Task Force Sets Clinical Guidelines for Manual Titration

June 1, 2008

The American Academy of Sleep Medicine’s (AASM) PAP Titration Task Force has developed clinical guidelines for conducting CPAP and BPAP titrations in patients with obstructive sleep apnea (OSA). Recommendations include:
• Making sure all potential PAP titration candidates receive adequate PAP education, hands-on demonstration, careful mask fitting and acclimatization prior to titration.
• Increasing CPAP until the following obstructive respiratory events are eliminated or the recommended maximum CPAP is reached: apneas, hypopneas, respiratory effort-related arousals and snoring.
• Limits on how much water the CPAP device should have at the outset for both pediatric and adult OSA patients, as well as how much water should be added to the CPAP device throughout the course of the night and what conditions should be met in order for the CPAP level to be increased.

“It is anticipated that these guidelines will provide a more standardized method of titrating OSA patients with positive airway pressure and will assist sleep laboratories in the recognition of what comprises an acceptable vs. unacceptable titration,” said Clete Kushida, M.D., Ph.D., of Stanford University Medical Center, Task Force chair.