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Titatration Preference: In home or lab?
(12-05-2013, 10:35 AM)simplysara Wrote: I've rattled on a bit here, but my main question is what you recommend/prefer as far as in home/automated titration vs. doing it in the lab.
I prefer titration done at home in my own bed but my apnea is obstructive and not central or something else

I,m not a doctor and don,t need to be one but the people who designed my machine are doctors, mathematicians, engineers, scientists, etc ..
My own doctor is not of them, he rely on the information from the machine which I can also easily obtain from machine LCD screen sleep report or/and software .. its not rocket science

Beside data capable machine, trialing half dozen or so of different masks is important and even more important
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Thank you all for your input! I guess we'll wait and see what the insurance says. I feel better knowing there are pros and cons both ways, that it's basically to get the baseline figured out, and let the auto-machine do it's thing once I get it home. This is a daunting adventure and it sure helps to know I'm not alone.
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Another reason to do the in lab titration is the variety of different masks to try on. It's kind of difficult to sit with customer rep at your DME and just pick a mask that you like or think would work. Do you know if you breathe through your nose only? That might be something to think about if you go the home route.

I know I'm a mouth breather; so that narrowed down my choices considerably. I'm not ruling out trying a nasal pillow type mask but for now the FFM is doing OK.
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(12-06-2013, 05:24 PM)Nozzelnut Wrote: I know I'm a mouth breather; so that narrowed down my choices considerably. I'm not ruling out trying a nasal pillow type mask but for now the FFM is doing OK.

I am a mouth breather as well and have used a ffm for almost 3 years with a whole lot of trouble that has just recently been resolved by the sleep lab that I have a sleep study with next week bringing me 10 masks to try on (my DME doesn't let you try on masks and have a limited selection on mannequin heads to look at but don't try on). I chose the wisp and they also gave me a chin strap and it has been awesome and so much better for me than a ffm. My leaks are way down and in normal limits finally, my AHI is very low and a lot of times zero. I still wake up a few times but most of the time, unless I want a drink, I can go right back to sleep. My pressure is down as well which is a great thing for me. My snoring is way down too. The chin strap I have is not like the common one my DME has, it is like the SP Chad. I did have a stuffy nose on Wednesday last week and used Patanase and it cleared up so I could use the nasal mask.

I can get a drink without taking of a mask, can sneeze without taking off the mask. The headgear is so much better than the one I had with all 3 ffm that I had tried.
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If in home titration only involves typical APAP machine data your sleep Dr will be unable to discern when you're actually sleeping. The downside being that events that your APAP machine detects while you're awake are not excluded from the result.
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I had such a terrible time trying to sleep in my two sleep studies that I only slept after taking sleeping pills... Which I never do in real life. However, my titration study was in the lab and I slept fairly well. Without pills. I also believe the pills made my in-lab AHI reading worse than it actually is.

If I ever have to do a sleep study again it will be in home. I simply could not handle all the constricting connections.

Now I am on an auto pap and my pressures are never as high as they were in the lab. They are about 3 cm less, consistently. So I personally and anecdotally believe that the lab environment is not a good measure of one's actual sleep.
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