Respironics Apnea Titration Protocols

I ran across this Philips-Respironics titration document for the various protocols - CPAP, BiPap, AutoSV, AVAPS, etc.

Makes interesting reading. There is some discussion of how the parameters are used.

Titration Protocols

Thanks. I found it interesting. I failed my 1st titration study on CPAP & BIPAP so had the second titration study done on an Auto SV. I am still waiting for the results of that one. I have a copy of my initial sleep study and the 1st titration study. So I took a look at your protocols and compared them to my copy of the studies.

JDS74 wrote:I ran across this Philips-Respironics titration document for the various protocols - CPAP, BiPap, AutoSV, AVAPS, etc.

Makes interesting reading. There is some discussion of how the parameters are used.

Titration Protocols

Very interesting JDS74. Thanks for sharing.

I understand why this has to be done but the thought of being started with pressures at 4cm freaks me out big time as I would feel starved for air. I wonder if one could negotiate with the doctor to have a higher starting point, particularly if the data card provided evidence that was necessary.

49er

49er,
I think the starting numbers are for patients with no prior cpap usage or PSG studies.

My most recent PSG, staff was happy to have my current settings so they could bypass some of the early steps.
It is interesting to think that with these protocols published, you couod actually do your own titration. It would likely take a few weeks but it cold be done.

What it could not do is a diagnostic study. That requires the EEG and abdominal sensors.

JDS74 wrote:49er,
I think the starting numbers are for patients with no prior cpap usage or PSG studies.

My most recent PSG, staff was happy to have my current settings so they could bypass some of the early steps.
It is interesting to think that with these protocols published, you couod actually do your own titration. It would likely take a few weeks but it cold be done.

What it could not do is a diagnostic study. That requires the EEG and abdominal sensors.

Thanks JDS74, I didn't know that.

49er

I hope that this doesn't make me sound excessively ignorant, but....

On the far right of the flow chart on page 7 says the tech should "Observe for Central Apneas/Hypopneas". If yes, then decrease pressure. Reducing pressure for CA's makes sense. reducing for Hypopneas does not. Can anyone explain the rationale for this course of action?

Thanks JDS, I'd been looking for that specific PR titration and analysis paper (it's popped up on this forum a few times before) but I couldn't find it last June... it appears I'm pretty sloppy with my Firefox bookmarks, plus I've got loads of them . Anyway, this time I saved the PDF and put it on my backup drive where I'm sure I'll be able to find it again .

bv1800 wrote:I hope that this doesn't make me sound excessively ignorant, but....

On the far right of the flow chart on page 7 says the tech should "Observe for Central Apneas/Hypopneas". If yes, then decrease pressure. Reducing pressure for CA's makes sense. reducing for Hypopneas does not. Can anyone explain the rationale for this course of action?

The block immediately to the left of the one you referenced asks about partial airway obstruction. To get to your question, no partial obstruction is observed. So a reduced air flow must be because of a reduced effort, i.e., central that may be pressure induced. Just my thought.

Dropping off the bottom right implies testing for ASV protocol.