Need Titration Study?

[codger]

My cpap crashed and I went back to my doctor for an Rx for new machine.
I had read about auto Cpaps and Dr wrote RX for APAP with pressure range 8-12. He also scheduled a new sleep titration study.

I have had 3 sleep titration studies in the past. It is my understanding that the new APAPS (I bought a Devilbiss Intellipap Auto) will automatically adjust pressure by raising and lowering pressure as apnea events occur.
I hate sleep studies, and although the study produces lots of scientific data, the only result is that a CPAP is set at a pressure numerical value.

Do I need another titration study? Won't the Intellipap find the pressure ranges that are best for me. Hasn't the Dr done me a disservice by limiting the pressure ranges on an automatic machine?

[StuUnderPressure]

I got a new ResMed S9 AutoSet in January 2012.
This was my 3rd machine in 13 years.

My one & only Sleep Study & Titration was done 13 years ago.
Neither was repeated as a condition to be able to get another machine.

Stand your ground & tell them you want to postphone another Titration until you see what the Auto CPAP information tells you (for at least 3 months).

Then, once you have the machine you want, just never agree to have the Titration done.
The information you will get from the Auto CPAP will tell you everything you need to know.

Now, if you or your Doctor suspects other problems than just a needed pressure change, you may need the full blown Sleep Study again.

[Dawei]

Welcome to the board, Codger! I'd agree with Stu's comments. During my own recent care, I and my sleep doc discovered that the titration pressure called for during a recent sleep study proved to be WRONG. Then, when I convinced my doc to write for an autoset machine on a loaner basis, it found that I actually needed higher pressure to control my apneas. I'm talking significantly higher (5-7 cm) than the study's titration reported. My doc, who is a boarded sleep specialist, couldn't figure out why the sleep study titration was off. He told me that he asked the technician if I was sleeping on my back, which I was and which I do at home too. When I got the Autoset loaner, the doc set its range at 8-19, which is fairly wide open to let the machine find the best pressure range for me. So, this makes me wonder why your doc set your new apap at such a narrow range. For 5 years, I had been on 7 cm pressure, which was from my first sleep study. Over time, my pressure needs had significantly increased, I and my doc discovered. My current pressure is up around 17-19 cm with AHI down below 5.

[Sleepster]

I have had 3 sleep titration studies in the past.

If you were diagnosed with simple OSA, then I would agree with the advice you got from Stu.

[codger]

I appreciate the feedback on the need for a new titration study. I thought that a new titration study was unnecessary, but my wife was (is) of different opinion.

The last sleep study called for a setting of 14. I could not sleep at that pressure and I learned how to lower the pressure. After experimenting over time I found a pressure of 12 worked best for me. The sleep study, performed almost entirely on my back, was useless. My throat occlusion increases significantly when sleeping on my back, so I sleep only on my side.

I am awaiting an email from apneaboard.com revealing how to raise the range that the doc prescribed last week. And I am going to cancel the titration my Dr ordered.

I have now logged over 14,000 hours on CPAPS.

Codger

[Sleepster]

If you get the right software you'll be able to determine whether or not your therapy is effective. That'll settle the debate between you and your wife. :-)

[trish6hundred]

Hi codger, First, WELCOME! to the forum.! Sounds like you got some great suggestions, best of luck to you.

[PaulaO2]

IF you have just obstructive sleep apnea (OSA), then the autoset would work for you.

IF you have other conditions such as periodic limb movement disorder (PLMD) or low blood oxygen at night, then a sleep study might be a good idea.

The newer machines can report 'clear airway events' which may or may not be central apnea events. They can report if you are snoring.

But they cannot tell if you are struggling when you stop breathing (the difference between OSA and CSA) or if your body is twitching (PLMD) or your heart rate or blood oxygen levels. If none of these are an issue, then forget the sleep study and use the APAP to do it for you.

[zonk]

And I am going to cancel the titration my Dr ordered.

I have now logged over 14,000 hours on CPAPS.

Codger

if were me I would not cancel the sleep study
the sleep study can tell me for certain if my apnea is obstructive, central or both and other sleep disorder

congrats on the 14000 PAP hours

[Suzjohnson]

Are you paying for the machine yourself? I was under the impression most insurances required a new sleep study when you got a new machine.

Suz