A comparative cloud-based view of adherence data over 1 year of CPAP versus APAP uses in OSA patients: Adherence depends on PAP device.

Abstract

Introduction: Compliance or adherence with positive airway pressure (PAP) therapy is a major issue in obstructive sleep apnea (OSA). The telemonitoring gives an opportunity to track a group of patients on cloud-based devices. In this study, we followed up patients with this cloud-based method for more than a year and followed up two different cohorts who are on continuous PAP (CPAP) and auto adjusting PAP (APAP) devices. The main objective was to judge whether one device scores over the other.

Methods: This was a retrospective study. We included 60 patients in the CPAP group and 80 patients in the APAP group in the study who are using the device for 1 year or more; they all were on cloud-based devices, and for them, we had data of completed 1 year at least. The data were reviewed periodically for compliance, AHI (Apnea-Hypopnea Index), and leak and compared.

Results: Both the groups were matched in terms of age, BMI, and AHI. Adherence at 365 days was significantly more (P < 0.001) for CPAP than APAP. Overall adherence was not lesser than 60% for CPAP in any patient. The mean AHI was 1.48 in CPAP group and 2.30 in APAP group. When we measured the leak in CPAP versus APAP group, it was 0.53 liter/minute more in CPAP group than in APAP group, but it was statistically non-significant (P = 0.8553). The mean pressure level between APAP and CPAP was 11.11 cmH2O in CPAP group and 11.62 cm H2O in APAP group, and it was again statistically non-significant (P = 0.1960). CPAP group used the machine 5.77 hours average, while APAP group used it for 4.51 hours average.

Conclusion: CPAP adherence at 1 year was better over APAP in this study, which has a large cost implication.