Figure 4.

BPAP Titration Algorithm for Patients ≥12 years During Full- or Split-Night Titration Studies. Note: Upward titration of IPAP and EPAP ≥ 1 cm H2O for apneas and IPAP ≥ 1 cm for other events over ≥ 5-min periods is continued until ≥ 30 min without breathing events is achieved. A decrease in IPAP or setting BPAP in spontaneous-timed mode with backup rate may be helpful if treatment-emergent central apneas are observed.

* A higher starting IPAP and EPAP may be selected for patients with an elevated BMI and for retitration studies. When transitioning from CPAP to BPAP, the minimum starting EPAP should be set at 4 cm H2O or the CPAP level at which obstructive apneas were eliminated. An optimal minimum IPAP-EPAP differential is 4 cm H2O and an optimal maximum IPAP-EPAP differential is 10 cm H2O.