Titration Study vs. APAP

[tigeragent]

My sleep Dr. recommended a new titration study after a year, however is there a need to do this if I have an APAP? Isn't the only difference the EEG and pulse ox? It seems silly to pay for a new sleep study just for that, since my S9 is titrating for me every night! I have been using Rescan and my average pressure is 10cm, which is 1cm less than my titration last time.

Thanks

[dtsm]

I've only been on cpap for a little over a year and gotten good results. Others with more history/experience can probably have more insight.

When I started Jan 2010, had a follow-up visit with my doc about 10 wks later. By then I had decent numbers and felt better. He said come back in a year for an annual follow-up. As time passed, I felt even better and my numbers improved. Come March 2011, time for follow-up....and I've yet to book that appointment. If anything, he'll probably just download my yearly summary, see that my numbers are solid, asked me a few questions, check my blood pressure,put a stethoscope to my chest and then out the door

It seems to me - if you're doing ok, i.e. you feel good, your numbers a solid, not sure why a titration study is even being considered? If you're on straight cpap, using apap for a few days [up to full week] should validate if your pressure setting is on-target. Maybe do exactly that, print out the data and then have a regular follow-up visit with your sleep doctor...

[LSAT]

The machine I use does not give data...after using the device for a year, my doctor suggested a new sleep study. He arranged for me to rent an auto from DME for two weeks, He reviewed the data and adjusted my pressure. I have since purchased an auto from craigslist to use as my back up.

[tschultz]

As someone fairly new the whole OSA and CPAP issue this is something I have tried to argue with the sleep clinic but find for some reason they seem reluctant to accept the auto-titration. This even though with a full PSG the prescription IMHO only an educated wild ass guess at best anyhow. I argued that basing a setting on a single night's sleep in a strange environment with wires and everything hooked up, although having value, should be combined with at least a weeks data using an auto-titrating CPAP machine. No one sleeps the same every night and the week long home auto-titration would better take into account the many variables that affect our sleep.

IMHO if you know you suffer from only OSA and not combined the many other neurological related sleep disorders that many have, then the lab PSG is unlikely to be any more useful than using the APAP to auto-titrate. The PSG would however be able to possibly pickup if anything "new" has developed that may also influence your OSA treatment. At home I would suggest that you also use a pule-oximiter for a while as this will give you some additional information that your APAP machine will not. I found it very surprising how well the oximiter data correlated with what was happening.

Keep in mind there may also be insurance of other requirements that may require a full lab PSG but I would discuss this full with your sleep doctor and insurance company to be sure.

[dtsm]

I argued that basing a setting on a single night's sleep in a strange environment with wires and everything hooked up, although having value, should be combined with at least a weeks data using an auto-titrating CPAP machine. No one sleeps the same every night and the week long home auto-titration would better take into account the many variables that affect our sleep.

Excellent point!

[jbn3boys]

My doctor has suggested a re-titration for me, based on my numbers not improving. My case may be different due to the presence of centrals. The nurse gave me the alternative of a month on auto. I asked which she preferred, and they always prefer the sleep lab over an auto-titration. She didn't explain, other than the wait time (a month before download for auto-titration vs next week for the sleep study.) I guess I'm going with the sleep study (whole night titration), since that's what the Dr wants (and my insurance will cover it).

[chunkyfrog]

My husband went with the Autoset instead of the Escape the DME wanted to stick him with
After he showed the sleep doctor his print-out with very good AHI and substantially lower pressure than the Rx,
the doc said,"Good going; you are doing the right thing."
If you are on Medicare, they may insist on a new sleep study--depending on how old the last one was.