FIG. 18: The first option to treat OSA is manual CPAP titration.  As shown in the Figure,^[3] with older generation ASV devices with a fixed EPAP, it was mandatory to precede ASV initiation with a CPAP titration, and for this, optimum CPAP titration was the pressure that fully suppressed obstructive apneas, hypopneas, and flow limitations.  Then, in the second step, the inspiratory pressure support of the ASV device was switched on to treat the rest of the apnea.