How accurate are your titrations from your sleep study?

I have been involved with three sets of titrations so far. Myself, my wife and a close friend.

I have so many problems they just sent me home titrated at 4/20 and let the machine do the work, but they titrated my wife at 6.0 and her friend at 7.0.

Thanks to the great advice I have received here, we all three got Respironics
Auto BiPAP machines and I got Encore Pro.

My wife's 90% IPAP is above 10 a lot, her max has been over 16 a few times.

My friend has been on the machine about two weeks. But her IPAP is over 12 most of the nights. The 90% IPAP is 10+ most of the time.

Maybe I am concentrating on the wrong numbers, but at this sleep center, it seems their criteria consistently come in low. How about yours?

Before I close these comments, let me add that I DO believe in the sleep studies because they found a lot of stuff my machine would never catch and it is part of our overall education into sleep apnea and its potential impact on our present and future physical, emotional and mental health.

Dilfo, I agree with you that a sleep study may reveal isues that a machine just cannot do and are needed. But, my biggest problem with the sleep study was the "artificial" type sleeping situation that patients have to go through. By that I mean, having to lay on my back with all of those wires, in a strange place was just not a reflection of my typical sleep habits. When I received a titration of 8, I found that a fixed pressure cpap at 8 was just too much air for me when I slept my normal way, on my side! The aerophagia was horrible! Yet, a few times, I would wake up abrubtly feeling like I could not get enough air!
Once I went to an apap, I've done great! (My 90% pressure is 7! w/AHI's usually under 2!)
Bottom line- IMHO. I just do not feel that the titrated pressure from 1 sleep study is 100% all the time!

only problem is your bipap auto doesn't have EEG and respiratory belts around your chest to measure respiratory effort, meaning it cannot detect central apnea events. So without those items, your machine is blind.

In a manual titration they increase pressure until optimal sleep is obtained, snoring ceased OR it blows a central event. If the latter happens and you are still sleeping they back off pressure to where sleep is maintained and does not trigger the central, that LOWER pressure becomes your titrated pressure.

your machine is lousy at best at detecting central events, it has no EEG, it has no belt to indicate respiratory effort, if anyone says it can accurately is blowing smoke up your butt.

why is there a difference between what the auto is saying and what the lab found? Could be reasons stated above, either that or your machine is not delivering the same pressure it displays on the LCD.

you all 3 got Bipap Autos and your pressure is only 6.0, 7.0 and 10cm?

complete waste of money as I see it. there is absolutely no medical reason why you would require those machines over a standard auto at those pressures.

Amazingly enough the sleep study I had for titration seems pretty accurate IF YOU ONLY CONSIDER ME SLEEPING ON MY BACK DURING THE PHASE OF SLEEP WHERE I HAVE THE HIGHEST PRESSURE NEED.

I do go up to (or very close to) my titrated pressure (13) and sometimes a little tiny bit above almost every night

BUT most of the night I am at 10 (my low on the range). I do wonder if I could manage even lower than 10 but it may affect how quickly the machine can respond so I doubt it is worth expanding the range.

SO, while the lab maximum titration seems to be pretty accurate, it does not reflect the overall nightly need well and hence the auto I pushed for and got is so very worth it to me.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, auto

Came out of titration study with a pressure of 12 cm H2O; on 123 minutes of stage 1 & 2 of sleep after laying awake for 2 hours, stuffy nose & beginnings of sinusitis, angry & frustrated, and wondering how I was going to use the CPAP the rest of my life.

Used CPAP for 4 months. Now after 6 months of APAP & mask experiments-the best number is 11.

I've never seen the reports from my PSG/split study, but the doctor said I didn't have any centrals or RLS/PLMD events.....so for THAT part, I took him at his word.
As far as the titration and prescription, he got that part WAY off. Since I've never seen my reports, I don't know for sure what pressure(s) they used. I don't even know if the machine had remote pressure adjustments or not.

Doctor prescribed a pressure of 18 cm based on the titration pressure of (possibly) 16 cm.....he really didn't seem to know (he actually asked ME if I knew what the machine had been set to). SO, when I got my machine, I set it up for 10 cm. and monitored my therapy with Encore Pro and MyEncore.
Have used straight pressure settings of 10, 11 and 12 and have done just fine.
I figured if HE could pull numbers out of his A$$, so could I.

Den

Was titrated at 8. After a few months of no improvement was put on a one week auto trial and they moved me to 11. I didn't sleep well in my study and never hit REM. I assume that is why the big difference.

Recently did a three week autopap trial and again they came up with 11, but I tracked the numbers off the LCD screen each morning and my 95% ranged from 8 to 15. The Doc was just going to keep me at 11 until I pulled out my spreadsheet showing my daily results. Finally convinced him (or annoyed him) into an Auto. I don't think he ever went past the summary sheet on the results to look at the daily results. Not sure why the big range for me, but I am looking forward to having my own auto that I can track and tweak!

You're comparing apples to oranges- a strait CPAP pressure would be equal or close to EPAP, not IPAP. What is your wifes average EPAP? Here's a post from last year on the subject ~BiPAP titration~ particularly pay attention to SWS & Titrator's comments.

I don't consider mine accurate... was having an asthma attack in the middle of the PSG due to the feather pillows. Still looking for the magic numbers... my min EPAP seems to do well at 10.