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CC BY-NC-ND 4.0 · Sleep Sci 2024; 17(04): e401-e406
DOI: 10.1055/s-0044-1782526
Original Article

An Alternative In-Home Protocol to Diagnose and Treat Obstructive Sleep Apnea

Tarcya L. G. Couto Patriota 
,
Rodrigo Pinto Pedrosa 
Funding Source The authors declare that the present study was funded by ResMed Healthcare Professional (San Diego, CA, United States).
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Abstract

Objective Obstructive sleep apnea (OSA) is a major public health problem of pandemic proportions. In-laboratory OSA diagnosis and continuous positive airway pressure (CPAP) titration are insufficient, considering the number of patients affected. Finding alternative ways to diagnose and treat OSA is mandatory, especially in this era of the coronavirus disease 2019 (COVID-19) pandemic. The present study aims to describe an alternative in-home protocol to diagnose and treat OSA.

Materials and Methods We enrolled consecutive patients aged ≥ 18 years with moderate/severe OSA, who underwent in-home type-III polysomnography and home-based titration with automatic CPAP, coupled with an oximetry sensor for 3 consecutive nights. Patients were remotely monitored for 90 days to evaluate CPAP compliance and the use of an engagement tool was encouraged.

Results We included 86 participants. The median time until the diagnosis was of one day. The mean time from the baseline visit until the acquisition and initiation of the CPAP therapy was of 33 (range: 17 to 52) days. Telemonitoring ensured good compliance in the first 30 (79.2%), 60 (76.3%) and 90 (74.3%) days, with an average daily use of 6.2 ± 1.4 h, 6.0 ± 1.4 h, and 6.0 ± 1.3 h respectively. About 1/3 of the patients used the engagement tool, and CPAP compliance was significantly higher among these patients compared with those who did not used the tool: 89.9% versus 73.5% (p < 0.002), 87.9% versus 70% (p < 0.003), and 86.6% versus 67.6% (p < 0.001) at 30, 60, and 90 days respectively.

Conclusion We demonstrated that an alternative in-home protocol to diagnose and treat OSA is effective, ensuring good CPAP compliance after 90 days. Telemonitoring and engagement tools could be strategies to improve CPAP compliance.

Keywords

obstructive sleep apnea - diagnosis - continuous positive airway pressure - compliance - telemonitoring


Publication History

Received: 13 April 2023

Accepted: 20 December 2023

Article published online:
09 April 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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