Could an external Medical Center with telemonitoring help in home positive airway pressure treatment? A pilot study

Telemedicine is useful for home management of sleep disordered breathing (SDB). However, the number of patients with SDB is high and public resources are low. The aim of this pilot study, conducted by the Universities of Pisa and Palermo, was to assess whether an external Medical Center, based on telemonitoring, could help in the management of patients on home positive airway pressure (PAP) treatment.

The management model included the following professional figures: the sleep physician, the local home care provider performing diagnostic studies and home PAP titration, and the external Medical Center monitoring PAP therapy alerts. A dedicated App allowed patients to answer questionnaires, receive alerts and contact the external Medical Center. Data on mask leakage, hours of use and efficacy were available on a web platform. Patients were evaluated with videocalls at 1, 2 and 4 months and as needed.

We enrolled 30 subjects, 27 patients received Continuous PAP and 3 patients received Bilevel devices. Five patients withdrew during titration and 1 during follow-up. The number of interventions for technical problems requested by patients to the external Medical Center was highly variable. During the titration phase the interventions required were 2.1 ± 2.0 (range 0-11), while during the 4-month follow-up they were 6.0 ± 4.5 (range 0-18). At the end of follow-up, 93% of patients were satisfied by the telemedicine protocol.

A model of telemedicine using an external Medical Center can help in the home management of patients with SDB during both home titration and long-term treatment. FISR2020IP_02014 Project (MUR). May 2021.