Does CPAP remote monitoring improves compliance and adherence?

Abstract

Although continuous positive airway pressure (CPAP) is an extremely effective, acceptance & adherence can be difficult. Remote monitoring (RM) may help but little research has been done. The aim of this study was to explore the effectiveness of RM on acceptance & adherence to CPAP therapy.

31 patients were set –up on auto CPAP therapy with RM and reviewed by telephone at 1, 4 & 8 weeks before returning to clinic at 12 weeks. The results were compared with retrospective data from a control group (C) of 27 patients who had been set up on CPAP without RM and returned to clinic after 12 weeks. All subjects received standardized CPAP setup & education & were offered further clinic visits, as required, until a decision of acceptance or decline of treatment was made. We examined the average nightly usage, adherence (% of nights with CPAP use), compliance (% of nights with more than 4 hours use), and rate of acceptance and length of trial.

No significant differences in age, gender, AHI or ESS between the two groups. Results are reported as mean±SEM. Daily CPAP usage was significantly longer (504±0.0 vs. 460±0.4 mins; P<0.01) and length of trial shorter (95.5±26.1 vs. 195.1±32.8 days; P < 0.05) in RM compared to C. No significant difference was seen in CPAP compliance (49.8±4.5% vs. 42.10±8.6%), CPAP adherence (68.9±2.24 vs. 55.3±9.5%). Acceptance rate was higher in RM compared to C (65.5 vs. 59.3%).

Remote monitoring is effective at improving nightly CPAP usage and reducing length of trial. Compliance and adherence within CPAP tended to be better with remote monitoring but did not reach a level of statistical significance. Further work is needed to see if a larger sample size will show significant changes.