[split] Vibratory Snore and RERA

[lasalle]

Thanks for the welcome, I have also downloaded sleepyhead which is interesting. Last week avg. ahi 2.66 is ok but my vibratory snore vs2 seems high 4.05 and reras 1.38. My wife tells me she hears no snoring at all and internet doesn't seem concerned with vs2 but does seem somewhat concerned with reras. Do you or anyone out there have input on this?
Thanks

[holden4th]

RERAs are a grey area and the jury is still out on what they are and how machines detect them.

When I was using a Respironics it became a bit of an obsession for me that I no longer have with my Resmed S9 as it doesn't flag them. One thing I do remember a number of people posting is that RERAs below 2.0 are perfectly acceptable and 1.5 is even better.

[jaswilliams]

I would turn off the VS2 statistic it’s not clear what is measured an it makes the charts look a mess

[SnoringInOregon]

As others have said, probably best to ignore VS2 since it's not clear what it really is.

Here are my last 5 days of statistics. You will see my VS2 is really bad but my others are great. The RDI includes everything in AHI plus adds in RERAs:

AHI       RDI       VS2

0.00     1.71     13.16
0.00     2.75     10.99
0.00     1.12     12.55
0.00     1.00     12.48
0.00     1.06     10.96

I'm showing off a bit because my AHI is rarely above 1.0. Advice here and on the (other) forum has given me the ability and desire to tweak my pressure settings to make that happen.

My RDI is a little more stubborn. Once in a while it will even go above 7.0. Turning up pressure doesn't seem to help much. I'd probably need to go from min of 9.5 to over 11.0 to reduce my RERAs any more, and so far I've not done that. I don't want any of the other problems and such of higher min pressure.

Believe it or not, my VS2 is worse since I turned up the pressure enough to get AHI and RDI low. VS2 was around 5.0 when I had lower pressure settings.

[OpalRose]

Thanks for the welcome, I have also downloaded sleepyhead which is interesting. Last week avg. ahi 2.66 is ok but my vibratory snore vs2 seems high 4.05 and reras 1.38. My wife tells me she hears no snoring at all and internet doesn't seem concerned with vs2 but does seem somewhat concerned with reras. Do you or anyone out there have input on this?
Thanks

Hi lasalle,
Here is some information on snoring data from The beginners Guide to SH.  
Scroll down for the information on VS and VS2 for Respironics machines.  

http://www.apneaboard.com/wiki/index.php...oring_Data

As others have said, you may want to turn off the VS2 flags.  It clutters up the graphs and doesn’t seem to indicate real snoring.

I wouldn’t totally discount RERA’s.  They are small disturbances (arousals) and disturb sleep.
I always referred to them as “baby apneas.”  They aren’t counted in the AHI, but you can feel unrested by morning if you have a lot of them.

"The respiratory disturbance index (RDI) — or respiratory distress Index — is a formula used in reporting polysomnography (sleep study) findings. Like the apnea hypopnea index (AHI), it reports on respiratory events during sleep, but unlike the AHI, it also includes respiratory effort-related arousals (RERAs). RERAs are arousals from sleep that do not technically meet the definitions of apneas or hypopneas, but do disrupt sleep. They are abrupt transitions from a deeper stage of sleep to a shallower.
A RERA is characterized by increasing respiratory effort for 10 seconds or more leading to an arousal from sleep, but one that does not fulfill the criteria for a hypopnea or apnea.
Some research studies have found that a high RDI was significantly correlated with excessive daytime sleepiness, and that this correlation was stronger than that for the frequency of oxygen saturation decreases below 85%, but other studies have found only a weak correlation."

You can also find information on RERA’s in the SH Guide.

Usually, a slightly higher minimum pressure handles RERA’s.  You could try moving your minimum pressure up to 6cm to see if that makes a difference.

[Walla Walla]

The problem with the machine reported RERA's is there is no way for the machine to know if you were aroused. The assumption is when the breathing returns to normal it indicates you were aroused. This may or may not actually be what happens.

[Ron AKA]

Thanks for the welcome, I have also downloaded sleepyhead which is interesting. Last week avg. ahi 2.66 is ok but my vibratory snore vs2 seems high 4.05 and reras 1.38. My wife tells me she hears no snoring at all and internet doesn't seem concerned with vs2 but does seem somewhat concerned with reras. Do you or anyone out there have input on this?
Thanks

My approach is to focus on obstructive apnea events only. CPAP has the most direct effect on that measure, and I use that as the prime indicator that pressure levels are correct, or need adjustment. Perhaps it is a somewhat naive assumption, but I do assume if I reduce OA events, then H and RERA will reduce too. In my mind they are precursors to a full OA event. Same with snoring and flow limitations. I assume they will be reduced along with OA. And in any case the machine responds to snoring and flow limitations to correct them anyway. Just my thoughts...

[cate1898]

Welcome to the group lasalle! Sounds like you're off to a great start with your AHI well under 5. That is considered effectively treated. Well done.

[Hypoxic]

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As others have said, probably best to ignore VS2 since it's not clear what it really is.

Here are my last 5 days of statistics. You will see my VS2 is really bad but my others are great. The RDI includes everything in AHI plus adds in RERAs:

AHI       RDI       VS2

0.00     1.71     13.16
0.00     2.75     10.99
0.00     1.12     12.55
0.00     1.00     12.48
0.00     1.06     10.96

I'm showing off a bit because my AHI is rarely above 1.0. Advice here and on the (other) forum has given me the ability and desire to tweak my pressure settings to make that happen.

My RDI is a little more stubborn. Once in a while it will even go above 7.0. Turning up pressure doesn't seem to help much. I'd probably need to go from min of 9.5 to over 11.0 to reduce my RERAs any more, and so far I've not done that. I don't want any of the other problems and such of higher min pressure.

Believe it or not, my VS2 is worse since I turned up the pressure enough to get AHI and RDI low. VS2 was around 5.0 when I had lower pressure settings.

When was the last time you replaced the light blue (non-washable) filter?

[SnoringInOregon]

---

When was the last time you replaced the light blue (non-washable) filter?

I think that really depends on where you live. That will make the biggest difference as to how often you need to replace.

We have pretty clean air here and I replace my non-washable filter every 2 months. Holding it side-by-side with a new filter you can definitely see the dirt. Also the old filter is no longer perfectly flat; you can see how the machine has "sucked" it and distorted it a bit. I definitely wouldn't want to replace less often than every 2 months.

My DME only allows me to purchase 1 filter per month so I couldn't replace it more often than that without buying off the internet. Many suppliers on the Internet sell only knock-off filters whereas my DME sells genuine parts. Is there a quality difference? I don't know.