RERA question

Hello smart people.

I split my time primarily between two locations with a few days a month at a third property. For a while now I thought I was seeing a pattern and now I am quite certain.

I seem to get much higher RERA numbers at the location where I sleep on an old school, full wave waterbed?

(Overall I have the highest numbers (1.10 -ish) in the RERA section. The obstructive is usually 0.25-ish or lower and the hypopnea 0.30-ish.)

Could the extra movement in the waterbed possibly be responsible for the RERA increase at that location? I am not really certain what RERA are?

Also (since I am asking questions), about six months ago my very new airsense seemed to be having a problem with it's on/off button. I was scared it was going to break and so I began using the auto on/off feature. (a tip I learned here) I really like this feature, but I am embarrassed to tell you how often I come back hours later and my mask is still blowing. I have to hold it up for a few seconds to make it stop. I am certain this is causing some issues with my sleepyhead results.

Overall, I think my sleepyhead results are pretty good. I am feeling good. I love the cpap as it puts me right to sleep, but occasionally I do wonder about my sleepyhead data and try to get motivated to understand it a little better .

Thanks in advance for any hints or clues about RERA that you may want to share.

hi Grace~~~~~~~~ so nice to see you are back.

Great you found a partner. Love is the best medicine. I think the RERA's are transitional and due to the new pattern. Your CPAP has to adapt to the new situation.

Do you have the CPAP also on the water bed ? maybe just don't put Him/ForHer in between this new forming relation. Ask your CPAP and your lover if it is OK.

A RERA is basically a milder form of sleep disturbance than an apnea or hypopnea.

Your numbers are quite good. But you should post SleepyHead results if you want help from people here to fine tune them.

SleepyHead supports reporting either AHI or RDI (which is AHI plus RERA events). Too bad it's either/or. Can't report both at the same time. But it's real easy to do the math yourself.

AHI = clear + obstructive + hypopnea
RDI = AHI + RERA

I had a plethora of RERAs using the 7-20 pressure settings my DME set me up with. After a number of months I changed my pressure to 8-15 and my RERAs vastly reduced. My Dreamstation is supposed to auto-adjust but increasing min pressure manually has turned out better for me than allowing the machine to decide to increase automatically. Previously my RDI was sometimes above 5.0 and now it is consistently around 1.0. Just that little bit of increased minimum pressure made a big difference for me.

Here's a link to Wikipedia explaining RERA. Sorry it's not a real link I can't do those since I'm not registered.

https: //en. wikipedia. org/wiki/Respiratory_disturbance_index

There are also plenty of other resources around including SleepyHead documentation.

well ... before you jump to conclusions, you should consider the obvious!

your machine, the resmed airsense 10 (autoset / for her) does not report "artefacts" or any kind of indications of "falsifications" of the signals. It does not even track a duration for the RERAs.

your RERA-count is kind of low - it would help to see the distribution of that through the night, but the most obvious would be: it is you (or your partner) turning around in the bed!

someguy28 wrote:well ... before you jump to conclusions, you should consider the obvious!

your machine, the resmed airsense 10 (autoset / for her) does not report "artefacts" or any kind of indications of "falsifications" of the signals. It does not even track a duration for the RERAs.

your RERA-count is kind of low - it would help to see the distribution of that through the night, but the most obvious would be: it is you (or your partner) turning around in the bed!

Thank you for the insights. I only wish my waterbed had the excitement of ESEL's story. The waterbed has one of those 'so embarrassingly cheesy bad I'm going to pretend it's hip' headboard shelves and the cpap sits in one of those cubbies. (I'm sure those cubbies have seen more interesting toys) So the cpap itself is stable while recording but I definitely move around a lot more in that bed than the others.

I read the link GUEST provided about the definition of RERA. Thank You, I wasn't even thinking of RERA like a light obstruction? I somehow thought it was in a category all it's own? Now I am all curious about my esophagus? I can tell I don't still understand, but I like that information bouncing around in there ... looking for a place to fit. One analogy away from some 'RERA insight'.

