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Miss Emerita wrote: ↑

Sat Sep 07, 2019 9:17 am

I have probably been misunderstanding the term "titration." I thought it meant changing pressures to maximize treatment effectiveness. I've seen the experts here often advising people to raise their minimum pressure to improve treatment, occasionally to lower the maximum, and sometimes to change pressure support. But I guess that isn't titration? Maybe the technical term is "tweaking"!

"A titration is a technique where a solution of known concentration is used to determine the concentration of an unknown solution. Typically, the titrant (the know solution) is added from a buret to a known quantity of the analyte (the unknown solution) until the reaction is complete."

That term has been perverted to mean the partial night where you're wired up in a lab and a tech twiddles with the pressures and settings *in real time* to try and get what is nothing more than a starting point for settings of your machine (as we've seen repeatedly here).

I don't think of what we do here as a 'titration'. anymore than any other thing someone is doing, evaluating results, making changes, and repeating the process is a 'titration'.

One wouldn't call tuning a musical instrument a 'titraion'... but that's much more what we're doing here... strum the string (sleep) listen to the note (review data), tighten or loosen the string (adjust settings), repeat.

I'd say, we're *tuning*.

A woodworker who's shaving off finer and finer bits of a piece to make it fit perfectly wouldn't be said to be titrating it... etc.

You're forgetting one important thing. Not all automatic devices detect respiratory episodes well (and they can't even do it because there's too little data). This is very visible in my study. You can't see all the hypopneas, you don't know which are the central ones. It is not known at what stage of sleep you are. Home titration (without PSG) may not be enough...

pcstud wrote: ↑

Sat Sep 07, 2019 4:51 pm

You're forgetting one important thing. Not all automatic devices detect respiratory episodes well (and they can't even do it because there's too little data). This is very visible in my study. You can't see all the hypopneas, you don't know which are the central ones. It is not known at what stage of sleep you are. Home titration (without PSG) may not be enough...

One can always find an exception to almost everything if one digs far enough out on the fringes of the bell curve.

This doesn't help the claims that it's well established that the ResMed algorithm overshoots the needed pressure by a wide margin.

Root'n Toot'n Overshoot'n wrote: ↑

Mon Aug 26, 2019 11:07 am

Actually its well established that the ResMed algorithm overshoots the needed pressure by a wide margin. This is a byproduct of the "fast response" that is designed into ResMed. Personally, I like to set the mask straps at the lowest force to withstand the pressure so it would drive me crazy to have the pressure run up to 15 when I only need 11. Of course, the best thing is to have the initial pressure set correctly to start.

Although some folks praise the ResMed fast algorithm, I wonder if its responsible for so many people complaining about leaks.

Largely because that claim is... technically... horsecrap, made by someone out of their depth.

Dog Slobber wrote: ↑

Sat Sep 07, 2019 7:54 pm

This doesn't help the claims that it's well established that the ResMed algorithm overshoots the needed pressure by a wide margin.

Root'n Toot'n Overshoot'n wrote: ↑

Mon Aug 26, 2019 11:07 am

Actually its well established that the ResMed algorithm overshoots the needed pressure by a wide margin. This is a byproduct of the "fast response" that is designed into ResMed. Personally, I like to set the mask straps at the lowest force to withstand the pressure so it would drive me crazy to have the pressure run up to 15 when I only need 11. Of course, the best thing is to have the initial pressure set correctly to start.

Although some folks praise the ResMed fast algorithm, I wonder if its responsible for so many people complaining about leaks.

Thank you for your thoughtful sharing/testing . . . .