Nurse-managed telemonitoring in patients with sleep apnea syndrome treated with positive pressure ventilation.

Abstract

Purpose: Obstructive sleep apnea (OSA) is the commonest sleep disorder, it is characterized by episodes of complete or partial upper airway obstruction, sleep fragmentation and intermittent hypoxia (Am J Epidemiol 177:1006-14, 2013). Continuous Positive pressure ventilation (CPAP), is the gold standard treatment for Obstructive Sleep Apnoea Syndrome (OSAS). Several psycho-educational and technological interventions have been implemented to improve compliance but their impact on therapeutic adherence hasn't turned out to be substancial (Am J Respir Crit Care Med 159:1108-1114, 1999). Technological progress facilitated the use of tele-monitoring (TM) in OSAS patients (Eur Respir J 49:1601128, 2017). The use of TM, by trained nurses, improves compliance and allows for real-time adjustments to ventilatory parameters and correcting any therapeutic error. This can reduce the need for additional hospital visits and optimizes resources.

Aim: To evaluate the differences in compliance, proper usage, number of visits, and overall efficacy/benefit during follow-up between two groups of OSAS patients treated with CPAP.

Methods: A prospective, randomized controlled trial was conducted involving patients with OSAS treated with CPAP. Participants were randomized into two groups. Group 1 underwent standard follow-up visits at 1, 6, and 12 months. Group 2 was monitored via nurse-managed telemonitoring, which included monthly telephone contacts during the first six months, followed by contacts at 60-day intervals thereafter.

Results: No significant differences were observed between Group 1 and Group 2 in terms of comfort, proper usage, and benefit from CPAP. However, Group 2 showed a reduction in hospital visits.

Conclusions: OSAS patients under CPAP treatment can be effectively managed via telemonitoring, yielding results comparable to those obtained through traditional medical visits. The TM approach enables to postpone in-person visits optimizes the use of healthcare resources.