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Titration Study

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Titration Study

Postby libertino85 » Sun Oct 08, 2006 12:10 am

How exactly does a titration study work? My loaner machine has a chip in it, and at the end of the week I'm going to get a new machine and the doctor is going to set the air pressure.

How does the doctor find the right air pressure? Isn't there machines that adjust the air pressure as you need it automatically? Or do you need the SAME air pressure every night?
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Postby Zen » Sun Oct 08, 2006 9:06 pm

If you are at a sleep lab the technician will have the pressure set to a certain level.The results will be noted. If that pressure does not reduce the number of apneas or hypopneas, the technician will adjust the air pressure and continue until the proper pressure to keep your airway open is achieved.

An auto adjusting machine with a data card to record the results might be used for home study
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Postby RPSGT88 » Mon Oct 09, 2006 6:20 am

That's a good description of a complicated process. The protocol used to titrate CPAP and Bilevel in my sleep lab is 12 pages long.
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Postby CrohnieToo » Wed Oct 11, 2006 11:29 am

And, boy!, curious soul that I am I would LOVE to read all 12 pages!

I do have a question: I ended up needing 2 titration studies. The first I only slept 42.5 minutes total and felt that was my fault because we'd had a family crisis just an hour prior to my leaving for the study and my first instinct had been to cancel but let my hubby talk me into keeping the appointment.

The second study I managed to sleep all of 98 minutes. BUT the second study they didn't go to as high a pressure as they did the first study. The first study I encountered a couple of episodes of my mouth filling w/air and finally it all expelling thru flapping lips. I didn't encounter that the second study.

I refused the equipment until I could talk to my sleep pulmo and discuss what equipment I was going to get. I wanted some input. He mentioned I would be set at the highest pressure in the second titration study. I got data files, graphs, etc.

So I get my equipment. Have done two nights "flying solo". A total of 7 hours w/the mask & machine on. I'm experiencing pressure in the ears, almost an ear ache, and the mouth filling w/air and expelling thru flapping lips. Not a pleasant experience! I do okay during the 15 minute ramp (highest I'm allowed whether by the machine or the settings the DME supplier made, I don't know). I'm actually dozing off relatively quickly given the newness. Then I wake up w/the ear, mouth, lips bit. My sleep tech says that this is due to the humidity being set too low. I have it set at only one notch below the highest level so will try setting the humidity at maximum tonight.

Does the lack of enough humidity make sense to you, RPSGT88, as a cause of the mouth filling w/air and uncomfortable ear pressure?? Or is it just a matter of adjusting to the pressure level?

Between the two titration studies so close together and these first two nights of adjustment to PAP I'm getting pretty darn witchy! I need some SLEEP!
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Postby RPSGT88 » Wed Oct 11, 2006 8:46 pm

You will have to experiment with the humidity. That setting will vary depending upon the type of humidifier and hose (F&P has a heated hose to prevent rainout!) and the pressure and the leak.

What pressure and mask are you using?
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Postby CrohnieToo » Wed Oct 11, 2006 9:07 pm

I've used both the Swift nasal pillows and the F & P HC 407 nasal mask. Its happened w/both. The Humidaire 3i has a range of 1-5. The DME RT suggested starting at 2.5. I did raise that to 3 as that seemed more comfortable than 2.5. Half way thru last nite I upped it to 4. I've had no problem w/rainout.

The first titration study they got up to 7, I only slept 40 minutes. The second titration study 6 was the highest pressure used and I slept 98 minutes. I've had no problem w/rainout.

Thanks for your consideration of this for me.
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Postby RPSGT88 » Wed Oct 11, 2006 9:59 pm

I hope this is not an embarassing topic but do you wear dentures? Trying to use CPAP without dentures in to support the lips is perhaps the worst cause of oral leaks and lip flapping.
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Postby Sally » Sat Nov 18, 2006 6:31 pm

CPAP vs. DENTURES

I am a Newbie, having had my CPAP for about 2 months. Have had dentures for what seems like forever. They were 25 years old, and really needed to be replaced. Also its time for my 2 year old glasses to be replaced. Feeling very determined to make all this work for my good, I chose to set some priorities. Sleep apnea was controlling my life. As you all know, sleeping 16 hours a day doesn't leave a lot left for anything. I always slept with my dentures in so I left them in with the machine. No problem.

So first I got the Cpap. My mouth is drying out horribly. Still working on that. Thursday got the new dentures. Felt perfect for the first hour or so. Next day the were horrible.Friday I went back to doc, he worked on them a bit. OK. This morning I have more sore places. I left the lowers out and the uppers in. Can't see doc until Monday.

bottom line is: When my dentures are in, the mask makes sore spots. When my dentures are out, the mask leaks.

Someone once said, "Getting old is not for Sissies".

Think I'll just have a nice cup of tea and pet my cat.

Thanks for a shoulder.

Sally
May the sun shine where ever you, especially in your heart.
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Postby CrohnieToo » Sat Nov 18, 2006 8:02 pm

There's no fit like that first set of dentures!!! What type of mask are you using?
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Year Diagnosed: 2006

Postby Sally » Sat Nov 18, 2006 10:41 pm

Hi Crohnie Too,

Thanks for your response.You asked about my mask. It is an ResMed Ultra Mirage Full Face Mask.
I see you are using brands.

Life is interesting. At least I know I am not the only one with these problems. Seems like the manufacturer would certainly be interested solving their customers problems. But we certainly are not all alike. I appreciate this board. And reading the support that you all give to each other.

I think tonight I will try upper and lowers in. and use a scant amount of denture adhesive
on the inside of my lips to keep my mouth shut. let you know what happens.
May the sun shine where ever you, especially in your heart.
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Postby CrohnieToo » Sat Nov 18, 2006 11:25 pm

Good luck tonight, Sally!

Goshes, RPSGT88, my apologies. I didn't see your post. Yep, as you've guessed by now, I do wear dentures. And, yup, I wore my dentures during my sleep and titration studies. Sometimes I wear them to bed, sometimes I don't. Depends on how tired I am before hitting the mattress. Hmmmm. I'll have to pay attention next time I get the flapping lips and/or ear pressure.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Posts: 7943
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Mask: Resmed Quattro FX Small
Humidifier: Resmed H3i
Year Diagnosed: 2006

Postby Sally » Sat Nov 18, 2006 11:59 pm

Hi CrohnieToo,

Thanks for the good wishes. I just thought about a product called Baby Numsit. Don't know if that is the correct spelling or not, but it is used on teething babies and toddlers. we have a 3 year old across the street. So i called his Mom. she didn't any of that but brought over chlorseptic spray. Didn't take long for that to take effect. So will see how the night goes. I'm thinking positive here.

Sally
May the sun shine where ever you, especially in your heart.
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