During a titration study, what are the appropriate pressures to begin a bilevel titration if apneas are eliminated at 10 CM H2O but hypopneas and snoring continue at 16 CM H2O?

In a bilevel titration study, the goal is to effectively manage and eliminate apneas, hypopneas, and other forms of respiratory disturbances such as snoring. In this scenario, apneas are eliminated at a pressure of 10 CM H2O. However, hypopneas and snoring remain present even when the pressure is increased to 16 CM H2O.

The correct choice reflects an approach to maintain the elimination of apneas while effectively addressing the remaining issues of hypopneas and snoring. By setting the IPAP (Inspiratory Positive Airway Pressure) at 10 CM H2O and the EPAP (Expiratory Positive Airway Pressure) at 14 CM H2O, the settings create a difference in pressure that aids in maintaining airway patency during expiration without overly increasing inspiratory pressures, which might otherwise lead to discomfort or unnecessary pressure during sleep.

This combination allows the maintenance of the level of pressure needed to prevent apneas while simultaneously providing a higher EPAP to counteract hypopneas and snoring. This strategy effectively balances the need for sufficient airway pressure during both inhalation and exhalation, making it appropriate for this clinical situation.

Other choices present pressures that may be too high