CPAP Titration

If you are diagnosed with obstructive sleep apnea syndrome, your doctor will probably prescribe the CPAP:  continuous positive airway pressure. CPAP is an apparatus that takes in room air and then pumps it out as pressurized air through a plastic tubing connected to a mask. That air  enters your nose and/or mouth and travels down your throat. It acts to prevent those muscles from collapsing. The collapse is what causes the apneas (“no breathing”) when you sleep. CPAP is an effective way to treat sleep apnea. The challenge is adjustment and patience with the mask and how the airflow feels. It takes time.

The purpose of the CPAP titration study is to find the correct airway pressure that eliminates the apneas, snoring and related drop in oxygen. It is a type of sleep study that is performed at the sleep center or laboratory. It might be the same location where you had your first sleep study where you were diagnosed with sleep apnea.

During the titrations study, a technician will work with you. They will first place wires on your head and belts around your chest and abdomen before the study begins. They will get you fitted with a comfortable mask. When the actual study begins and you start to sleep, they will apply a very low air pressure through the CPAP and gradually increase it to one that works to eliminate the apneas. Some people might need a pressure of 7, others of 15 and so on.

A doctor who specializes in sleep medicine will then read the results of the CPAP titration study. The doctor’s office then faxes these settings to a home health company which would likely provide you the actual CPAP equipment and mask. They should work with you on the set up and appropriate use of the mask and head gear and hygiene issues. At home, you want to place the CPAP machine on a table next to your bed.

Tips on getting adjusted to the use of CPAP and the mask

If you have sleep apnea and now you got your CPAP and are struggling with the mask, be a little patient ! It takes time to get adjusted, but once you do, it is worth a great deal. You can now breathe well when you sleep and be more awake and energetic during the day. By treating the sleep apnea, you will reduce your risks for heart disease and hypertension, for example.

Follow these steps if you are struggling with CPAP:

  • Put your mask on during the day when you are sitting around your kitchen table or in your living room- so there is no pressure to sleep. Do not use the CPAP machine now, just place the mask on your face and try to breathe- make friends with it.  Do this exercise for 15-30 minutes every day.
  • When you are comfortable with the mask, do the same exercise, except now use the CPAP with the mask and feel the airflow. Now try to get adjusted to it while sitting up in your kitchen table.
  • When you get adjusted to the mask and airflow, take the CPAP to your bed and start using it while lying on your back in your bed. But do this exercise during the day when the pressure to sleep is absent. Do it for about 15-30 minutes.
  • When you are ready, try to sleep with it. Hopefully, you are now more comfortable with it and begin to sleep and feel better.
  • If you cannot keep it on all night, that is ok; take it off, but make sure you put it back on the next night and so on until you get used to it. It is better to do it this way than to force yourself to keep it all night and have the feeling that you “failed”.  There is no failure, only slow successes. It takes time.  It may take weeks or months to get used to the CPAP for some people.
  • Anytime you feel the mask is not fitting correctly or the airflow is too high or low talk to your home health company and to your doctor. Try to write down what bothers you about the CPAP and share it with those who can help you. Be specific- like “the mask is pushing on my nose bridge”, “mask is leaking” or “I have a hart time breathing against the airflow” and so on.