Manual Titration with Positive Airway Pressure
This chapter describes the steps of manual positive airway pressure (PAP) titration among adults and children. It the proper mask for the patient. The chapter discusses and recognizes the quality of titration study. Continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BPAP) are the gold standard and the most effective treatment for obstructive sleep apnea (OSA) and other sleep-related breathing disorders. Non-invasively, positive airway pressure applied through a mask provides a continuous stream of air pressure through the nose and/or mouth. Positive air pressure prevents airway collapse, allowing the patient to breathe freely during sleep. Usually, titration of the PAP device pressure is done gradually under polysomnography (PSG) monitoring. Prior to PAP titration, all patients should receive adequate education about PAP, hands-on demonstration, careful mask fitting, and acclimatization prior to the process. The recommended minimum starting CPAP should be 4 cm H2O for pediatric and adult patients.