title: Telemonitoring of CPAP therapy may save nursing time.
abstract: OBJECTIVE
  Telemonitoring might enhance continuous positive airway pressure (CPAP) adherence and save nursing time at the commencement of CPAP therapy. We tested wireless telemonitoring (ResTraxx Online System®, ResMed) during the habituation phase of the CPAP therapy in obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  In total, 111 consecutive OSAS patients were enrolled. After CPAP titration, patients were followed with the telemonitoring (TM, N = 50) or the usual care (UC, N = 61). The TM group used fixed pressure CPAP device with and the UC group similar device without wireless telemonitoring. Patients and study nurses were unblinded. The evaluated end-points were hours of CPAP use >4 h/day, mask leak <0.4 L/s, and AHI <5/h. Nursing time including extra phone calls, visits, and telemonitoring time was recorded during the habituation phase. CPAP adherence was controlled in the beginning and at the end of the habituation phase and after 1-year of use.
  
  
  RESULTS
  TM and UC groups did not differ in terms of patient characteristics. The average length of the habituation phase was 4 weeks in the TM group and fixed 3 months in the UC group. Median nursing time was 39 min (range 12-132 min) in the TM group and shorter compared to that of 58 min (range 40-180 min) (p < 0.001) per patient in the UC group. Both treatment groups had high CPAP usage hours (>4 h/day) and the change in usage at the end of the habituation phase did not differ between the groups (p = 0.39). Patients in both groups were equally satisfied with the treatment protocol. CPAP adherence (6.4 h in TM vs. 6.1 h in UC group, p = 0.63) and residual AHI (1.3 in TM vs. 3.2 in UC group, p = 0.04) were good in both groups at 1-year follow-up.
  
  
  CONCLUSIONS
  Wireless telemonitoring of CPAP treatment could be relevant in closing the gap between the increasing demand and available health-care resources. It may save nursing time without compromising short- or long-term effectiveness of CPAP treatment in OSAS.
authors.affiliation: Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland. ulla.anttalainen@tyks.fi.|Department of Physiology, Sleep Research Center, Turku University, Lemminkäisenkatu 3B, 20520, Turku, Finland. ulla.anttalainen@tyks.fi.
authors.forename: Ulla
authors.initials: U
authors.lastname: Anttalainen
authors.affiliation: Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Melkko
authors.affiliation: Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.
authors.forename: Sirkka
authors.initials: S
authors.lastname: Hakko
authors.affiliation: Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.|Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.|Department of Physiology, Sleep Research Center, Turku University, Lemminkäisenkatu 3B, 20520, Turku, Finland.|Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Saaresranta
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000191:economics* / Q000451:nursing*; D017046:Cost Savings / Q000706:statistics & numerical data*; D004471:Economics, Nursing / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000191:economics* / Q000451:nursing*; D013686:Telemetry / Q000191:economics* / Q000295:instrumentation / Q000451:nursing*; D013996:Time and Motion Studies
keywords: Adherence; CPAP; Nursing time; Sleep apnea; Telemedicine; Telemonitoring