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Use of historical remote monitoring data to determine predictors of CPAP non-compliance in patients with OSA

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnoea. This study aimed to use complete usage data collected remotely from modern CPAP devices to identify compliance trends and clinical predictors of CPAP usage.

Methods

Group usage data were analysed for a large cohort at a single tertiary sleep-centre before a detailed review of a 90-day reporting window for each patient was conducted. Individual data were collected for a smaller cohort of patients including demographics, past medical history and diagnostic sleep study results. A zero-inflated negative binomial regression model was used to determine associations between patient characteristics and usage days.

Results

Of 6450 patients who were prescribed CPAP and included in the initial service analysis, 476 patients were included in the sub-group. Complete usage data revealed that 46% of patients were fully compliant with CPAP therapy. Compliance fell from 55 to 46% by day 90 and remained at this rate going forward. Significant predictors of CPAP non-compliance included being in the lowest quartile of Index of Multiple Deprivation scores (most deprived) compared with the highest quartile (least deprived) (p = .005), and less severe oxygen desaturation index (ODI) on diagnosis (p = .03).

Conclusions

Complete usage data show that compliance at day 90 appears to be a good indicator of future CPAP usage. Predictors of CPAP non-compliance may include lower socioeconomic status, and lower ODI.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK

    Jake Cowen, Lydia Thom, Matt Thomas, Joanna Sedano & Sonya Craig

  2. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK

    Stephanie Harrison & Gregory Y. H. Lip

  3. Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK

    Stephanie Harrison & Gregory Y. H. Lip

  4. Resmed UK, Quad 1, First Floor, Becquerel Ave, Harwell Campus, Didcot, UK

    Phil Stephens

  5. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    Gregory Y. H. Lip

Authors
  1. Jake Cowen
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Contributions

JC composed the first draft of the manuscript. JC, LT, MT, PS and JS collected and were responsible for the necessary data. SH provided statistical analysis and creation of tables and figures. SC conceived the study. SC and GYHL contributed to study design. All authors drafted the manuscript for intellectual content, contributed to revision of the final manuscript and approved the final version submitted. SC acts as a guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting authorship criteria have been omitted.

Corresponding author

Correspondence to Jake Cowen.

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Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

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For this type of study, formal consent is not required.

Conflict of interest

P Stephens is employed as an account manager by ResMed UK. This author provided the data for the study but was not involved in study concept or design. All remaining authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Cowen, J., Harrison, S., Thom, L. et al. Use of historical remote monitoring data to determine predictors of CPAP non-compliance in patients with OSA. Sleep Breath 27, 1899–1908 (2023). https://doi.org/10.1007/s11325-023-02806-3

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