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

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.

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.

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.

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.

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.