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RERA events and gasping for breath at sleep onset

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p3000g +0 points · about 2 months ago Original Poster

Hello folks Have a question on RERA events Have been using CPAP therapy for last 2 years , fairly successful in the sense that my AHI has come diwn to below 1. However, of late I have been noticing an increase in sudden gasps of breath , at sleep onset , waking me up. This may seem like sleep onset apnea, but it is not. There is no stoppage of breathing and the machine does not record any events. Sleepyhead does show some RERAs , but they are not counted towards the AHI.
Has anyone else experienced this? What counts as a RERA but not an apnea? Will post sleepyhead data if required.. Would appreciate your opinions on this

Thanks

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Sierra +0 points · about 2 months ago Sleep Patron

I believe RERA stands for respiratory effort related arousal. Not sure how the machine measures it, but it much be based on the amount of air you are breathing and a disturbance in the rhythm that indicates you have woken up. The RERA events should be flagged in SleepyHead on the bottom bar of the event tag section. I have them occasionally but really don't see anything out of the ordinary associated with them. I basically ignore them.

Did you ever figure out how to set the EPR to ramp only? I looked back through some old posts and see that was an issue. Perhaps your issue was that to set EPR to ramp only you have to have a ramp and ramp start pressure set. Perhaps you do not.

Go to the Comfort section of the Clinical Menu (Press the round button and rectangular button at the same time for 5 seconds or so) and make these settings:

  • Ramp Time - Auto
  • Start Pressure - 7 cm (although if that does not feel like enough air, you can go higher. I use 9 cm)
  • EPR - On
  • EPR Type - Ramp Only
  • EPR Level - 3 cm

If you are having issues at sleep onset I would try to use as high a Start Pressure as you find comfortable. I use 9 cm. More pressure should keep the airway open and potentially avoid RERA events as well as apnea events.

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p3000g +0 points · about 2 months ago Original Poster

Thanks Sierra for responding as always. My EPR and ramp are both turned off, and pressure is at 10.8. These events occur as I am trying to sleep. Refer to the sleepyhead picture shown below, I am referring to the sharp spikes in flow rate seen towards the end. The machine and sleepyhead record no events and AHI is reported as zero

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p3000g +0 points · about 2 months ago Original Poster

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Sierra +0 points · about 2 months ago Sleep Patron

I really have no idea what the significance of the RERA events are. I can find something similar in my sleep files, but they tend to be in the middle of the night. I wonder if they could be a cough because of the spike in pressure. I also note that they are often accompanied by an increase in the Flow Limitation value. If you are not using any ramp then you will be at full pressure when it is happening to you.

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