titration - can tech run out of time for correct numbers?

I have been wondering and searching and cannot find the answer to my question.

To put it as simply as possible, from what I gather, a standard titration study involves the pressure being increased in the lowest possible increments for periods of one hour (during mine it was straight numbers and not the .5 settings available...). The final pressure arrived at during my titration study was only used about 18 minutes, at which time the tech wakened me to end the study. If less than 60 minutes is a sufficient amount of time to pronounce a therapeutic pressure, how is it that the previous pressures were each tried for 60 minutes? Why wouldn't the pressures be changed immediately upon observance of apneas and/or hypopneas? And if iless than an hour is not enough time at a single setting (which I suspect happened to me), why is the final pressure not used for a whole 60 minutes to verify it is correct? This becomes more of a puzzle for me (and maybe others of the mild OSA category), when considering that the first nights' observation was inconclusive as to the OSA diagnosis, and only given final determination when viewed as a whole with all my health conditions and daytime sleepiness.

Maybe there are some RTs or sleep lab techs who can explain this better to me.

girlsaylor

Hi Girlsaylor,

Here's my impression: The tech sets a pressure and waits for obstructive apnea events. Then ups the pressure and waits for obstructive apnea events. Continues to up the pressure and wait for obstructive apneas until:
1. there are no more apneas
OR
2. central apneas occur.

If central apneas start to occur, the tech will not keep increasing your pressure because that will only make for more centrals. So if you still have a TOTAL apnea index less than 5 (centrals + obstructives), they will set you to that final pressure, figuring it is a good compromise.

I'm sure others will correct me if I'm wrong, which is good because I need to understand it too!

Cathy

I agree w/you, Cathy. Assuming you have a good sleep tech who knows what he/she is doing. For the most part they do, but occasionally you run across one who doesn't have all his/her candles lit or who lacks experience.