can have arousals from lots of things not related to the airway at all so all it means is you woke up...as to why that is often unknown.

Any awakening/arousal can mess will all the sleep stages and potentially make us have to start all over with the sleep stages.
My OSA is 5 times worse in REM (roughly one event per minute in REM) and I simply wasn't getting much REM. Would get kicked out of REM very often.

As with anything though there are always exceptions and it's not a given that everyone will have the sleep stages totally messed up with apnea events or even RERAs or spontaneous arousals. Some people can and do go back to sleep in pretty much the stage they woke up in....but most of the time we get kicked out.

The only absolute rule with this stuff is "there are no absolute rules"....lots of YMMV stickers here.

I have a lot of arousals showing up in my flow rate but not many (very rare) RERAs because most of my arousals are related to other medical issues that I have. About the only time I might see an arousal related to some sort of airway event is when I see the arousal breathing AFTER a flagged OA or hyponea which means the apnea event caused the arousal and occasionally I might see RERA flagged at the same time. It's very rare though...90% of my arousals are totally unrelated to the airway itself and instead all related to other issues. On a bad sleep quality night I might have evidence of 50 plus arousals and still have AHI less than 1.0 and I never have flow limitations worth talking about and I might only remember actually waking up maybe a dozen time but my flow rate tells me I slept like crap and it usually corresponds with my feeling like crap as well. Not all sleep problems are airway related. I wish they were because they would be a lot easier to fix than the other medical issues that I have that mess with my sleep.

Thank you, Pugsy, you are a wellspring of information. I'm sorry you have to deal with other sleep issues on top of apnea, it's just the pits having all these interruptions to the sleep we need.

[Yousuf]

Any awakening/arousal can mess will all the sleep stages and potentially make us have to start all over with the sleep stages.
My OSA is 5 times worse in REM (roughly one event per minute in REM) and I simply wasn't getting much REM. Would get kicked out of REM very often.

How do you know you're in REM sleep? Have you tried increasing or decreasing your pressure?