Which way to titrate?

So, I've just talked to the sleep tech and the results of my study have come in. Severe case with an AHI of 42 and no central apneas. O2 dropped only 87% at lowest.

The tech says I can have the option of a titration night in the lab or going home with an apap.

I had a devil of a time going to sleep and resting on that bed in the lab during my study. I didn't expect to have any issues, so I'm wondering which option to take with my Dr. calls and wants to know what I want done.

Also, if I decide to take home an apap - any recommendations on which I should push for? My theory is that the Resmed Airsense would be the way to go. It has the heated tube option which I know I'll need at least in the winter - and a dishwasher safe humidifier tank available which may help me with maintenance. <shrug>

Any suggestions?

Thanks!
Jim

I would opt for the home titration on the APAP if it was me and I had it to all do over.
I had an in lab titration and I had horrible sleep and they didn't get the pressure right and I ended up doing at home with my machine what I could have done in the first place if I had known better.
Should problems arise that can't be sorted out at home then do the in lab titration later if the need comes up.

And yes...the ResMed AirSense 10 AutoSet would be a good choice.

I will make your decision harder for you - that is what we are here for, no?

I had two titration studies, the first one I slept so little it was a bust, had to do it again. Next time the doc prescribed a Xanax for my "anxiety". Whatever, it worked great and got a good titration. I have inched my pressure up a bit over time, but they hit it almost exactly.

So it is possible to get a good result and in hindsight I am glad I got it done. It allowed me to get acclimated to the machine faster and start feeling better very quickly, rather than spending weeks or months dial winging.

So, there is the other side for you. Now doesn't that make it easier to decide?

I will make it even harder yet.
Once I got my software so I could see my data...took me 3 nights to get my pressures optimized.
2 weeks total but the bulk of that was waiting on the software because back then we didn't have SleepyHead or other quick easy ways to find the software...we either paid for it (back then even ResScan could be bought) or had a friend send us a disc by snail mail.

To me a home titration makes incredible sense for the following reasons:
1. It can be done in your own bed, under your usual sleeping conditions.
2. It can be done over the course of several nights, rather than just one, so that you are in essence getting an HD picture rather than a snapshot.
3. It will be done with the type of equipment you will be using for treatment--the settings can be optimized to the particular quirks of that equipment.
4. It gives you a trial run to see how CPAP treatment goes and gives you the opportunity to iron out any issues before you "fly solo".
5. No miserable night in a strange bed, wired up and being watched all night.

OTOH, some disadvantages--
1. No on site help if you are having difficulty or need support to sleep with the mask on. (But the light is always on at cpaptalk.com )
2. No trained eye observing your response to CPAP in case there are things that wouldn't show up in efficacy data.
3. The first few nights (or more) of CPAP are VERY challenging for most.

I am all for home titration so long as patient does not have Sa02/Sp02 issues.

I say this because aps/hyps may clear at a low pressure but that pressure may not be enough for adequate oxygen saturation. That is where the lab's titration study
provides a good starting point.

If it may be an issue, suggest that you consider purchasing an overnight pulse oximeter to check things out as pressures are changed.