Effects of cloud-based tracking system with telemonitoring on continuous positive airway pressure adherence in obstructive sleep apnea
Abstract
OBJECTIVE
To evaluate the effects of a cloud-based tracking system with telemonitoring on continuous positive airway pressure (CPAP) adherence compared to the standard usual care of patients with obstructive sleep apnea (OSA).
METHODS
This is a prospective open-label single-center randomized controlled trial of newly diagnosed OSA patients who received initial treatment with CPAP at Chiangrai Prachanukroh Hospital, Thailand from January 2019 to November 2020. The patients were allocated to either the telemedicine intervention using a cloud-based tracking system (CB group) for 90 days with monthly telephone-linked communication or the standard usual care (SD group). The primary outcome was the percentage of nights with good adherence to CPAP measured using the information given from CPAP machines. The secondary outcomes included percentage of CPAP usage time, sleep time, residual apnea-hypopnea index (AHI), AHI reduction, the CPAP leakage, Epworth sleepiness scale (ESS) reduction and sleep quality improvement.
RESULTS
A total of 83 patients were enrolled in the study; 41 in the CB group and 42 in the SD group. The CB group had better adherence than SD group. In CB group and SD group, the percent of nights with good adherence to the CPAP were 86, 72 respectively with statistical significance (P<0.001) and the percent of time with CPAP use were 93, 78.5 respectively with statistical significance (P<0.001). After adjusted of age, gender, body weight, ESS, AHI, mean oxygen saturation overnight and CPAP pressure, there were significant improvement in percent of nights with good adherence of the CPAP (adjusted difference, 11.89; 95% CI, 8.00 to 15.78; P<0.001) and percent of time with CPAP use (adjusted difference, 11.95; 95% CI, 7.32 to 16.58; P<0.001).
CONCLUSION
This study demonstrated that OSA patients with CB tracking systems with telemonitoring for initial CPAP use had promising results in relation to good adherence with effective treatment outcome at 90 days.
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