Do the presence of RERAs automatically mean sleep apnea?
My polysonogram showed the major sleep disruptions came from RERAs (77). THe RDI was 25 but the AHI was 5. The majority of sleep disruptions were from RERAs. There were some hypopneas (21) and no apneas. Of a total sleep time of 3.9 hours I achieved REM for .5 hours. The diagnosis was moderate sleep apnea.
I thought if the AHI was low that it indicated UARS, not sleep apnea. And I didnt achieve much REM sleep.
I believe my sleep is fragmented. After two months of cpap I still don't feel that great; very tired in the am and it takes awhile to get fully functional. My AHIs are routinely less than 2.
What is the current thinking regarding RERAs and the diagnosis of sleep apnea/UARS? I am wondering if I should be taking a different approach to my sleep problem.
Essentially, there's no difference between RERAs, apneas and hypopneas. It's all in how we define obstructive sleep apnea, which is defined as the total number of apneas and hypopneas per hour on average. RERAs, even though you stop breathing and wake up, doesn't get counted, even though it disrupts your sleep and can lead to significant symptoms. The only difference between a RERA and an apnea is how long the breathing pause lasts: it can only be counted as an apnea or hypopnea is the breathing pause lasts 10 seconds or longer. If you stop breathing 25 times every hour but wake up after 1-9 second episodes, then your AHI is 0.
UARS is treated the same way as OSA, since this is an anatomic problem. It's better to treat this now, be fore it progresses later on into OSA.
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