Correct statements about acceptable PAP titration results include all of the following EXCEPT:

Correct statements about acceptable PAP titration results include all of the following EXCEPT:

• A. It reduces the respiratory disturbance index (RDI) to less than 5 for at least 15-minute duration and should include supine REM sleep at the selected pressure that is not continually interrupted by spontaneous arousals or awakenings
• B. It reduces the RDI to 10 or less or by 50% of the baseline RDI less than 15 and should include supine REM sleep that is not continually interrupted by spontaneous arousals or awakenings at the selected pressure
• C. It reduced the RDI to less than 5 for at least 15 minutes duration without supine sleep seen at the selected pressure
• D. It does not reduce the RDI to 10 or less but reduces the RDI by 50% from baseline in severe patients

Answer: (D)

In PAP titration, the end point is to show meaningful control of breathing at the prescribed pressure, with clear thresholds for residual events. Acceptable results include either achieving an RDI below 5 for at least 15 minutes while the patient sleeps in supine REM at the chosen pressure (and without repeated arousals), or meeting a broader improvement threshold that still carries an absolute cap on residual events—for example, reaching an RDI of 10 or fewer, or achieving a 50% reduction from baseline with the final RDI under 15, provided supine REM sleep is represented and not continually disrupted. The statement about severe patients accepting a purely proportional improvement without meeting an explicit absolute RDI limit is not an acceptable end point. Even in severe cases, guidelines require a defined residual-event threshold (such as ≤10 or ≤15, depending on the criterion) rather than relying solely on a percentage reduction. Without meeting that absolute ceiling, titration would not be considered successfully completed.

In PAP titration, the end point is to show meaningful control of breathing at the prescribed pressure, with clear thresholds for residual events. Acceptable results include either achieving an RDI below 5 for at least 15 minutes while the patient sleeps in supine REM at the chosen pressure (and without repeated arousals), or meeting a broader improvement threshold that still carries an absolute cap on residual events—for example, reaching an RDI of 10 or fewer, or achieving a 50% reduction from baseline with the final RDI under 15, provided supine REM sleep is represented and not continually disrupted.

The statement about severe patients accepting a purely proportional improvement without meeting an explicit absolute RDI limit is not an acceptable end point. Even in severe cases, guidelines require a defined residual-event threshold (such as ≤10 or ≤15, depending on the criterion) rather than relying solely on a percentage reduction. Without meeting that absolute ceiling, titration would not be considered successfully completed.