If RERAs are so bad, why aren't they a part of the AHI?

Earlier today I started a more general thread about CAs and RERAs, but I thought this was a little different.

In lowering my pressures in an ongoing effort to control leaks I have discovered that my AHI numbers have actually come down as I've decreased pressures. I can only attribute this to more effective therapy as a result of better leak management. But looking back on my data for the last several months it has become obvious to me that my RERA number has increased as I have lowered my pressures. My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

Being a guy who is into knowing these things, or more correctly, trying to know things, I've come across articles that say RERAs are about as bad as any other SDB event. In particular, a doctor named Barry Krakow says that they are but one event on the continuum of SDB events and should be treated as such.

In short, I'm wondering if I should ease my pressures back up a bit to try to lower the RERA events, or is anything under "5" acceptable? And even if they got up to say "8" or whatever, should I still let how rested and good I feel during the day be my guide? I currently feel pretty darn good during a day when I got 5+ hours of sleep the night before with a good leak line and an AHI under 1.0-regardless of what the RERA number is. I almost wish I hadn't become aware of it.

Yes, I could easily have invented something to worry about but now that I'm aware of it I need to resolve what if anything I should do about it.

I should say that in my case PAP therapy isn't only about feeling better; sleep apnea was evidently a precipitating factor in my onset of Atrial Flutter, which I'm truly concerned about and trying to do what I can to keep at bay.

If you are lowering your pressure and you are having RERAs. I am wondering if you are also snoring. Do you see vibratory snore in your report?
If you are taking your pressure down to much you maybe causing other problems. This is such balancing act.

My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

feeling better

SHADDUP!

What?

OhHelpMe wrote:

My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

feeling better

SHADDUP!

Pardon me?

old dude wrote:

OhHelpMe wrote:

My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

feeling better

SHADDUP!

Pardon me?

Julie wrote:What?

Ignore them, OhHelpMe. People around here are grumpy by nature and lack anything even resembling a sense of humour. Don't worry, I got it.

ddk wrote:
Ignore them, OhHelpMe. People around here are grumpy by nature and lack anything even resembling a sense of humour. Don't worry, I got it.

+1

Very good OhHelpMe.

Let's see if today someone comes along and expounds on your perfect shorthand advice!

ChicagoGranny wrote:

ddk wrote:
Ignore them, OhHelpMe. People around here are grumpy by nature and lack anything even resembling a sense of humour. Don't worry, I got it.

+1

Very good OhHelpMe.

Let's see if today someone comes along and expounds on your perfect shorthand advice!

Well tell you what Granny, perhaps then you could explain it to me-OK?

I posted a serious question that was of concern to me, particularly as a bit of a newbie. Now I have a sense of humor to rival anyone's, but I can discern the difference between good clean fun and smart-aleckness. Can you?

I get it if the question was beneath anyone, but it was a serious question.

old dude wrote:

ChicagoGranny wrote:

ddk wrote:
Ignore them, OhHelpMe. People around here are grumpy by nature and lack anything even resembling a sense of humour. Don't worry, I got it.

+1

Very good OhHelpMe.

Let's see if today someone comes along and expounds on your perfect shorthand advice!

Well tell you what Granny, perhaps then you could explain it to me-OK?

I posted a serious question that was of concern to me, particularly as a bit of a newbie. Now I have a sense of humor to rival anyone's, but I can discern the difference between good clean fun and smart-aleckness. Can you?

I get it if the question was beneath anyone, but it was a serious question.

old dude,

I am sorry your question wasn't taken seriously.

If I am interpreting your previous message correctly, you're sleeping pretty well in spite of the elevated RERAS right? If that is the case, then I wouldn't worry about them. If you're not, then that is another issue.

Sorry, I am not that knowledgeable on their technicalities so that is why I can't really give you a detailed response. But I did want to respond since all you have been receiving are mostly smart allecky replies.

49er

49er wrote:

old dude wrote:

ChicagoGranny wrote:

ddk wrote:
Ignore them, OhHelpMe. People around here are grumpy by nature and lack anything even resembling a sense of humour. Don't worry, I got it.

+1

Very good OhHelpMe.

Let's see if today someone comes along and expounds on your perfect shorthand advice!

Well tell you what Granny, perhaps then you could explain it to me-OK?

