Should I be concerned? No titration?

Just got diagnosed recently as "severe"...Dr has put through paperwork for a machine, but no titration study...I did an at home study for 2 nights with an appliance strapped to my forehead and a canula to measure breathing. My understanding was that next step was to be an overnight titration study, but when they called today they indicated no titration was ordered, that they would submit to insurance and the machine rep would be in touch...

Not sure if I should be concerned at there being no titration test...is it THAT bad they want me on the machine ASAP, or is it NOT that bad that a titration isnt neccessary? Or perhaps I misunderstood, and the 2 night appliance WAS a titration so they have all the info they need? ::::

I have a call in to the Dr's office and waiting for callback, just not sure if its something I should be concerned with or not.

Thanks

Many people don't do titration... don't worry about it. It's just means they did get the info they needed and so will get you going as soon as possible, but that doesn't mean you're in dire straits or anything (you well may have had apnea to whatever degree for years after all). It's not at all abnormal.

Mrsfixitct,

It's worth asking the doc's office if they intend to set you up with an APAP running in Auto mode. They may be planning on using a week or two of data from an APAP as the titration. And there's nothing wrong with that. If they do set you up with an APAP to start with, try to hang onto that machine once the autotitration period is done rather than letting the DME swap the APAP out for a bottom-of-the-line CPAP that only records usage hours.

Mrsfixitct wrote:Just got diagnosed recently as "severe"...Dr has put through paperwork for a machine, but no titration study...I did an at home study for 2 nights with an appliance strapped to my forehead and a canula to measure breathing. My understanding was that next step was to be an overnight titration study, but when they called today they indicated no titration was ordered, that they would submit to insurance and the machine rep would be in touch...

Not sure if I should be concerned at there being no titration test...is it THAT bad they want me on the machine ASAP, or is it NOT that bad that a titration isnt neccessary? Or perhaps I misunderstood, and the 2 night appliance WAS a titration so they have all the info they need? ::::

I have a call in to the Dr's office and waiting for callback, just not sure if its something I should be concerned with or not.

Thanks

It wouldn't bother me. I like doing my own titration with an auto machine and software. It's not hard to do with help from the forum members.

You have to make sure you get the right machine up front. Best choice is ResMed AutoSet S9 with humidifier and heated hose.

My doctor had to check with insurance to see if they'd approve a titration, so it could be your insurance wouldn't cover it

Thank you all for your responses.

Heard back from Dr's office, and, as someone indicated, not to worry. Final outcome now is that although I fall into the "severe" range, the results indicate that they will be putting me on an APAP, rather than a CPAP...I guess it was the "severe" terminology that threw me for a bit of a loop.

It's now off to the insurance company to find out their part in all of this, then will hear from them. Another thing that had me shook I think was in one breath, they're tagging it as "severe" and then telling me it could be 2 weeks before it all clears insurance, getting the machine, etc. "Severe" to me would be something requiring more immediate attention, I guess.

So, now, I just wait it out...
thanks again!

I guess it was the "severe" terminology that threw me for a bit of a loop.

Most people are "severe". If you got it, you got it.

It's other people that are "mild" or "moderate".

Mrsfixitct wrote:Thank you all for your responses.

Heard back from Dr's office, and, as someone indicated, not to worry. Final outcome now is that although I fall into the "severe" range, the results indicate that they will be putting me on an APAP, rather than a CPAP...I guess it was the "severe" terminology that threw me for a bit of a loop.

It's now off to the insurance company to find out their part in all of this, then will hear from them. Another thing that had me shook I think was in one breath, they're tagging it as "severe" and then telling me it could be 2 weeks before it all clears insurance, getting the machine, etc. "Severe" to me would be something requiring more immediate attention, I guess.

So, now, I just wait it out...
thanks again!

Well yes and no -- it actually could be a problem. You just have to see how your doctors handle you. No one would use the word "severe" to describe a condition to a patient, if it weren't so. And perhaps you do have severe apnea, so they need to treat it as such. With severe OSA/SDB they should do a full titration study. They may be able to sneak by with doing an auto machine test and look at the data and try it that way, indirectly, but you are correct the gold standard is a full titration study. I did not have one, just an auto machine. Frankly the full study would have been better, even though my AHI was pretty low to start with. They set my machine wide open at 4-20 and only after months did the pressure range get to a place the Resp Therapist at the DME set the start pressure to a more appropriate higher level. So if your insurance will cover it I would do a titration study, especially if you have severe problems. But talk to your doctor and as what he thinks would be best.