Sleep study questions RE RERA's

betty303 · Post by **betty303** » Fri Apr 20, 2007 11:44 am

On my sleep study, during my baseline sleep of just a couple of minutes over 2 hrs, I had 6 OAs, 1 mixed, 30 Hypopneas and 74 RERAs (respiratory event related arousals) which resulted in 53.9 events per hour or AHI=18 & RERA=36/hr)

What are RERA's? What causes them? I had no nocturnal myoclonus (muscle twitches) and only 1.1 leg movements/hr.

What creates the RERA's?

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

Snoredog · Post by **Snoredog** » Fri Apr 20, 2007 12:05 pm

your RDI is 53.9 (sum of OSA and RERA's).

Diagnostic Criteria (Employing the Previously Specified Techniques)
Based on the American Sleep Disorders Association Criteria for Measurements, Definitions, and Severity Ratings of the Sleep Related Breathing Disorders Task Force Report[10] :

* Apnea is defined as the cessation of airflow 10 s
* Hypopnea is defined as a recognizable, transient reduction, but not a complete cessation of, breathing 10 s. A 50% decrease in the amplitude of a validated measure of breathing or a < 50% amplitude reduction that is associated with either an oxygen desaturation of 3% or an arousal must be evident
* Obstructive apneas and hypopneas are typically distinguished from central events by the detection of respiratory efforts during the event
* A respiratory effort-related arousal (RERA) is an event characterized by increasing respiratory effort for 10 s leading to an arousal from sleep but which does not fulfill the criteria for a hypopnea or apnea. A RERA is detected with nocturnal esophageal catheter pressure measurement, which demonstrates a pattern of progressive negative esophageal pressures terminated by a change in pressure to a less negative pressure level associated with an arousal. Novel techniques are available that may allow for increased technical ease in the detection of RERAs
* The RDI is defined as the number of obstructive apneas, hypopneas, and RERAs per hour averaged over the course of at least 2 h of sleep as determined by NPSG.

tillymarigold · Post by **tillymarigold** » Fri Apr 20, 2007 12:06 pm

My results defined RERAs as reductions in airflow that caused an arousal but weren't bad enough to be considered hypopneas. So my understanding is that they're caused by whatever's causing the hypopneas.

Snoredog · Post by **Snoredog** » Fri Apr 20, 2007 12:10 pm

[quote="tillymarigold"]My results defined RERAs as reductions in airflow that caused an arousal but weren't bad enough to be considered hypopneas. So my understanding is that they're caused by whatever's causing the hypopneas.

Guest · Post by **Guest** » Fri Apr 20, 2007 1:07 pm

Great - very helpful info.

So what do I need to be concerned with when I am working with my numbers? How do I know if the RERAs are improving or not - by the Flow Liimitation numbers?

The Respironics bi-pap print-outs have no flow limitation numbers llike the APAP and CPAP.

tillymarigold · Post by **tillymarigold** » Fri Apr 20, 2007 2:07 pm

Snoredog wrote: A Flow Limitation would qualify as a RERA if it didn't have the associated 3% drop in oxygen to classify it as a Hypopnea.

They don't usually show FL's on a PSG report unless they include it in the RERA scoring.

3%? My sleep study results said 10% desaturation to count as a CMS Hypopnea (no arousal necessary) and then a Partial Hypopnea required an arousal with no desat necessary. (In both cases, a pre-requisite was a 30% reduction in airflow lasting 10 seconds or more.) Different software maybe?

As I said, RERAs were defined as reductions of *less than* 30% that lasted 10 second or more and caused an arousal with or without desaturation.

Flow limitation occurred throughout my study (as in, whenever I was asleep the flow was limited) but not counted in any of my events including RERAs.