...and SOMEGUY28's idea that I am just waking up more often due to the squishy nature of the bed is exactly what I thought.

...which would mean it isn't part my biology or any sort of apnea at all. That is what I have been thinking since I noticed this sudden RERA waterbed connection.

So I think I can cautiously ignore the fact that RERA make up the biggest (YELLOW) portion of my colorful SleepyHead circle.



On my other question?
Is the issue of the auto off/on sometimes not turning off a common problem?
I feel terrible wasting hours on the machine and am always shocked when I find I've messed up and it's still blowing away.

What would sleepyhead experts expect something like that to do to your numbers?
Where or what stat would you look at if you were 'detective reading' sleepyhead and were able to detect "OH, that has been blowing in to the pillow for 8 hours?" Knowing that it wasn't something a human would be doing.

Grace~~~ wrote: On my other question?
Is the issue of the auto off/on sometimes not turning off a common problem?
I feel terrible wasting hours on the machine and am always shocked when I find I've messed up and it's still blowing away.

What would sleepyhead experts expect something like that to do to your numbers?
Where or what stat would you look at if you were 'detective reading' sleepyhead and were able to detect "OH, that has been blowing in to the pillow for 8 hours?" Knowing that it wasn't something a human would be doing.

Actually the machine knows if you are attached or not. If you aren't attached and the machine continues to blow it will show up as "breathing not detected" and any AHI or whatever numbers you see are going to be based on the time you were attached and it could detect your breathing.
Breathing detected time frame gets removed from all the calculations so it really won't affect the actual therapy hours or AHI or whatever.

You could also just turn Smart Start on and the machine will stop on its own when it detects "no breathing" as long as your pressure is 6 or 7 or more. That feature doesn't always work so great at the lower pressures.
Smart Start on...means you can take a few breaths and the machine will start on its own and if you remove the mask it will turn itself off fairly quickly so there really won't be any "breathing not detected" flagging.

Hi Pugsy!

That is great to know that the machine can detect and fix that mistake blowing! So smart.
One more thing to not worry about!

YAY ... because I think my numbers are pretty good and I was afraid that perhaps they were artificially good due to that once every two weeks or so unmasked blowing.

I do have on smart start (which I called auto on/off) - smart start is MUCH catchier! Smart Start was when I began getting the mistake blowing. I almost never touch the button, which I love.

...but when I pull my dreamware mask off over my head in the morning sometimes is doesn't "smart stop".

Not often. I am fairly cognizant that I have to hold my mask in the air for 6-10 seconds to make it turn off.
Which is silly because I could just touch the off button ...but I fear my button is somehow damaged and about to break.

If you have Smart Start turned on and the machine doesn't turn itself off within a respectable length of time in the morning after you remove it the perhaps your pressure being used at that time is so low that the machine is having a bit of trouble.
Seems like low pressures along with some nasal pillow masks can confuse the machine a bit when it comes to the Smart Start.
I think I read where ResMed says that Smart Start might not work so great at pressure below 7 cm.

If it doesn't turn itself off within 15 to 30 seconds just reach over and push the button. Letting it blow for hours is going to be harder on the machine motor in the long run than pushing that button for a millisecond.

I've been 8-12 for a long time. No doubt I am due for a tweaking but I've been focused on other issues and cpap is one of the better parts of my life. So I've just left well enough alone.

Most days the smart start shuts off. Usually though I have to hold the mask in the air for a bit. I think the dreamware sides collapse just right sometimes so that I think it's off but it's only pinched.

I am sure I could retrain myself to do it manually but I just thought the smart start was so nifty. And I thought it was saving the life of my on/off button to boot.

If it only happens sometimes...I wouldn't worry about it but you eventually need to manually shut it off if it is blowing for very long.
Probably you were at the 8 cm pressure and with the mask the machine can't tell if you are attached or not.
Maybe the times it does work you are using a higher pressure.

Which do you want to wear out first...the blower or the on/off button?