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12 Positive airway pressure adherence and remote versus face-to-face education for sleep apnoea during the novel coronavirus (COVID-19) pandemic
  1. Johan Meurling1,
  2. Adam Birdseye1,
  3. Rohan Gell1,
  4. Eliza Sany1,
  5. Richard Brown1,
  6. Sean Higgins1,
  7. Rexford Muza1,
  8. David O’ Regan1,2,
  9. Guy Leschziner1,3,4,
  10. Joerg Steier1,5,
  11. Ivana Rosenzweig1,3 and
  12. Panagis Drakatos1,5
  1. 1Sleep Disorders Centre, Guys and St. Thomas’ NHS Foundation Trust, London, UK
  2. 2School of Medicine, King’s College London, London, UK
  3. 3Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
  4. 4Department of Neurology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  5. 5Faculty of Life Sciences and Medicine, King’s College London, London, UK


Introduction We aim to quantify adherence of positive airway pressure (PAP) initiated during the COVID-19 pandemic and compare the effects of remote versus face-to-face (FTF) education in patients with obstructive sleep apnoea (OSA).

Methods Prospective cohort study in a tertiary National Health Service (NHS) hospital sleep disorders centre in London, United Kingdom, involving 141 patients aged >18 years with newly diagnosed OSA initiating PAP during the first national coronavirus (COVID-19) lockdown in 2020. We compare 70 patients educated on PAP remotely to 71 patients receiving standard FTF education. We measured adherence over a continuous 30-day period within the first three months of PAP usage, including average nightly usage, usage per nights used, percentage of nights used, and percentage of nights used for >4 hours.

Results Of 141 patients, there was a two-thirds male predominance, and half of the patients (56%) above 45 years of age and sleepy at baseline (Epworth Sleepiness Score >10, 48.9%). 114 patients (81%) were diagnosed with moderate or severe OSA. 54 patients (38.3%) achieved good adherence (≥70% of nights with ≥4 hours usage), with an average of 4.7 hours of PAP usage per night used. Patients receiving FTF PAP education had a comparable level of good adherence (38.03% versus 38.57%, p=0.915), and hours per nights used (4.76 versus 4.61 h/night, p=0.711) to remotely educated patients. More severe OSA, lower mask leak, and a nasal mask were associated with achieving good PAP adherence.

Discussion PAP adherence of newly diagnosed individuals with OSA during the COVID-19 pandemic was modest at 38.30%, and not significantly affected by remote PAP education delivery, but rather the effects of the COVID-19 pandemic.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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