Abstract
Introduction First-line treatment for obstructive sleep apnoea hypopnoea syndrome (OSAHS) is continuous positive airway pressure (CPAP). Compliance with CPAP is essential for treatment to be effective. Excess air leakage from the CPAP mask can be uncomfortable for patients and is an important independent predictor of CPAP compliance. As the incidence of OSAHS is rising, novel treatment pathways must be utilised to maintain service standards whilst also maximising CPAP usage. The aim of this study was to determine whether a novel remote monitoring pathway could decrease excess CPAP mask leak and increase usage of the CPAP machine.
Methods Patients (n=48) started on CPAP were allocated to receive either Standard Care (SC) (n=22) or Remote Monitoring (RM) (n=26) follow-up according to their appointment time. Nurses consulted software (AirviewTM; Resmed Ltd) three times per week to review RM patients and contacted them if required. Additional contact could be initiated by patients from either group at any time. Patients were followed-up 4–6 weeks after CPAP issue; SC patients were reviewed in hospital, whilst RM patients were reviewed by telephone. Data was collected on median mask leak (L/min) and mean compliance (hrs/night).
Results There was no significant difference in compliance between SC (4.76±2.39 hrs) and RM (5.20±1.78 hrs) groups (p=0.486) (figure 1). There was a significant difference in mask leak between SC (13(8–25) L/min) and RM (3(1–7) L/min) groups (p<0.001) (figure 2).
CPAP Usage
Excess mask leak
Discussion A novel remote monitoring system implemented within NHS Lothian did not significantly increase patient CPAP compliance. Excess leak from the mask was significantly reduced however, suggesting that compliance may be affected in a study inclusive of a greater number of patients and over a greater period of time. Therefore, more highly powered studies are required to determine if remote monitoring in the treatment of OSAHS patients can help to improve patient compliance.
