What is a CPAP Titration Sleep Study?

Sometimes a patient will participate in a sleep study to identify or confirm a diagnosis of sleep apnea.

Imagine their surprise, then, when they discover they need to go back to the sleep center and take part in yet another sleep study?

This doesn't always happen; some sleep studies identify sleep disorders other than sleep apnea, and they usually only require one trip to the sleep lab for diagnosis.

For those who do have sleep apnea, they might undergo a same-night "split night study" to both diagnose and treat moderate to severe sleep apnea, which doesn't usually require a return trip to the lab. This is because they have more severe symptoms and have been "green lighted" by the sleep physician to start therapy right away.

However, someone who has mild to moderate sleep apnea may need to return for a test called a CPAP titration study.

What is a CPAP titration study?

As we discussed in our recent post on split night studies, part of the protocol for treating patients with CPAP involves trialing continuous positive airway pressure (CPAP) therapy. Their symptoms are severe enough to warrant an intervention, which is determined by protocols well established in the field of sleep medicine.

However, for those with mild to moderate sleep apnea, who do not qualify in real time for a split night study, they may still need therapy. The return to the lab is done so they can have a full night to trial CPAP therapy (or, in some cases, oral appliance therapy, which also requires titration). This is a protocol that is shaped not only by sleep medicine agencies, but by insurance payers.

The CPAP titration study is useful and thorough. It provides the sleep technologist with the opportunity to help these sleep patients find the most comfortable mask, to ensure a good mask fit, and to identify pressure and comfort settings unique to the patient.

What to expect during a CPAP titration study

If you've already had one sleep study, then you already know what to expect in terms of the preparation required to launch your test. However, there's one key difference: you will start your test using your CPAP therapy from the moment it begins.  

Your sleep technologist will be available to you throughout the night to ensure you are comfortable and that all of your sensors are connected and functional.

They will be remotely changing the pressure on your machine as you sleep until it reaches the level that prevents the pauses in breathing—the apneas—from happening.

 

The pressure will start at a low level and will be very gradually increased in order to help you remain comfortable. If you experience discomfort, they can help you by adjusting other factors, like pressure relief or humidity, all from their station in the lab.

Remember, everyone is different in terms of how much pressure they need; you may need a lot more than your friend, or you may need far less than your coworker.  

The importance of CPAP mask fit

One area of special focus for the sleep technologist during your visit will be the fit of your CPAP mask. If it leaks, it distorts the accuracy of the sleep test. Any breach in the seal of the mask will render it ineffective; it will be part of their job to help you achieve a proper, and comfortable, fit to avoid problems with mask leak.

Don't be surprised if they enter your room several times to make adjustments or to ask you how you are doing with the mask. This is a high-priority part of the test.

You will continue to use CPAP therapy throughout the night. The results of the data collection from this study will determine how your sleep apnea machine will be set so you can receive the most appropriate therapy for your needs when you actually take your therapeutic equipment home. 

Once your study is complete, your sleep physician will review it to determine the proper prescription for your CPAP machine and mask. Once these are issued, you are ready to begin with CPAP therapy. 

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