Effects of daylight savings time transition on compliance and effectiveness of positive airway pressure therapy

Spring transitions into daylight savings time (DST) result in increase of sleep latency and fragmentation and decrease of sleep time and efficiency. We evaluated the effects of DST on patterns of positive airway pressure (PAP) use and its effectiveness by utilizing continuous tracking of PAP therapy available with cloud-based sleep care management systems. 62 compliant adult OSA patients from Jacksonville, Florida, USA on stable continuous PAP (CPAP)/autoPAP (APAP) therapy were enrolled and PAP usage and residual apnea-hypopnea index (AHI) were collected for the "pre-DST period" (Sun-Mon-Tue, 7-9/03/2021) and "DST period" (Sun-Mon-Tue, 14-16/03/2021) from compliance reports generated or downloaded via cloud-based sleep care management systems. Demographic variables, average compliance and effectiveness of PAP during the two weeks that included both intervals of interest (from Wednesday 3rd to Wednesday 17th) were further analyzed. Statistics included repeated measures ANOVA, non-parametric Wilcoxson's rank sum tests, independent and paired T tests, and Chi-square test. Majority of patients were Caucasian (73%); with average age of 57.5 ± 11 years, 443.1 ± 124 min of nightly PAP use, and 0.97 ± 0.06% of PAP compliance. 73% of patients were male, with no significant differences noted for sleep variables between genders. There was significant decrease in PAP usage duration between pre-DST Mondays and DST Mondays (delta_normalized_PAP_duration = -0.18, p = 0.0027). AHI demonstrated significant decrease on DST Mondays, followed by significant increase on DST Tuesdays (deltaAHI = - 0.54 and 0.47 respectively). This study demonstrated that the effects of DST on duration of PAP use and sleep disruption monitored by AHI are seen days after DST transition, even in the zones with very stable light/dark cycles like Florida, USA.