CPAP Titration

Author / Instructor: Michael P. Cronin
Profession: Respiratory Therapists
Jurisdiction: Alabama, Alaska, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Guam, Hawaii, Idaho, Illinois, Indiana, Iowa, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Vermont, Virgin Islands (U.S.), Virginia, Washington, West Virginia, Wisconsin, Wyoming
Course Number: 7140
CEU Hours: 5
Course Method: Online
Amount: $35
Active: Yes

Learning Objectives


Upon successful completion of this course, you will be able to:


  • Define what is meant by Daytime CPAP Titration


  • Compare results of patients who receive a regular nocturnal CPAP titration with patients who

receive a daytime CPAP titration.


  • Explain the purpose of daytime CPAP titration





What is a CPAP titration study, and why did my doctor order this test?

CPAP stands for continuous positive airway pressure. Nasal CPAP therapy is a non-invasive, non-surgical way to treat obstructive sleep apnea.

When a patient comes into the Sleep Center to be titrated on nasal CPAP, he or she is fitted with a relatively small, comfortable mask that goes over the nose only. This mask is hooked up to a CPAP unit, which delivers an air pressure through the nose into the back of the airway to splint the airway open during sleep with air. Initially, the CPAP unit uses a low air pressure that allows patients to breathe easily in and out against the slight pressure. When the patient is asleep, the pressure is adjusted (titrated) to keep the back of the airway open during sleep. Pressure is titrated to keep the patient apnea-free in all stages of sleep and in all body positions. The CPAP allows the patient to achieve restful and deep sleep without interruption during the night. Patients with sleep apnea not only get a good night’s sleep on CPAP therapy, but also prevent long-term damage to their heart and body that could be caused by lack of oxygen and poor sleep.

Course Objective: Continuous positive airway pressure (CPAP) is the treatment of choice for patients

diagnosed with severe obstructive sleep apnea (OSA). The implementation of CPAP therapy has

traditionally been based on full-night titration studies or split-night protocols. This study

compared a group of patients who received a regular nocturnal CPAP titration with patients who

received a daytime CPAP titration. The objective of the study was to determine if daytime CPAP

titration is a viable alternative for the implementation of CPAP treatment in patients with severe



Study design: Fourteen patients (13 men and one woman) received a daytime CPAP titration (day

group). The day group was matched to 18 patients (17 men and one woman) who were titrated

under a full-night regular nocturnal study (night group). Eligible patients were those with severe

OSA (respiratory event index > 40). The groups were matched by age, sex, and body mass index.

Results: Daytime and nocturnal CPAP titration studies yielded sufficient amounts of rapid eye

movement (REM) and non-REM sleep to help determine CPAP settings. Importantly, the diurnal

and nocturnal CPAP titrations resulted in comparable therapeutic pressures as well as a comparable

resolution of sleep-disordered breathing. After 1 week of treatment, the groups exhibited

similar CPAP use and comparable improvements in subjective sleepiness as indicated by their

increase in sleep/wake activity inventory scores.