help with my sleep report

I joined this form about a month ago when I first got a CPAP. I have since had a battle with flu and pneumonia, but am back now.

I had 2 sleep studies - one where I was told I had moderate OSA, and the second that determined that I needed CPAP of 7. But despite asking, my sleep specialist doctor never actually went over the results of the study. Finally, after my 3rd frustrating visit, I just asked for a copy of the report (which I had never seen, nor had they ever showed me.) I am trying to find a new sleep specialist, but in the meantime I am wondering if you all can help me understand what is in this report.

1ST STUDY (NO TITRATION)

2 apnea events, mean duratioon of 16 seconds.
26 hypoapnea events, mean duration of 19.9 (longest 35.5). Which brings me to my first question: What is a hypoapnea event?

RESPIRATORY EVENTS:
apneas and hypoapneas: 28
RERA's: 159 total
Total Respiratory Arousals: 186 (147- non-REM; 39 REM)
Spontaneous EEG Arousals: 33

Which brings me to my next question: What is a RERA? I know it stands for "Respiratory Effort-Related Arousal", but I do not know what that means. And RERA's prevented by CPAP?

PLM's: 0. But in my titration study, it is indicated that I had a total of 186 PLM's. Why would I have 0? Does that indicate that the machinery was not working properly on my legs?

TITRATION STUDY:
0 apneas or hypoapneas
RERA's: 72
Arousing PLMs: 28
Non-arousing PLMs: 158
Spontaneous EEG Arousals: 113

So overall, if you could help me answer those specific questions above, that would be very helpful. Also please help me know what further questions I should be asking.

Let me know if you need more information.

I thank you in advance.

--Greg

gtaylorfry wrote: Which brings me to my first question: What is a hypoapnea event?

I think of a hypopnea as a "baby apnea." Apnea is no, or almost no, airflow. A hypopnea is "some" airflow but not enough.

gtaylorfry wrote:Which brings me to my next question: What is a RERA? I know it stands for "Respiratory Effort-Related Arousal", but I do not know what that means.

You're right about what "RERA" stands for. It means you were having some difficulty getting enough air, and your respiratory muscles were trying to get more in, but couldn't. Your brain "aroused" you just enough to breathe better. You were probably not waked up by it enough to remember being "aroused", but you were aroused enough out of whatever stage of sleep you were in to "breathe better." Arousals fragment the sleep stages and don't let you stay in whatever stage of sleep you were in as long as you should. Arousals are disruptive to getting restful sleep. So, even though a "RERA" isn't necessarily an apnea or a hypopnea, it means your breathing was not "good enough", so your brain issued an arousal signal to get you breathing better....to get you breathing better BEFORE the event deteriorated on down into having an apnea or a hypopnea.

gtaylorfry wrote:And RERA's prevented by CPAP?

Yes. RERAs can be prevented by CPAP at a pressure that keeps your airway open enough to breathe easily.

gtaylorfry wrote:PLM's: 0. But in my titration study, it is indicated that I had a total of 186 PLM's. Why would I have 0? Does that indicate that the machinery was not working properly on my legs?

I don't know.

gtaylorfry wrote:So overall, if you could help me answer those specific questions above, that would be very helpful. Also please help me know what further questions I should be asking.

I suppose the question I'd ask the sleep doctor is why so many arousals are continuing, despite CPAP being used.

And... with the appearance of the "PLMs" during the titration, are those respiratory-related post arousal Limb Movements? Or has CPAP given true Periodic Limb Movement Disorder a chance to surface?

Generally speaking, a doctor will give the patient as much information as the patient requires of them. If a few sentences seem to suffice as going over the results, they aren't likely to keep going thru details. Before you decide to find another doctor, you might want to for your next visit tell the scheduler you want enough appointment time for a line by line discussion of your results. That long of a visit isn't routinely scheduled. As the visit begins, tell the doctor you scheduled enough time for a line by line explanation of your report. Have your copy with notations by unclear items. However, by the time you do some reading here, I doubt you'll even feel the need for an all encompassing discussion, rather will want it more targeted.

But you may be scheduling another appointment about those limb movements if they persist. They may settle down after a bit of time on cpap, but if they don't, you may need to have them studied while on cpap. There are some limb movement issues that might not be apparent when there are so many breathing related arousals, but when the body and brain quiets and sleeps, they can emerge. I don't know your sleep situation, but an observer's report on any nighttime movements could keep you in tune to their status. 28 arousals from these alone would be pretty disruptive to your sleep. Hopefully they will resolve.

Kathy
P.S. I see now that Rested Gal has it covered. You're on the ball, RG.