I posted a serious question that was of concern to me, particularly as a bit of a newbie. Now I have a sense of humor to rival anyone's, but I can discern the difference between good clean fun and smart-aleckness. Can you?

I get it if the question was beneath anyone, but it was a serious question.

old dude,

I am sorry your question wasn't taken seriously.

If I am interpreting your previous message correctly, you're sleeping pretty well in spite of the elevated RERAS right? If that is the case, then I wouldn't worry about them. If you're not, then that is another issue.

Sorry, I am not that knowledgeable on their technicalities so that is why I can't really give you a detailed response. But I did want to respond since all you have been receiving are mostly smart allecky replies.

49er

Thanks much 49er!

OhHelpMe wrote:

My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

feeling better

SHADDUP!

old dude, I think your question was taken seriously but answered in a brief funny way. Maybe OhHelpMe is a little frustrated with his own therapy and envious of your results.

I think what he is saying, in an abbreviated way, is if your AHI is below zero and you are feeling well, you should not worry about a small number of RERAs. You are doing very well!

The machines are just "guessing" at RERAs anyway. In a lab you have sensors on your chest to measure Respiratory Effort and sensors on your skull to make an EEG and measure Arousals. Your CPAP does not have this capability and uses some crude algorithms to "guess" when you are aroused from sleep. So again, don't worry about a small amount of arousals.

OhHelpMe, That was funny. Sorry that others did not get it. Maybe the next time you have a funny quip you can follow behind it with an explanatory post.

A home-machine-reported "RERA" is not a real lab/center-reported RERA. A home-machine "RERA" is only a maybe-possibly-could-be-perhaps so-called "RERA." So to keep yourself from chasing ghosts the rest of your life, go by how rested you feel instead.

Just to oversimplify dial-wingin' a bit: Choosing a CPAP pressure as a home dial-winger is mostly a matter of trying either (1) a higher pressure or (2) a lower pressure. Once you have found the pressure (or range of pressures, in the case of APAP) that consistently gives you the lowest home-machine-reported average AHI, you are through with phase one of dial wingin'. Phase two is not to start chasing other ghostly info that a home machine may report, which is given only for trending info. Phase two is to tweak based solely on how rested you feel in the mornings as averaged over weeks of time. You tweak for feeling rested without increasing AHI, if possible.

Dr. K. was talking about REAL RERAs. NOT home-machine-reported maybe-possibly-could-be-perhaps so-called "RERAs." And he is talking about the people he treats--people who don't feel better once their AHI is down, not all people everywhere.

Get your sleep as good as you can get it, but no better.

jnk wrote:A home-machine-reported "RERA" is not a real lab/center-reported RERA. A home-machine "RERA" is only a maybe-possibly-could-be-perhaps so-called "RERA." So to keep yourself from chasing ghosts the rest of your life, go by how rested you feel instead.

Just to oversimplify dial-wingin' a bit: Choosing a CPAP pressure as a home dial-winger is mostly a matter of trying either (1) a higher pressure or (2) a lower pressure. Once you have found the pressure (or range of pressures, in the case of APAP) that consistently gives you the lowest home-machine-reported average AHI, you are through with phase one of dial wingin'. Phase two is not to start chasing other ghostly info that a home machine may report, which is given only for trending info. Phase two is to tweak based solely on how rested you feel in the mornings as averaged over weeks of time. You tweak for feeling rested without increasing AHI, if possible.

Dr. K. was talking about REAL RERAs. NOT home-machine-reported maybe-possibly-could-be-perhaps so-called "RERAs." And he is talking about the people he treats--people who don't feel better once their AHI is down, not all people everywhere.

Get your sleep as good as you can get it, but no better.

Well put and thoughtfully explained- I appreciate it very much!

old dude wrote:My AHI numbers have been fairly consistently less than 1.0, but my RERA number has been in the 3-5 range.

Mazel tov! You're golden. Stop fretting.

old dude wrote: Well tell you what Granny, perhaps then you could explain it to me-OK?

I posted a serious question that was of concern to me, particularly as a bit of a newbie. Now I have a sense of humor to rival anyone's, but I can discern the difference between good clean fun and smart-aleckness. Can you?

I get it if the question was beneath anyone, but it was a serious question.

Oh for crying out loud, do you even have a skin? Get over yourself.