What is a CPAP titration study?

A CPAP titration study is an overnight sleep study used to properly set continuous positive airway pressure (CPAP) therapy. CPAP is a common treatment used to manage sleep-related breathing disorders including sleep apnea, hypoventilation, and hypoxemia. Once you are diagnosed with one of these disorders, you may need a CPAP study before you can begin treatment.

In some cases, members of the sleep team may perform a CPAP titration study on the same night as a sleep study. This is known as a split-night sleep study. The CPAP titration occurs in the second half of the night. This is usually only offered if the sleep apnea is severe and the diagnosis is clear.

In more mild cases, the CPAP titration study may occur after a physician reviews the results of the sleep study. The doctor will decide if you need to come in for a CPAP study.

How to prepare for a CPAP titration study?

A CPAP titration study involves an overnight stay at a sleep center, hospital or a special hotel room. The testing environment is set up so you will be comfortable during your stay.

On the day of your sleep study:

Follow your normal routine as much as possible
Avoid napping
Avoid caffeine after lunch
Avoid using hair sprays or gels that can interfere with the sleep recording

If you are on a regular medication, speak with your sleep doctor, who may recommend you stop taking the medication temporarily.

When it is time to report for your CPAP titration study, bring any items that you need for your nightly routine. Prepare for the sleep study as if you are staying at a hotel for a night. Guests are usually not allowed. You may want to bring:

Comfortable pajamas or clothes to sleep in
A toothbrush, toothpaste and dental floss
Makeup remover
Reading material
Clean clothes for the morning

What is the testing process for a CPAP titration study?

During a CPAP titration study, members of the sleep team will calibrate your CPAP. The goal is to find the right amount of air pressure to prevent your upper airway from becoming blocked. This eliminates breathing pauses in your sleep.

When you show up for the study in the early evening, you will be fitted with a nasal mask or a full face mask that is connected by a tube to a small electric unit. The fitting process is an important first step in the CPAP titration. Be sure to tell the technologist if the mask is uncomfortable or if there are air leaks around the edges of the mask. The electric unit has a fan that blows air through the tube, into your mask. When you wear the mask, the air will gently blow into the back of your throat.

You will have some time to make yourself at home. There will not be any other patients in your room. You will have a bathroom available to use, and you may have a television that you can watch.

When you are ready to go to sleep, tell the sleep technologist. The technologist will attach sensors to your body to monitor your sleep just like a sleep study. These sensors measure your brain waves, heartrate, breathing, oxygen levels and leg and arm movements. The wires are long enough to let you move around and turn over in bed. You will be asked to move your eyes, clench your teeth and move your legs to make sure that the sensors are working.

At certain times throughout the night, the technologist will remotely change the air pressure you receive through your mask. Pressure starts at a very low level and gradually increases. If there are problems, the technologist may come into the bedroom to adjust or replace the CPAP mask. Tell the technologist if you have any discomfort with the CPAP treatment.

In the morning the technologist will test and then remove the sensors. The CPAP titration study is complete once you are awake and the sensors have been removed. You are free to leave and return to your normal activities.

How are CPAP titration study results reviewed?

The sleep doctor will review the information gathered during the CPAP titration study to determine what level of CPAP treatment will work best for you. Your doctor will contact you when the results are ready. You will receive instructions on how to get a CPAP unit and mask for use in your home.

When do CPAP titration studies require a follow-up?

On rare occasions, a CPAP titration study may fail to find the right pressure to treat your sleep apnea. In these cases, you may need a variable pressure device instead of continuous pressure. The sleep physician may recommend a second titration study or ask you to use an auto-adjusting CPAP device. These devices are similar to CPAP except the air pressure is set automatically. A memory chip stores the data for the sleep doctor to review. Newer web-based devices can also provide the sleep doctor the same data. Changes in pressure and device type may be needed during the first few months of treatment.

Sometimes the CPAP titration study may not determine your ideal settings. If you have problems with the masks, straps, pressure or air temperature of your machine, contact your sleep doctor as soon as possible. She may suggest a new mask, a machine that provides variable pressure or a heated humidifier to make your treatment more comfortable. A nasal spray may help CPAP users with nasal congestion problems. Always talk to your sleep doctor before making any changes to your treatment.