Apnea Forum Posting

Posted by Kevin (in Walla Walla) on February04, 2000 at 12:43:41:

In Reply to: Dry nose and snoring again posted by Savannah on February03, 2000 at 14:43:54:

Savannah,
1 or 2 hours is not enough time for a xPAP titration. We've found that we need a minimum of 6 hours data, and that we MUST have supine REM sleep. Also, the most significant apnea will occur in the last REM period, usually just before you wake up. If your xPAP pressure was based on a very limited sleep period the odds are that your pressure is wrong. That's why in our "split-night" PSG's we make the decision to start xPAP after the first full sleep cycle, or the first 2 hours of the test. We also tell our patients that we don't wake them up at a set time in the morning. We let them sleep until they naturally wake up. We've had some patients who've slept 14 to 16 hours here because they've been so sleep deprived. If we don't get a good idea of what the final pressure should be, we either bring them back or set them up on an auto-titrator for several days, the longer the better. I've been doing this so long that I remember the good old days when everyone was studied 3 nights in a row. The first was just diagnostic, the second was the tiration, and the third was at the final pressure, just to make sure. Needless to say, insurance companies no longer let us do that.

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