Titration Study

What is a Titration Study?
When and how often should it be done?

I have been using my Resmed S9 Autoset with S5i Humidifier and Climate line hose for just over a year now.

I have never had a Titration Study and don't know what it is.

bwexler wrote:What is a Titration Study?
When and how often should it be done?

I have been using my Resmed S9 Autoset with S5i Humidifier and Climate line hose for just over a year now.

I have never had a Titration Study and don't know what it is.

How was it determined that you had sleep apnea? How was your pressure determined?
A Titration is the initial sleep study that determines whether you have sleep apnea and what pressure is needed to control it.

Sometimes a sleep study may be a split night study- half off the machine for diagnosis then half on the machine to titrate, or find the right pressure. Sometimes a titration study is done on another night after a diagnostic sleep study.
Sometimes a titration is done when pressure needs may have changed.

Do you monitor the results of your treatment, do you know your prescription?

It seems that it is possible to get an Rx for a CPAP from a physician without titration but based on diagnostic results only. In such a case the physician would prescribe the set pressures. I could see experienced physicians in sleep medicine, like Barry Krakow for example, doing it quite successfully. But what about law suits protection?

I did have a sleep study done. The report says "Results of split PSG". this was a check box, another check box not checked was "results of bipap titration study".
My AHI was 84.
Recommended CPAP pressure 10 cm.

I see people here referring to a sleep study AND a Titration study. Is a split PSG a combo of both?

With my S9 Autoset my minimum pressure is set at 5 max at 20, the average is 6.75. When my pressure gets above 10 it becomes difficult for me to breathe.

With info I got from sleep study and DME I would be lost. Thank goodness for this group.
I am just now trying to learn what is behind the curtain, as the Wizard said.

Bwexler wrote: I see people here referring to a sleep study AND a Titration study. Is a split PSG a combo of both?

Yes

bwexler, you posted this:

With my S9 Autoset my minimum pressure is set at 5 max at 20, the average is 6.75. When my pressure gets above 10 it becomes difficult for me to breathe.


it seems to me that your S9 Autoset was given to you without setting the pressures on it by a clinician. But since you read on the machine that it chose an average pressure of 6.75 cmH2O it seems to me that you could set the pressures at a min of 5 cm and a max of 10 cm, while in Autoset mode, untill you discuss it with your therapist.. I AM NOT A DOC. JUST ANOTHER USER.

If the 10 cm gives you a hard time exahaling into it I would set the EPR on 2 at all time, and try. Do you know how to set these? Otherwise, you need the Clinicians Manual. Check this:

http://www.apneaboard.com/CPAP%20Adjustment.htm

After reading a few responses here and re reading my sleep study report I Googled PSG

Diagnostic Overnight PSG - General monitoring and evaluation.
Diagnostic Daytime Multiple Sleep Latency Test (MSLT) - Used to diagnose Narcolepsy and measure the degree of daytime sleepiness. To ensure accurate results, it is performed on the morning following a Diagnostic Overnight PSG.
Two Night PSG with CPAP Titration - General monitoring and diagnostic evaluation is conducted on the first night. If Sleep Apnea is discovered, the patient returns for a second night to determine the necessary CPAP pressure required to alleviate apnea.
Split Night PSG with CPAP Titration - Split Night PSG is conducted when moderate or severe Sleep Apnea has been discovered or strongly suspected during the first part of the nights study. The second half of the night is used for CPAP Titration.

Now I know what a titration and a split night sleep study is.

I now know how to set all the parameters on my machine thanks to this group.
I also have and use Rescan and Sleepyhead software and when I have time I will ask many more questions about what I see when I look at the reports.

I did not have a titration study, (in fact, I did a home sleep test) but my AHI results are to my sleep doc's likings, so the pressure he prescribed seems to be working. I did not have severe apnea, but moderate (just over the line from mild), so perhaps that's why.

Debbie

avi123 wrote:It seems that it is possible to get an Rx for a CPAP from a physician without titration but based on diagnostic results only. In such a case the physician would prescribe the set pressures. I could see experienced physicians in sleep medicine, like Barry Krakow for example, doing it quite successfully. But what about law suits protection?

needzzzzs wrote:I did not have a titration study, (in fact, I did a home sleep test) but my AHI results are to my sleep doc's likings, so the pressure he prescribed seems to be working. I did not have severe apnea, but moderate (just over the line from mild), so perhaps that's why.

Debbie

avi123 wrote:It seems that it is possible to get an Rx for a CPAP from a physician without titration but based on diagnostic results only. In such a case the physician would prescribe the set pressures. I could see experienced physicians in sleep medicine, like Barry Krakow for example, doing it quite successfully. But what about law suits protection?

More, as of Dec 2007:

"Pressure titration during an attended laboratory polysomnography is often performed to identify an effective pressure level to control apnoeas, hypopnoeas, snoring and respiratory arousals. While this procedure is still standard practice in many laboratories for the assessment of individual CPAP treatment needs, polysomnographic titration is expensive and time-consuming. Recent studies have evaluated whether the initiation of CPAP treatment can be simplified, using either Auto-CPAP devices or prediction formulae to estimate effective Fixed-CPAP levels. If such evidence could be provided, this would open up a perspective for considerable savings in terms of financial costs and reductions in the waiting lists for polysomnography. "

avi123 wrote:But since you read on the machine that it chose an average pressure of 6.75 cmH2O it seems to me that you could set the pressures at a min of 5 cm and a max of 10 cm, while in Autoset mode, untill you discuss it with your therapist

I would not cripple my machine by lowering the max pressure. That's like saying that it's better to choke than wake up from high pressures.
It seems to me that OP is "titrating" automatically just fine.