BackgroundAdherence to continuous positive air pressure (CPAP) in patients with obstructive sleep apnoea (OSA) has remained invariably low over the last decades. Remote monitoring of the nocturnal CPAP treatment, within telemedicine (TM)-based follow-up programs, in these patients has been suggested as a potential tool to improve adherence and release the workload of sleep units. The aim of this study was therefore to assess whether a follow-up program carried out by a Remote Medical Care Centre (RMCC), outside the sleep unit, improves adherence to CPAP in the short and long term in patients with OSA.MethodsIn this pilot protocol, we enrolled 37 patients starting CPAP in our Sleep Centre (SC). After three months of standard care in our SC, patients initiated a six-month remote follow-up carried out by the RMCC, functioning as an intermediary between patients and SC. Monthly reports and indication for face-to-face visits were sent to the SC for six months. After this period patients returned to usual care for one year. Results were compared with those obtained in 38 patients (controls) followed with usual care over the same time range.ResultsMean nightly use of CPAP increased from 3.2 ± 2.4 h pre-RMCC to 5.2 ± 1.9 h post-RMCC ( p < 0.0001). Nights/month of CPAP use improved from 19.8 ± 9.2 to 25.2 ± 2.5 ( p < 0.05) and nights/month with CPAP use >4 h from 12.5 ± 10 to 21.03 ± 8.9 ( p < 0.05). This improvement remained stable after 12 months from the return of patients to usual care. No significant changes in CPAP use were observed in controls over the time.ConclusionA six-month follow-up through a remote facility can significantly improve adherence to CPAP in the short and long term. This pilot study provides a solid base for the design of multicentre randomized trials focusing on new models which are able to increase the long-term efficacy of TM programs.

中文翻译：

---

远程医疗中心的远程随访可提高阻塞性睡眠呼吸暂停患者短期和长期对 CPAP 的依从性

背景 在过去的几十年里，阻塞性睡眠呼吸暂停 (OSA) 患者持续正压通气 (CPAP) 的坚持率一直很低。在基于远程医疗 (TM) 的随访计划中，对这些患者夜间 CPAP 治疗的远程监测被建议作为提高依从性和释放睡眠单位工作量的潜在工具。因此，本研究的目的是评估远程医疗护理中心 (RMCC) 在睡眠病房之外实施的随访计划是否可以提高 OSA 患者短期和长期对 CPAP 的依从性。方法在本试验中根据协议，我们招募了 37 名在睡眠中心 (SC) 开始 CPAP 治疗的患者。在我们的 SC 接受三个月的标准护理后，患者开始了由 RMCC 进行的为期六个月的远程随访，RMCC 充当患者和 SC 之间的中介。每月报告和面对面访问的指示已发送给 SC，为期六个月。此后一年，患者恢复正常护理。结果与在相同时间范围内接受常规护理的 38 名患者（对照组）获得的结果进行比较。结果平均每晚使用 CPAP 的时间从 RMCC 前的 3.2 ± 2.4 小时增加到 RMCC 后的 5.2 ± 1.9 小时 (p < 0.0001)。每月使用 CPAP 的天数从 19.8 ± 9.2 改善至 25.2 ± 2.5 (p < 0.05)，每月使用 CPAP >4 小时的天数从 12.5 ± 10 改善至 21.03 ± 8.9 (p < 0.05)。患者恢复常规护理后 12 个月后，这种改善保持稳定。在此期间，对照中没有观察到 CPAP 使用的显着变化。 结论 通过远程设施进行为期六个月的随访可以显着提高短期和长期对 CPAP 的依从性。这项试点研究为多中心随机试验的设计提供了坚实的基础，该试验侧重于能够提高 TM 项目长期疗效的新模型。