• Cognitive Behavioral Training to
    Implement the PAP NAP


    ONLINE TRAINING - CEU Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.
  • IRT
    Imagery Rehearsal Therapy


    ONLINE TRAINING - CEU Credit Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.
  • New Pathways for Chronic Insomnia
    Sleeping Pills or Sleeping Test?


    ONLINE TRAINING - CEU Credit Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.

Recent Research: In the News

Pharmacotherapy Failure in Chronic Insomnia Patients



Published in the Mayo Clinic Proceedings
Pharmacotherapeutic Failure in a Large Cohort of Patients With Insomnia Presenting to a Sleep Medicine Center and Laboratory: Subjective Pretest Predictions and Objective Diagnoses

The Secrets to a Superior Titration | July / August 2009


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by Barry Krakow, MD  | Sleep Review Magazine |  Download the PDF

Unconventional Wisdom

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.

Read full article at Sleep Review