Impact of telemedicine in long-term CPAP therapy: A twelve-month follow-up study in Japan utilizing propensity score matching

Daisuke Endo ¹, Toshiki Akahoshi ², Kenichi Nagaoka ³

¹Shinjuku Sleep and Respiratory Clinic, KEISHINKINENKAI Medical Corporation, 12F Shinjuku-I-land Tower 6-5-1 Nishishinjuku Shinjuku-Ku, Tokyo, 163-1312, Japan.
²Shinjuku Sleep and Respiratory Clinic, KEISHINKINENKAI Medical Corporation, 12F Shinjuku-I-land Tower 6-5-1 Nishishinjuku Shinjuku-Ku, Tokyo, 163-1312, Japan; Yurakucho Sleep and Respiratory Clinic, KEISHINKINENKAI Medical Corporation, North Tower 5F Yurakuchodenkibiru 1-7-1 Yurakucho Chiyoda-Ku, Tokyo, 100-0006, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho Itabashi-ku, Tokyo, 173-8610, Japan.
³Yurakucho Sleep and Respiratory Clinic, KEISHINKINENKAI Medical Corporation, North Tower 5F Yurakuchodenkibiru 1-7-1 Yurakucho Chiyoda-Ku, Tokyo, 100-0006, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho Itabashi-ku, Tokyo, 173-8610, Japan.
⁴Department of Medicine, Division of Respirology and Allergology, Showa Medical University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan.
⁵Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo, 160-0023, Japan.
⁶Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho Itabashi-ku, Tokyo, 173-8610, Japan.
⁷Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, 30-1 Oyaguchi-kamicho Itabashi-ku, Tokyo, 173-8610, Japan; Department of Human Disease Genomics, Center for Genomic Medicine, Kyoto University Graduate School Medicine, 53 Shogoinkawahara-cho Sakyo-ku, Kyoto, 606-8507, Japan.
⁸Agency for Student Support and Disability Resources, Kyoto University, Yoshida-honmachi Sakyo-ku, Kyoto, 606-8501, Japan.

⁰Shinjuku Sleep and Respiratory Clinic, KEISHINKINENKAI Medical Corporation, 12F Shinjuku-I-land Tower 6-5-1 Nishishinjuku Shinjuku-Ku, Tokyo, 163-1312, Japan.

Respiratory Medicine +

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November 20, 2025

View abstract on PubMed

Summary

Telemedicine (TM) for continuous positive airway pressure (CPAP) therapy showed less adherence improvement compared to standard care over 12 months. Further research is needed to optimize TM for long-term CPAP adherence.

Area Of Science

Sleep Medicine
Digital Health
Telehealth

Background

Digital technology enables telemonitoring of CPAP data, increasing telemedicine (TM) use in CPAP management.
During the COVID-19 pandemic, Japan temporarily allowed telephone consultations to reduce in-person visits.
This study compared 12-month CPAP adherence between TM and standard care groups.

Purpose Of The Study

To evaluate the difference in 12-month CPAP adherence between telemedicine and standard care groups.
To assess the impact of TM on continuous positive airway pressure therapy adherence.
To inform future telemedicine strategies for improving long-term CPAP adherence.

Main Methods

116 patients receiving TM and 171 receiving standard care were analyzed.
Propensity score matching created comparable groups of 45 patients each.
Adherence change was categorized as ≤-5%, >-5% to <5%, or ≥5% over 12 months.

Main Results

Fewer patients in the TM group showed adherence improvement (17.8%) compared to the standard care group (42.2%).
Significant differences in CPAP adherence changes were observed between the groups (χ² = 6.50, P = 0.039).
The TM group exhibited significantly fewer improvements in CPAP adherence over 12 months.

Conclusions

Continuous positive airway pressure (CPAP) adherence improved less with telemedicine compared to standard care over 12 months.
Telemedicine strategies require optimization to enhance long-term adherence to CPAP therapy.
Further research is necessary to refine telemedicine approaches for effective CPAP management.

Keywords:

Continuous positive airway pressure Obstructive sleep apnea Propensity score-matched analysis Telemedicine adherence