Titrated at 7 - needing much more !!

[adksleepygal]

In my sleep study I was titrated at 7 which is what I started out on in a straight Cpap (PR One System). I felt like I was suffocating along with my other complaints. I was then switched to Auto on the PR One with the full range it allowed. When I finally got to the new machine - the Resmed S9 - the RT set me up at 6 - 12 range. I have been needing at least 9 and sometimes 10.8 most every night. Is this because I was titrated wrong or because its a different machine or what? My AHI has been amazing - today it was 1.4 and I do not feel like I am suffocating. I could easily sleep all night except I am dealing with shoulder pain for the past 4 months - some kind of impingement problem - which it looks like I may need PT for - GRRR.... But for me to sleep all night before treatment was unheard of. I am really feeling so much better and alert - think I am doing great - will be working on the shoulder problem and hope that eases off. Just wondered about the number of the original titration if anyone has any ideas - thanks!

[cobra4x4]

Titrated pressure is the pressure which eliminated most events on that particular night (In alot of cases in an unfamilar bed and uncomfortable setting) therefore in my opinion its a guideline and can/should be tweaked as required.

That being said you shouldn't go changing pressures without using software to interpret what is happening in addition to reading & understanding what the risks are when changing pressures.

I too am at 7cm and I have found that I feel the best at 8.3cm on avaerage, I'm hoping to get an APAP soon which will tell me more and adjust on a nightly basis if need be.

[cflame1]

a study in a lab is a one night uncomfy picture... it may or may not be correct. It may have been correct for that one night but isn't right now. Personally I've had lab studies anywhere from an 8 to 10 to 11 and up.

[Janknitz]

IMHO, the in-lab titration takes place in very artificial circumstances. You are hooked up to all sorts of wires, wearing a mask that's very unfamilliar to you, in a strange bed, a strange room, and with the knowledge that people are watching you all night. You may sleep, but it's not likely to be the kind of deep, restful sleep you can get at home in your own bed and sleeping conditions when your airway is open. So I think that the titration pressures have to be taken with a grain of salt.

That's one of the reasons that at the very least EVERYONE should have a data capable machine, and in most cases, it should be an auto just so you can determine your ideal pressures now, and in the future if things change. I'm not saying everyone is capable of determining their own titration numbers, but at least with a data capable machine, the CPAP user and his or her professionals have useful data to use when making pressure setting decisions

[kentoboo]

janknitz- you have the same machine as I do, my DME tells me the card reader only gives time of usage, not any other info????

[jonquiljo]

a study in a lab is a one night uncomfy picture...

Yes, it's so artificial. In fact has anyone here ever slept a good night at a sleep clinic?

I've never understood how they could even believe titrations, especially with people who have never been connected to a CPAP before. It takes a while to get used to.

Sounds like you're feeling pretty good, though! Congrats.

[mayondair]

Janknitz says it well, a lab is just one night, and usually not a good one. Data and and auto are great for tweaking. I bet a lot of people give up because they haven't gotten a good tritation , feel lousy and get no help from MD or DME. Glad you are sleeping well!

[DoriC]

ken, Janknitz has the PR Auto which is data capable, you have the Plus which is the basic low-end model and gives nothing but compliance info for insurance purposes. Any chance of getting it switched? A PR Pro is also data capable but only gives straight pressure.

[linagee]

IMHO, the in-lab titration takes place in very artificial circumstances. You are hooked up to all sorts of wires, wearing a mask that's very unfamilliar to you, in a strange bed, a strange room, and with the knowledge that people are watching you all night. You may sleep, but it's not likely to be the kind of deep, restful sleep you can get at home in your own bed and sleeping conditions when your airway is open. So I think that the titration pressures have to be taken with a grain of salt.

That's one of the reasons that at the very least EVERYONE should have a data capable machine, and in most cases, it should be an auto just so you can determine your ideal pressures now, and in the future if things change. I'm not saying everyone is capable of determining their own titration numbers, but at least with a data capable machine, the CPAP user and his or her professionals have useful data to use when making pressure setting decisions

They aren't just watching you all night. They know exactly when you start sleeping because your alpha waves change once you are actually asleep. If you just have your eyes closed and pretend to be sleeping, they will know. This caused a bit of insomnia for me. Not knowing is better! (On the good news, I don't think they can actually know what you are thinking using an EEG. (Yet?))

[jbenenson]

adksleepygal, it seems to me that your message speaks clearly that you are at a setting that really works for you, so use it. It doesn't matter what you're titrated at, the result is to minimize your AHI and give you a good, healthy night's sleep. Congratulations, you've achieved it!