During a bilevel titration, which pressure is increased to eliminate hypopneas and snoring?

The correct approach during a bilevel titration to eliminate hypopneas and snoring focuses on increasing the Inspiratory Positive Airway Pressure (IPAP). This pressure helps to effectively maintain airway patency during inspiration by providing a higher pressure when the patient inhales. By increasing IPAP, the airflow risk of collapse in the upper airway is reduced, which addresses both the hypopneas (shallow breathing) and snoring, as these events are often linked to airway obstruction during sleep.

In contrast, while Expiratory Positive Airway Pressure (EPAP) plays an essential role in maintaining airway stability during expiration and can help alleviate some obstructive events as well, it is primarily effective in keeping the airway open at the end of expiration rather than during inspiration where the hypopneas and snoring typically occur. Continuous Positive Airway Pressure (CPAP) applies a constant pressure throughout the breathing cycle but does not differentiate between inspiratory and expiratory pressures, which is less effective in treating hypopneas when they are more pronounced during inhalation. SpO2 refers to peripheral oxygen saturation and is not a pressure setting, hence it does not directly relate to the management of hypopneas or snoring in this context.