Sleep and Breathing

, Volume 20, Issue 4, pp 1209–1215 | Cite as

Telemonitoring of CPAP therapy may save nursing time

  • Ulla Anttalainen
  • Sari Melkko
  • Sirkka Hakko
  • Tarja Laitinen
  • Tarja Saaresranta
Sleep Breathing Physiology and Disorders • Original Article



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.


Adherence 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.

Ethical standards

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 ( identifier: NCT02509247).


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Ulla Anttalainen
    • 1
    • 2
  • Sari Melkko
    • 1
  • Sirkka Hakko
    • 1
  • Tarja Laitinen
    • 1
    • 3
  • Tarja Saaresranta
    • 1
    • 2
    • 3
  1. 1.Division of Medicine, Department of Pulmonary Diseases and Clinical AllergologyTurku University HospitalTurkuFinland
  2. 2.Department of Physiology, Sleep Research CenterTurku UniversityTurkuFinland
  3. 3.Department of Pulmonary Diseases and Clinical AllergologyUniversity of TurkuTurkuFinland

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