by Dr. Barry Krakow
| Sleep Review Magazine
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When talking with groups of sleep technologists about ways to achieve superior PAP therapy titration studies, I always ask, “What are the two most important factors in performing outstanding titrations?”
Let’s be clear, this is a trick question and rarely is it answered correctly, except by unusually savvy sleep technologists.
Many vote for the perfect mask and mask fitting; others are persuaded to find the right pressure delivery system; still others exclaim that titrations are more art than science, leading them to extol the virtues of careful observation and diligence as the real keys to success.
All these factors are highly relevant, but they are not the two most important factors. The next round of contributors move closer to the secrets of success but don’t quite get there: patients must be effectively desensitized to the mask as well as the pressurized airflow prior to starting the titration; patients must be thoroughly educated about their sleep breathing symptoms and how PAP therapy will correct the problem; and patient motivation must be thoroughly assessed, and, if lacking, then a healthy dose of support and encouragement must be provided to raise the motivational level.
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