Efficacy of a telemonitoring system in continuous positive airway pressure therapy in Asian obstructive sleep apnea

Study Objectives: A telemonitoring system is a promising wireless technology that possibly enhances adherence to CPAP therapy. The study aimed to determine the effect of a telemonitoring system on CPAP therapy adherence among Asian patients with moderate-to-severe OSA. Methods: A prospective randomized controlled trial enrolled 60 Asian adults (70% male) with moderate-to-severe OSA. Thirty patients each were randomized to a group using CPAP with a telemonitoring system or a group using CPAP with usual care. The telemonitoring system functioned by transferring CPAP-usage data via cellular network. When there were any triggers occurring 2 nights consecutively (usage hours < 4 hours per night; leakage > 27 L/min or AHI > 5 events/h), the investigator contacted the patients. The primary outcome was the 4-week CPAP usage hours per night. The secondary outcomes included the percentage of good adherence (defined as a 4-week period of therapy with CPAP usage > 4 hours/night on > 70% of total days), median leakage per night, adverse events from CPAP therapy, sleep quality improvement, and daytime sleepiness reduction. Results: The mean AHI was 50.3 events/h. The mean 4-week CPAP usage hours per night were insignificantly higher in the telemonitoring group (5.16 +/- 1.47 hours/night vs 4.42 +/- 1.91 hours/night; P =.18). However, the percentage of good adherence was significantly higher in the telemonitoring group (64.2% vs 34.4%; P=.024). Median leakage per night was also significantly lower in the telemonitoring group. Furthermore, significant sleep quality improvement was observed in the telemonitoring group. Overall adverse events and daytime sleepiness reduction were not different. Conclusions: The telemonitoring system implementation showed a trend toward increasing CPAP nightly usage hours and significantly improved adherence and sleep quality among Asian patients with moderate-to-severe OSA.