What Is a CPAP Titration Sleep Study?

Most people are familiar with an overnight sleep study, commonly used to diagnose obstructive sleep apnea (OSA) and other sleep disorders. Less well-known is a CPAP titration study. Though there are similarities between the two sleep tests, they have different purposes. Let’s take a deeper look at how a titration study works and how it’s used during the course of sleep apnea diagnosis and treatment.

The second test you’ll need to undergo is a CPAP titration study. In this scenario, ‘titration’ refers to the process of adjusting your CPAP machine’s air pressure until it delivers the adequate level to keep your airways clear while you sleep, but not so much that it causes discomfort or bloating. You may need a CPAP titration study before you can begin therapy, or when your CPAP air pressure level needs to be adjusted.

Once your level is set and the CPAP machine properly calibrated, you can go home and continue CPAP treatment comfortably and effectively.

A full-night CPAP titration study is much as it sounds, a titration study that is conducted over the course of one full night of sleep. Conversely, a split-night sleep study is used to both diagnose a sleep disorder AND to calibrate a CPAP device on the same night.

In a split-night study, a traditional polysomnogram is conducted in the first portion of the night. The titration study takes place during the second portion of the night. They are sometimes combined into one session this way if the sleep apnea is severe and the diagnosis is quickly made.

A titration study in a sleep lab isn’t always necessary. Sleep specialists are likely to recommend CPAP sleep titration studies for people with certain characteristics and conditions, including: 

• Suspected central sleep apnea
• OSA along with a cardiovascular or pulmonary disease
• Any mental or physical health conditions that could interfere with an at-home CPAP titration
• Facial features that could cause a CPAP mask to leak
• Previously unsuccessful attempts with at-home auto titration
• A living situation that makes at-home CPAP titration difficult
• The need to test several CPAP masks or machines

A CPAP titration study begins in the evening. You’ll have a private room, where a sleep technologist will fit you with a mask that’s connected to a small electric unit. You’ll be able to feel air blowing softly at the back of your throat. It’s important to tell the technician if the mask is uncomfortable, or if you notice any air leaks around the edges. 

Once you’re ready to sleep, the technologist will attach sensors to your body. These sensors will monitor your heart rate, breathing, oxygen levels, brain waves, and arm and leg movements as you sleep. 

You will have some time to make yourself at home and get comfortable. You might be asked to make simple movements such as clenching your teeth or waving a hand to help ensure the sensors are working. 

Throughout the night, the technologist will adjust the air pressure coming into your mask by small increments. You’ll start the night at a low pressure level that will gradually increase as the night goes on. The technologist might come into the room to adjust your mask. In the morning, the sensors will be removed and you’ll be free to leave.

Based on your results, you may be advised to use fixed CPAP therapy at the newly adjusted pressure setting. Or, you may be prescribed an APAP (automatic positive airway pressure) machine instead. An APAP can automatically adjust the air pressure level higher or lower depending on the need. In other words, the pressure will increase when there is an obstruction, and go back down when the obstruction is cleared.