Journal des troubles du sommeil et de la thérapie
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Titration and Technology - A Single or Multidimensional Perspective?

Khem Ballaho

Oftentimes we look at titration as a one-way street where the techs increase pressure until the patients exhibit acceptable or normal range AHI (<5/hour). Depending on the diagnosis, CPAP is usually the first line of defense to addressobstructive sleep apnea(OSA). While this the gold standard for OSA, advancement in technology continually evolve and offer more dynamic modes that can further increase adherence to therapy due to comfort and varying pressure requirements. The other related hurdle to optimized therapy is the transfer of settings from in-lab titrations to home-care devices. Settings are sometimes changed or modified per physicians' approval in order to fulfill prescription orders even if the complete settings and sub-settings that optimized the titrations in-lab (and experience of the patients) are not fully transcribed due to manufacture differences and/or the limitations of the DME inventory. This article is of two-folds, one-to look at titration in and outside of the lab for long-term therapy adherence; and two-utilizing technology as additional standard of practice.