Posted by Roy on April 10, 2003 at 14:05:13:

In Reply to: CPAP titration and mask/mouth leak question posted by mp on April 09, 2003 at 07:02:04:

There is no way to know if there is a mouth or mask leak unless they give you a quantitative channel of mask pressure. With mask pressure you still don't know if it is a mask or mouth leak from looking at a ANR. But the pressure will change, depending on the CPAP machine. Sometimes you can get a clue if the pressure is less during sleep than when there is are awake.

For titration, when increasing pressure the first thing to dissapear is the apneas, next the snoring, then you need to get rid of any repetitive arousals. They are the last thing to dissapear. So if the pressure is not optimal you will see arousals due to negative pressure (UARS).

Finally, you want to see the patient on his back in REM sleep to find the optimal pressure.

There are others who may want to add to this. So make follow-ups.

Roy

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