Implementation of a Positive Airway Pressure (PAP) Grading System Improved Percentage of Optimal PAP Titrations

Abstract

PURPOSE: Demonstrate improvement in quality of overnight PAP titration studies performed in multiple sleep centers using the AASM PAP Titration grading system to validate PAP titration effectiveness. METHODS: PAP titration data was collected from 9,337 full PSG titration studies performed from 2008 through 2011. All titrations were performed using Respironic’s Omni-Lab Clinical PAP devices and Compumedic’s E-series PSG systems. PAP titrations were performed by RPSGT credentialed technologists, and data collected by 2 independent RPSGT technologists the week following each procedure. All titrations were graded as Optimal, Good, Adequate and Unsuccessful using criteria set forth in “Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apneasâ€, Journal of Clinical Sleep Medicine, Vol. 4, No. 2, 2008. Data was collected from 10 sleep facilities within one hospital system. RESULTS: Data collected in 2008 pre PAP titration grading program resulted in 53% of studies with an optimal titration grade and 72% with good/optimal titration combined grade. Data collected post implementation of a PAP grading program from 2009 through 2011 resulted in improved titration grades to 64% optimal titrations and 85% good/optimal titrations. CONCLUSIONS: Utilization of a formal PAP titration grading system enabled visualization of titration performance resulting in a significant increase in optimal titrations.