Telemonitoring of CPAP therapy may save nursing time
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Telemonitoring might enhance continuous positive airway pressure (CPAP) adherence and save nursing time at the commencement of CPAP therapy. We tested wireless telemonitoring (ResTraxx Online System®, ResMed) during the habituation phase of the CPAP therapy in obstructive sleep apnea syndrome (OSAS).
In total, 111 consecutive OSAS patients were enrolled. After CPAP titration, patients were followed with the telemonitoring (TM, N = 50) or the usual care (UC, N = 61). The TM group used fixed pressure CPAP device with and the UC group similar device without wireless telemonitoring. Patients and study nurses were unblinded. The evaluated end-points were hours of CPAP use >4 h/day, mask leak <0.4 L/s, and AHI <5/h. Nursing time including extra phone calls, visits, and telemonitoring time was recorded during the habituation phase. CPAP adherence was controlled in the beginning and at the end of the habituation phase and after 1-year of use.
TM and UC groups did not differ in terms of patient characteristics. The average length of the habituation phase was 4 weeks in the TM group and fixed 3 months in the UC group. Median nursing time was 39 min (range 12–132 min) in the TM group and shorter compared to that of 58 min (range 40–180 min) (p < 0.001) per patient in the UC group. Both treatment groups had high CPAP usage hours (>4 h/day) and the change in usage at the end of the habituation phase did not differ between the groups (p = 0.39). Patients in both groups were equally satisfied with the treatment protocol. CPAP adherence (6.4 h in TM vs. 6.1 h in UC group, p = 0.63) and residual AHI (1.3 in TM vs. 3.2 in UC group, p = 0.04) were good in both groups at 1-year follow-up.
Wireless telemonitoring of CPAP treatment could be relevant in closing the gap between the increasing demand and available health-care resources. It may save nursing time without compromising short- or long-term effectiveness of CPAP treatment in OSAS.
KeywordsAdherence CPAP Nursing time Sleep apnea Telemedicine Telemonitoring
ResTraxx Online System® was provided by ResMed Finland.
Compliance with ethical standards
Conflict of interest
Ulla Anttalainen and Tarja Laitinen declared no financial support or conflicts of interest. Tarja Saaresranta declared speaking fee from ResMed Finland. Sari Melkko and Sirkka Hakko declared congress travel fee from ResMed Finland.
The study was approved by the Division of Medicine of the Turku University Hospital. The Ethics Committee approval was not required, since this study was part of our quality assurance procedure to revise the treatment protocol. Patients allocated for the TM group gave their written informed consent for the management of their data through telemonitoring. The study is registered in the ClinicalTrials.gov (ClinicalTrials.gov identifier: NCT02509247).
- 12.Weaver TE, Sawyer AM (2010) Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Ind J Med Res 131:245–258Google Scholar
- 14.Fox N, Hirsch-Allen AJ, Goodfellow E, Wenner J, Fleetham J, Ryan CF, Kwiatkowska M, Ayas NT (2012) The impact of a telemedicine monitoring system on positive airway pressure adherence in patients with obstructive sleep apnea: a randomized controlled trial. Sleep 35:477–481CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Isetta V, Ruiz M, Farré R, Montserrat JM (2015) Supporting patients receiving CPAP treatment: the role of training and telemedicine. ERS Monogr 67:280–292Google Scholar
- 24.Chai-Coetzer CL, Luo YM, Antic NA, Zhang XL, Chen BY, He QY, Heeley E, Huang SG, Anderson C, Zhong NS, McEvoy RD (2013) Predictors of long-term adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea and cardiovascular disease in the SAVE study. Sleep 36:1929–1937CrossRefPubMedPubMedCentralGoogle Scholar