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Manual Titration of Positive Airway Pressure by Polysomnography

In the laboratory

What is a manual titration of positive airway pressure by polysomnography?

This is a test carried out at Biron once a diagnosis of sleep apnea has been made. Using a CPAP device, the test allows you to manually and gradually determine the optimal level of pressure required to counter the obstructions in the airways and thus control your sleep apnea.

Preparation for this procedure is the same as for a polysomnography (Split night).

Preparing for the Examination

Biron’s healthcare professionals trained in sleep care will accompany you throughout the examination process. They will ensure your comfort and wellbeing.

Here are some guidelines to follow in order to be well prepared on the day of the exam:

  • You may eat a normal meal before 7:00 pm. However, we ask that you refrain from consuming alcohol (e.g. beer, wine) or caffeine (e.g. coffee, tea, cola, chocolate) in the 6 hours before the test
  • Please avoid using face cream or body lotion
  • You may bring comfortable sleep wear and your own pillow. We provide towels, soap and shampoo, but you may also bring your own toiletries.

If necessary, remember to bring your usual medications.

Examination procedure

A manual titration of positive airway pressure (PAP) by polysomnography is risk-free and causes no pain. In rare cases, you may experience temporary skin irritation where sensors were applied to your skin.

The following is the typical process for a polysomnography at one of Biron's clinics.

  • The normal arrival time is between 8:30 and 9:00 pm (please be on time for your appointment). Depending on the time of your appointment and the preparation time, your bedtime may vary between 9:30 and 11:30 pm.

  • When you arrive at the clinic, a healthcare professional will welcome you, show you your private bedroom (with bathroom) and explain the examination procedure. Your bedroom will be dark and quiet so you can relax and fall asleep. It is equipped with an audiovisual system for diagnostic purposes and to ensure your safety. Your sleep will be observed throughout the night by a healthcare professional trained in sleep care, who will monitor proper recording of the data as well as your wellbeing at all times.

  • Before your bed time, several painless sensors will be applied to your scalp, temples, hands, chest and legs. These record:

    • Electrical brain activity
    • Eye movements
    • Muscle tone
    • Heart rate
    • Breathing movements
    • Blood oxygen level
    • Body position
    • Limb movements
    • Snoring
  • You may rise between 6:00 and 6:15 am and take a shower at the clinic.

Specificities and Contraindications

Please note that the manuel titration cannot be performed on a patient with low blood pressure, who is confused or who cannot cooperate fully during the examination.


The results of the sleep test will be interpreted by one of our specialist physicians trained in sleep health and will be available via MonBiron.

A medical prescription is required to perform this examination.

If your healthcare professional has prescribed this examination or if you have any questions, contact us at 1 833 590-2715.