RERA's?

This area is for discussion of Sleep Studies used in the evaluation of Sleep Apnea.


RERA's?

Postby ELLENVH » Mon Aug 29, 2011 9:56 am

I had my first sleep study conducted in June 2011. I was very surprised to get the diagnosis of severe sleep apnea. I have snored my whole life and always loved to sleep - but I never thought I had sleep apnea. I guess wanting to take naps every day was "my normal". I just chalked it up to having two young children. Even though tired, I have always been able to function (knock on wood).

My apnea rate per hour was 0.4 and my hypopnea rate per hour was 2.4. The doctor was not concerned with those. My RERA rate per hour was 41. The doctor was very concerned with this. The lowest my oxygen dropped to was 89.0 but the report says my average baseline was 97.0 - so not worrisome.

The doctor is putting me on CPAP and said all my events were partial obstruction and tonsil removal might significantly benefit me. What do you all think? The doctor is an ENT who specializes in sleep at a very well respected hospital.

Then in July I went for my titration study and when the pressure was at 13 - I still had 5 RERA's in 33 minutes. The report said the results indicated a partially occluded airway, at CPAP mask pressure of 13 there were continued events with an RDI of 10.8 events/hour. The patient demonstrated obstructive apneas with oxyhemoglobin desaturation that was incompletely reversed by CPAP at 13.

The recommendation was to start at 14, monitor for adherence, and have another titration if needed.

We discussed the first study - but my appt to discuss the second one is not until October. This week I am going to the DME place to get the machine.

I don't completely understand what a a RERA is and how having my tonsils removed could stop them from occurring. Any insight is appreciated!
ELLENVH
 
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Re: RERA's?

Postby Todzo » Mon Aug 29, 2011 7:23 pm

ELLENVH wrote:I had my first sleep study conducted in June 2011. I was very surprised to get the diagnosis of severe sleep apnea. I have snored my whole life and always loved to sleep - but I never thought I had sleep apnea. I guess wanting to take naps every day was "my normal". I just chalked it up to having two young children. Even though tired, I have always been able to function (knock on wood).

My apnea rate per hour was 0.4 and my hypopnea rate per hour was 2.4. The doctor was not concerned with those. My RERA rate per hour was 41. The doctor was very concerned with this. The lowest my oxygen dropped to was 89.0 but the report says my average baseline was 97.0 - so not worrisome.

The doctor is putting me on CPAP and said all my events were partial obstruction and tonsil removal might significantly benefit me. What do you all think? The doctor is an ENT who specializes in sleep at a very well respected hospital.

Then in July I went for my titration study and when the pressure was at 13 - I still had 5 RERA's in 33 minutes. The report said the results indicated a partially occluded airway, at CPAP mask pressure of 13 there were continued events with an RDI of 10.8 events/hour. The patient demonstrated obstructive apneas with oxyhemoglobin desaturation that was incompletely reversed by CPAP at 13.

The recommendation was to start at 14, monitor for adherence, and have another titration if needed.

We discussed the first study - but my appt to discuss the second one is not until October. This week I am going to the DME place to get the machine.

I don't completely understand what a a RERA is and how having my tonsils removed could stop them from occurring. Any insight is appreciated!


Hi ELLENVH!

These are from memory and many such definitions are being revised - the basic issues will be the same.

Arousal: A sleep stage jump from a deeper stage to a less deep stage not necessarily associated with an awakening (consciousness).

Obstructive Apnea: At least a 90% (often 100%) reduction in air flow for at least 10 seconds in spite of respiratory effort resulting in an arousal.

Hypopnea: At least a 50% reduction in air flow for at least 10 seconds with at least a 4% reduction in blood oxygen and resulting in an arousal.

Respiratory Effort Related Arousal: A reduction in air flow less than a Hypopnea whose respiratory effort results in an arousal.

The theory on the tonsils is simply that less stuff in the airway passage results in more room which may result in less effort needed. Mine were removed in childhood, I kind of wish I still had them.

I a currently likely dealing with RERAs. This has me back on my nasal corticosteroide (in spite of the cataract risk), eating anti-inflammatory foods, working with my dietitian, trying to get in my 10,000 steps in every day (much at aerobic heart rates), reducing stress, and concentrating of getting enough sleep and play. The basic idea is to reduce inflammation resulting in less obstruction. I am suspicious that it helps to exercise the airway passage and lungs as well (aerobics, breath disciplined exercise (Pilates, Yoga ...), taking up a wind instrument, singing or public speaking).

I do hope we find good answers - we need the good REM and deep sleep!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
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Re: RERA's?

Postby ELLENVH » Mon Aug 29, 2011 9:39 pm

Thank you for your response. I'm on nasonex, singulair, and zyrtec.... I did not know that nasonex could cause cataracts... I will have to look into that.

Why do you still want your tonsils? I hate mine!

What did you mean by anti inflammatory foods?

I do need to lose weight and work out but when I have free time I want to nap :(. I'm hoping when I sleep better that I have more energy and be motivated to work out as well as have the mental control to make better food choices... That is my hope at least!
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Re: RERA's?

Postby Perrybucsdad » Wed Aug 31, 2011 12:45 pm

Hi Ellen... anti inflammatory foods are those reduce inflammation without all the side effects that some of the drugs have. Some examples of AI foods are Kelp, Salmon, Shitaki mushrooms, green tea, papaya, blueberries, EVOO, Broccoli, and others. I'll admit, it's not a very appetizing list to me (except the tea, salmon,and blueberries), but they say they work in helping inflammation.
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