Upon successful completion of this course, you will be able to:
receive a daytime CPAP titration.
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.