What happens in a titration sleep study?

[HalfAsleep]

I've already had the sleep study from hell. Is the titration study more hellish? Will I need 3 days of sleep recovery? Will I be at risk of gagging, choking, or GERDing from the experimentation while they get it figured out? Who does the figuring out? Do they put wires all over you again? How much sleep am I likely to get if they keep fiddling with the machines?

[DeepBreathing]

G'day HalfAsleep.

I haven't been through a titration study myself so I can't say from personal experience how it's run. But from my reading, yes you will have probes and electrodes. The technician will fit you with a mask attached to a more sophisticated type of CPAP machine and vary the pressure up and down in stages to get an optimum solution for you. From this your doctor will write a prescription.

If your initial sleep study showed you have plain vanilla obstructive apnea (ie no central apnea component or other complications) then I firmly believe the titration study is not necessary, and could be quite misleading. You'll be sleeping in a strange bed, in a strange room, with the probes and electrodes and a CCTV camera watching your every move. Now, just relax and sleep normally... If you couldn't sleep during the initial test you probably won't sleep during the titration test. From this they will try to establish a single pressure to suit you more-or-less forever.

In my humble view, you should be provided with a Resmed Autoset with an SD card, the machine being set more-or-less wide open (ie 4 - 20). You should sleep in your own bed, in your own home. Go to bed at a time that suits you and get up at a time that suits you. No probes or electrodes. After a week you should go back with your data and the therapist should adjust your settings based on the first week's detailed data. Rinse and repeat. With a half-way competent therapist you will have settings tuned within a couple of weeks and have a much better chance of a successful outcome.

Now, having said all that, if you have central apnea or other complications, then home titration with an autoset may not be enough. But that is only a minority of cases.

[eplantz]

pretty much the same as before…… a mess of wires, etc.

you will wear a mask and the tech will fiddle with pressure settings while you sleep and watch the readings. this is how they determine the optimal pressure for you.

you may not even notice…… but if this is the first time you have worn a mask to sleep, it might be odd for you.

[dwd1249]

I had a home study first then a year later went in for a titration study.
It wasn't too bad for me as I was used to sleeping with a mask on and pressure. First half they just let the machine do it's thing then did some manual adjustments .
I came out of it knowing that I didn't have central apneas and that my pressure should be around 14 to control my osa. My BMC Resmart machine was only providing a pressure of 8 to 9 on auto.
So if you had a in lab test before it will be much the same.

[Gideon]

Titration Study: a study with a mask to determine your treatment settings.  

You will be "fully wired up".  This is both good and bad.  The good is that the study will show, and adjust to all the forms of sleep apnea that you have, very very good.  The bad part is that you are doing these sleep studies  "fully wired up" many, many wires to your head, torso and legs, on a strange bed, with a strange pillow, a video camera watching you all night, this odd (for now) contraption attached to your face, and you will even need help to go to the bath room.  Have a good "normal" nights sleep (right. . . . . ).

You will need to shampoo your hair after this study.

The result of this study is a recommendation for settings that your Doctor will use for your Prescription.  It is based on this one nights sleep and you will most likely be getting a prescription for a single, unchanging pressure to work for you for years too come.

Generally the Apnea Board likes to see an Auto machine prescribed, either an Auto CPAP, or when appropriate an Auto BiPap/BiLevel machine.  The Auto machines may be run as a single pressure Fixed CPAP or in Auto Mode changing to your changing conditions.  A short note here, in some cases a fixed pressure is the best solution (I didn't say a non-Auto machine).  I am sure your sleep studies represented "normal" nights sleeping, right. . . 

Note: This is an opportunity to try different masks on.  Use it for this.  The lab will get the data they need from any masks you use.  The chance to try on multiple masks is few and far between.  Take advantage of the opportunity to talk to your sleep tech, they work with many people that have never used a mask and are practiced at fitting them.  Occasionally I have received the samples I tried to take home.

[personal111]

Unless you have more complex types of sleep apnea it will be the same thing as far as monitoring equipment plus added CPAP gear.

They will fit you with a mask and then as you sleep monitor and if necessary wake you up and try different masks. The machine settings will be changed without you knowing it's occurring. They will probably give you a good wallop of Ambien (they can give you a larger dose than normal as you will be under observation while you are under its influence.)

It's really more of a PITA than all that awful.

Stay up late the day before, go TIRED!

[Walla Walla]

I don't think giving Ambien is a common practice for sleep centers unless it's a special case.

[Gideon]

My Titration study is a piece of cake, the diagnostic study was a different case. With an untreated AHI of 70-90 (depending on which study) it seems that actually want you to sleep sometime in the night. Go figure.

[PaytonA]

The sleep lab that I went to years ago was excellent. It had a very nice facility and they had put a lot of effort into setting it up so that it looked more like someone's bedroom than a lab. The environment was excellent. Although the bed was a little softer than I prefer, I was able to sleep fairly easily even with all the wires. I fell asleep fairly easily.

As a result, the prescription was dead on. I even tried playing with the pressures later on and ended up right back where the titration said I should be.

I was lucky to have a well done titration and good analysis. We have heard of many people that have had bad sleep tests.

Just my experience. Not necessarily indicative of the norm.

PaytonA