Starting pressure recommendation

napnean wrote:@John: The plan is to have the APAP machine (Respironics System One) do the titration. The expense of the lab titration was daunting, plus I felt that I was extremely unlikely to fall asleep (my usual time to fall asleep being around 3 am). If things don't work out well, the lab titration is still on offer.

I normally go t o bed between 4 and 6am. I also sleep horribly in hotels - awake a good portion of every hour. I dreaded my sleep study. I asked when I got the paperwork if they would give me anything to help me sleep. They said they do not, but I can ask my doctor to prescribe something. I got an ambien for that night only. I didn't feel any sleepier than normal, or drugged, but I slept pretty well. I woke up once about an hour in, for the bathroom. Just over 2 hours in, the sleep tech woke me up, sent me to the bathroom, and then hooked up the mask. I rolled over and woke up several hours later.

They determined that 11 took care of most of my apneas, and they weren't sure if they had mastered the supine sleeping apneas since I only slept on my back twice when I had the machine on. They got up as high as 15, so they recommended 11-17, and that has been great. It occasionally gets up to 15, and on rare occasions goes up to 16.9.

I can't imagine trying to get an accurate titration at home when it took me 6 weeks to master my mask, and my sleep tech fitted the same mask in less than 2 minutes and it fit correctly (without leaks) the very first time.

napnean wrote:@John: The plan is to have the APAP machine (Respironics System One) do the titration.

Hi,

The issue is that the APAP machine has only 1 channel of data, and that data channel only covers a very limited subset of sleep disorders. It cannot give you a diagnosis. It cannot tell if you are have arousals, it cannot read your oxygen level, it doesn't know your sleep states, and it cannot determine stuff like positional effects or central events. An APAP used incorrectly can make your sleep disorder worse.

It is worth a try if cost is that big of an issue. But keep in mind that you could end up spending far more in the long run if it takes you several attempts and multiple different machines to get it right, not to mention the cost of your time. A titration study has a good chance of getting it right on the first visit. For me, my time was too valuable to let things go on much longer. As they say, your mileage will vary.

-john-