spontaneous microarousals? PSG sleep study

[tedtomato]

Hi,

Looking at the result of my full overnight sleep study/PSG, and trying to understand the data better, I had the following events (without CPAP):

Microarousals analysis table

1) Respiratory microarousals: 3.5 per hour
2) PLM microarousals: 0
3) Snore microarousals: 1.9
4) Spontaneous microarousals: 12.6



I am assuming:

1) are hypopneas and obstructive events, but then the AHI measured was 15.1 (including a large majority of hypopneas events).

Does this mean those events occurred but didn't wake me up very often, as they don't match arousal numbers (3.5 arousals per hour related to respiratory issues)?

2) related to limb movements/restless leg (clearly not an issue)

3) waking up due to snoring (would be fixed with CPAP, as I don't have snoring detected when using CPAP)

4) Not sure what those are, but clearly the main issues (61% of microarousals). Would those be RERAs (or are those included in 1)? RERAs don't seem to be included in the table on the right.

Thanks,
T.

[WickedLoki]

RERAs are Respiratory Effort Related Arousals. That would make the 1) category RERAs as you opined. Arousals and apnea events are not necessarily the same. An apnea event can cause an arousal but does not always do so.

[tedtomato]

So if I have understood properly, I have an AHI of 15 events per hour, but only 3 of those create arousal and therefore are disruptive to sleeping...

I am not clear if RERAs are part of the respiratory events as they are not listed as a category.

[chunkyfrog]

Remember, when there are a thousand cuts, some may not be as deep, but added together, they all cause damage.
Clinical classifications often only exist for purposes of documentation, and are of little relevance therapeutically.

[ajack]

you don't have any PLMD, so I would put the sleep study away, get out sleepyhead and work on your AHI

[tedtomato]

you don't have any PLMD, so I would put the sleep study away, get out sleepyhead and work on your AHI

I already have SleepHead, and can already achieve a very low AHI when on CPAP (sleep study results posted were without CPAP being used).

Actually, last night, I slept for 5 hours, and achieved an AHI of 0. Snoring was also 0. Still not feeling that refreshed in the morning.

From the numbers showing on the sleep study, it would seem that spontaneous microarousals are the main issue (60% of microarousal events).

Untreated "respiratory events" (hypopnoea, obstructive, central events and snoring) don't seem to account for a large number of arousals, according to the PSG numbers.

I am thinking that my issues are beyond just an AHI number/OSA, so could be RERAs from UARS, but my machine (Resmed Airsense 10 Autoset) does not report RERA events, and those can only be guessed by the machine anyway, as the machine can't measure microarousals (need electrodes to check change in brain waves).

According to Resmed, European models don't report RERAs, unless it's a "for her" version. I have no idea what the rationale for that difference with American models is.

[Jay Aitchsee]

Actually, last night, I slept for 5 hours, and achieved an AHI of 0. Snoring was also 0. Still not feeling that refreshed in the morning.From the numbers showing on the sleep study, it would seem that spontaneous microarousals are the main issue (60% of microarousal events).

Microarousals might be an issue, but sleeping only 5 hours is more likely the cause of not feeling refreshed.
What did your doctor say about the spontaneous arousals? Actually, they are quite common. See the referenced paper, EEG Arousal Norms by Age, for more insight. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564772/

Ensuring you are practicing good sleep hygiene could be beneficial.

[robysue]

Jay,

Thanks for the link. It's a very interesting paper and one well worth knowing about.