Journal des troubles du sommeil et de la thérapie
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Application of Telemonitoring to CPAP Titration

Kimimasa Saito*, Yoko Takamatsu

The gold standard procedure for titration at Continuous Positive Airway Pressure (CPAP) initiation is inpatient split-night Polysom nography (PSG). However, titration using home-based monitoring technology should also be considered in terms of unfamiliarity of patients with CPAP and cost burden (or medical economy). Therefore, the application of telemonitoring to CPAP titration was reviewed using previous literature and our case study. We proposed a flowchart for CPAP titration with telemonitoring, which is currently used at our institution, and delayed Treatment-Emergent Central Sleep Apnea (TECSA) cases are presented. The application of telemonitoring to CPAP titration may be beneficial in real clinical world. In this case, the existence of TECSA is problematic. However, if we understand the characteristics of TECSA and consider the influence of dynamically changing loop gain and the presence of delayed TECSA, it may be more desirable to use a telemonitoring that can track daily Cheyne-Stokes Breathing% fluctuations.