Introduction Obstructive sleep apnoea (OSA) is a condition whereby the airway partially or totally obstructs during sleep. The gold-standard treatment for moderate to severe OSA is continuous positive airway pressure (CPAP). However compliance with treatment can be troublesome with 20-30% of patients stopping treatment. A recent meta-analytic review (Aardoom et al 2000) of telemedicine in CPAP treatment has concluded that the effectiveness of telemedicine on adherence remains undecided.

Methods A non-blinded, single centre, randomised controlled trial was carried out with patients randomised to 1 of 3 arms (arm 1 standard care and face-to-face appointments; arm 2 modem and virtual follow up clinic; arm 3 modem, Dreammapper™ and virtual follow up appointment). Consecutive moderate-severe OSA patients requiring CPAP were recruited to the study to a sample size of 90. Data was collected at first appointment, at 1st follow up from commencing CPAP (1-2 weeks) and at 6 months from commencing CPAP. Data collection included patient’s demographics (table 1), CPAP compliance (average hours of usage in 24 hours), mask leak, apnoea/hypopnoea index (AHI) and Epworth sleepiness scores (ESS). Qualitative data is currently being collected via interviews to explore the patient experience in each arm of the study.

Discussion Preliminary analysis (table 2) indicates that arm 3 demonstrated significant better compliance of 36 minutes at first follow up compared to arm 1, with compliance at 6 months between both these arms levelling out with no significant difference at 6 months. The patient group in arm 2 demonstrated a significantly reduced in compliance compared to the other two groups at both week 1-2 and 6 months. Preliminary results suggest that the type of telemedicine intervention could impact the early compliance experienced by patients.

Reference

1. Aardoom JJ, Loheide-Niesmann, Ossebaard HC, Riper H. Effectiveness of eHealth Interventation in improving treatment adherence for adults with obstructive sleep apnoea: meta-analytic review. Journal of Medical Internet Research 2020 Feb;22 (2): 1-12.