Telemonitoring improves CPAP adherence for those with sleep apnea

Patients with obstructive sleep apnea (OSA) are more likely to use continuous positive airway pressure (CPAP) when telemonitored and receiving personalized therapy adherence messages, according to a study published in the American Journal of Respiratory and Critical Care Medicine.

CPAP, while the most effective treatment for OSA, is not often utilized by patients long enough. This study examines the effects telemonitoring could have on adherence by transmitting data through a software program that sent users personalized messages.

"With this study, we explored potentially cost-effective strategies for improving CPAP use, given the well-known challenges with optimizing CPAP adherence," said lead study author Dennis Hwang, MD, a pulmonologist and sleep expert at the Kaiser Permanente Fontana Medical Center in Fontana. "Automated telemedicine strategies may improve patient engagement and reduce the need for labor-intensive, and costly, follow-up care."

The study enrolled 1,455 patients who received conventional treatment of one-hour small group classes on home sleep apnea and CPAP education. The intervention group further split the subjects into receiving online education, telemonitoring with automated feedback or a combination of the two. The automated messages included feedback encouraging the use of CPAP by email, text or phone and were sent when the participants usages fell below four hours on three consecutive nights.

Results showed that telemonitoring increased CPAP use for four hours or more a night by 70 percent or more during the first 30 days. After 90 day, telemonitoring used CPAP 36 to 60 minutes longer each night.

"We learned that both education and accountability strategies improve patient engagement, although in different ways," Hwang said. "We also learned that while patient education is important, it appears that accountability via telemonitoring is more effective at improving therapy adherence."