what is the treatment for RERAS?

I notice on my sleep studies I have Reras. I know they are respiratory events, but what is the treatment? Is the cpap suppose to treat it? I'm still waking frequently and looking for answers.

Hi Mary,

Yes, according to the American Academy of Sleep Medicine, CPAP is used to treat RERAs (Respiratory Effort Related Arousals) The idea is that they are a separate demonstration of airflow limitation from apneas and hypopneas. According to the AASM, the CPAP titration process should continue until RERAs are also reduced to a minimum. I think they say less than 10 per hour. That high a number can still have a bad effect on your sleep, though, so you should probably be trying to get the total of flow limited events (Apneas, Hypopneas and RERAs) as low as possible. Do you have a data capable machine? What type of mask? What CPAP pressure was prescribed?

If you give people here some details about your equipment and treatment, they may be able to help.

Right now I have just a plain cpap with no data but compliance. I have an appt. with a new sleep doc(Dr. Barbara Phillips) tomorrow. The Dr. I am currently seeing has me on a straight cpap of 5. I kept telling them it's not working and their response was dental appliance or surgery. I've tried the appliance and surgery was not an option. They were not willing to try to adjust my pressure. I think they are missing something. I keep my mask on every night but I never stay asleep. A cpap friend and I looked over my studies and saw that I had reras and wondered if they are what is keeping me awake. The Dr. I'm seeing tomorrow is not as conservative as my current one. The tech I spoke with thought she might autopap me for 30 days to see what is going on. I am just waiting impatiently to get some sleep.

frustratedmary wrote:Right now I have just a plain cpap with no data but compliance. I have an appt. with a new sleep doc(Dr. Barbara Phillips) tomorrow. The Dr. I am currently seeing has me on a straight cpap of 5. I kept telling them it's not working and their response was dental appliance or surgery. I've tried the appliance and surgery was not an option. They were not willing to try to adjust my pressure. I think they are missing something. I keep my mask on every night but I never stay asleep. A cpap friend and I looked over my studies and saw that I had reras and wondered if they are what is keeping me awake. The Dr. I'm seeing tomorrow is not as conservative as my current one. The tech I spoke with thought she might autopap me for 30 days to see what is going on. I am just waiting impatiently to get some sleep.

Mary, when you see Dr. Barbara Phillips tomorrow, please tell her there's a cpap-usin' woman down in Tennessee who admires her! I've never met Dr. Phillips, but I've read/seen quite a few of her presentations over the years, starting with a PowerPoint presentation she gave back in 2004 to the American Lung Association of the Central Coast. The presentation was called, "Not Every Patient Needs to Go to the Sleep Lab."

More recently I heard a Podcast of a Sleep Magazine interview of Dr. Phillips -- when they were getting her thoughts about Medicare's imminent (at that time) acceptance of portable home testing for diagnosing OSA.

I like Dr. Phillips' oft made statement about how some people are such obvious OSA cases that "even the janitor at the sleep lab could diagnose them." She does tell it like she sees it!!

The lady has great common sense in addition to being an extremely intelligent doctor, board certified in pulmonology and in sleep medicine.

Can you tell that I think Dr. Phillips rocks!!
(Please get her autograph for me -- I'll send you my mailing address if you can get me her autograph! Seriously.)

frustratedmary wrote:The Dr. I am currently seeing has me on a straight cpap of 5. I kept telling them it's not working and their response was dental appliance or surgery. I've tried the appliance and surgery was not an option. They were not willing to try to adjust my pressure. I think they are missing something.

I think you're right -- that the current doctor is missing something if he's not willing to try adjusting the pressure. A few more cm's would hurt to try, imho. Geeze, you'd think the doc would at least TRY that rather than talking about surgery. Is he an ENT by chance?

Also, since your machine shows only hours of use and no useful information about your treatment, there's always the possibility that massive mouth air leaks are compromising your therapy. Your profile showed that you have a nasal mask, not a Full Face mask. You'd think that if mouth leaks are bad, they'd wake a person up, but not necessarily. Hope Dr. Phillips will want you to have a machine that can show more than just "hours of use."

Good luck, Mary!

Dear Rested Gal, Joy from Kentucky had told me about Dr. Phillips so I took her advice and made an appointment. It's about an hour and a half but its worth it for expert advice. I did have an ENT consult but the Dr. didn't think I was a good surgical candidate. I would have had to exhaust every other possibility before seriously considering it anyway. Hopefully Dr. Phillips will have some tricks in her bag for me. I'll try to remember to get her autograph for you. I have a feeling if I forget there will be other opportunities to get it. The tech I spoke with to make my appointment really impressed me so I surethe Dr. will too.

I also came across Dr. Barbara Phillips writings when researching sleap apnea on the web, and was very impressed. She is very progressive and would rather see someone with all of the clincal signs of OSA get an APAP with no PSG than stand on ceremony. If she was close to me I would have camped outside her office door to see her.

You've got a good doc there.

Thinking about you and know much good will come from this appointment. Call me when you get back ~ can't wait to hear all about it.
"Tonight could be the night!"
L

Saw Dr. Phillips and she was great. A no nonsense kind of doctor and she spent plenty of time with me. She gave me so many ideas to help improve my sleep. Trying the first one tonight. She set my cpap from a 5 to a 9. She thought five was way too low.