Introduction Obstructive sleep apnoea (OSA) is a highly prevalent condition, involving collapse of the upper airway during sleep, intermittent hypoxia and micro-arousals. Continuous Positive Airway Pressure (CPAP) therapy is the gold standard treatment and recent technological advances have allowed for remote monitoring to provide support and encourage compliance. Although evidence suggests greater benefits for patients with increased CPAP compliance, the role of telemonitoring in providing improved physiological patient benefit through greater compliance is not well established. The aims of this review were to determine the impact of CPAP telemonitoring on compliance and measured physiological outcomes, as compared to traditional CPAP monitoring techniques and to identify an optimal telemonitoring period for long-term compliance and additional physiological benefits.
Method A systematic review of peer-reviewed English language articles identified using a range of databases and additional resources was performed in line with standard methodology. Articles were assessed according to the following eligibility criteria: adult participants (age >18 years) with a previous diagnosis of OSA; a CPAP telemonitoring intervention in comparison to standard care; and at least one subjectively or objectively measured physiological outcome.
Results A total of 50 articles were assessed, of which 10 full text articles were eligible to be included in this review (table 1).. Overall, there was a favourable effect associated with increased CPAP compliance in telemonitored groups. Telemonitoring demonstrated favourable effects on Apnoea-Hypopnoea Index (AHI) and Epworth Sleepiness Scale (ESS). The optimal CPAP telemonitoring period was calculated at >4 months. CPAP telemonitoring was also shown to significantly improve other physiological outcomes including cholesterol and the Quebec sleep questionnaire (table 2).
Discussion These findings suggest CPAP telemonitoring as compared to usual care, increases compliance and provides physiological benefits including reducing AHI and ESS. Further research is required to investigate the full physiological benefits of telemonitoring.
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